Академический Документы
Профессиональный Документы
Культура Документы
1.
HULL
DECK/RIGGING
MACHINERY/ENGINES
Attach copies of bill of sale or receipts (must contain name, address and signature of seller). Notarization is not required.
I (We) hereby certify that said vessel was built for my/our personal use. If other than for personal use, I (we) certify that
said vessel was constructed for the following individual or firm:
2.
_____________________________________________________________________________________
Name
Street Address
_______________________________________________________________________________________________________________________________
City
State
Zip
3.
4.
5.
I (We) hereby certify that all applicable sales tax has been paid on the material used in the construction of the vessel
described in item 5 below.
I (We) hereby certify that the vessel described below has never been previously registered or titled with the State of
Florida, or in any other state or country, and that a Manufacturers Statement of Origin or Builders Certificate has never
been issued for said vessel.
I (We) hereby certify that the following information applies to this specific vessel.
______________________________________________________
City
_________________________________
_______________ Zip: _____________ Year Vessel Construction Was Completed _______________ Hull Length ______________
VESSEL TYPE
Open Motorboat
Cabin Motorboat
Auxiliary Sailboat
Inflatable
Houseboat
Personal Watercraft
HULL MATERIAL
Sailboat
Airboat
Canoe
Pontoon
Other __________
Specify
Wood
Wood/Fiberglass
Fiberglass
Aluminum
Steel
Other _______________
Specify
PROPULSION
Outboard
Inboard
Inboard/Outboard
Air Propelled
Sail
Other _______________
FUEL
Gasoline
Electric
Diesel
Other _____________
Specify
Specify
______________________________________________________________________________________________________
PRINTED NAME OF APPLICANT
_______________________________________________________________________________________________________________________________
STREET ADDRESS
STREET ADDRESS
_______________________________________________________________________________________________________________________________
CITY
STATE
ZIP
CITY
STATE
ZIP
TELEPHONE NUMBER: _________________________________________
_______________________________________________________________________________________________________________________________
SIGNATURE OF APPLICANT
SIGNATURE OF CO-APPLICANT
HSMV 87002 (Rev.10/11)
www.flhsmv.gov
Check your local phone book government pages or visit the following website for current mailing addresses:
http://www.flhsmv.gov/offices/
www.flhsmv.gov