Fillable Form Mv-1046 - Boat Registration/title Application - New York State Dmv (Page 2 of 2) in pdf

CHANGES (To change information on your current boat registration and/or title.)

NAME CHANGE: Print your former name exactly like your former name is printed on the current registration or title.

FOR ALL CHANGES other than a name change, explain what the change is and the reason for the change.

REGISTRANT CERTIFICATION:

I certify that the registration information presented is true, and that the registration is not currently under suspension or

revocation in any jurisdiction. If I am using a credit card for payment of any fees in connection with this application, I understand that my signature

below also authorizes use of my credit card.

Print Name Here

(Print Name in Full - if registering for a corporation, print your full name and title)

Sign Here

(Sign Name in Full)

Additional Signature

SIGN HERE

(Sign Name in Full -Additional signature required for a partnership or if registering this boat in more than one name.)

IMPORTANT:

Making a false statement in any registration application, or in any proof or statements in connection with it, or deceiving or substituting in

connection with this application, is a misdemeanor under Section 392 of the Vehicle and Traffic Law, and may also result in the revocation or suspension of the

registration pursuant to regulations established by the Commissioner. The Department makes no representation that it will issue a certificate of title or

transferable registration until the Commissioner is satisfied that the applicant is entitled to a certificate of title or transferable registration, and until all

documentation required to establish ownership of the boat is submitted and deemed to be satisfactory. Pending review of this application, neither the

Commissioner of the Department of Motor Vehicles nor any of his or her employees, deputies or agents assumes any liability or responsibility for repairs

performed, improvements made or work done to the boat referenced in this application.

CREDIT CARD AUTHORIZATION IF CARDHOLDER IS NOT THE APPLICANT:

My signature authorizes ____________________________________________ to use my credit card for payment of any fees in connection with this application,

and I understand that I must be present for this transaction.

Sign Here

(Cardholder - Sign Name in Full)

TO BE COMPLETED ONLY BY A REGISTERED NEW YORK STATE BOAT DEALER

ADDITIONAL LIENHOLDERS - List any lienholders in addition to the one specified on page 1 of this form.

Lien Filing Code _____________________________ Lienholder Name _______________________________________________________________

(Assigned by DMV)

Mailing Address ___________________________________________________________________________________________________________

Number and Street

City

State

Zip Code

Lien Filing Code _____________________________ Lienholder Name _______________________________________________________________

(Assigned by DMV)

Mailing Address ___________________________________________________________________________________________________________

Number and Street

City

State

Zip Code

DEALER TRANSFER INFORMATION – Please complete the information below. For new boats, attach a Manufacturer’s Statement or Certificate of Origin

(MSO or MCO) and a bill of sale. For used boats, attach a signed title or transferable registration, along with bills of sale for any subsequent transactions.

Boat was

obtained from

________________________________________________________________________________________

_____________ ___________________

Name and Address

Date of Purchase

Boat was

sold by

Name and Address of your dealership

Facility No.

Date of Sale

NY DEALER CERTIFICATION: