Form 0777 - Hull Identification Number Request
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1TENNESSEE WILDLIFE RESOURCES AGENCY
HULL IDENTIFICATION NUMBER REQUEST
Completed requests are to be mailed to:
TWRA/Boating Division, P.O. Box 40747, Nashville, TN 37204, ATTN: Investigations
Requesting Agency:
TWRA
THP/CID
U.S.C.G.
Other:________________________________
Date of Request:_________________________
Case Number:_________________________
Reason for Request:
Homemade Vessel
Vessel built Prior to Nov. 1, 1972
TCA 55-5-108 Seizure
Other: _______________________________________________
VESSEL INFORMATION
Make:___________________________
Model:___________________________
Length:___________
Color:____________
Type: ___________________________
Hull Material:_____________________
Registration # (if any) ___________________
Where vessel is stored (if different than owner’s address): ____________________________________________________________
POWER
Outboard
I/O
Water Jet
Manual
Sail
Other:________________________
Engine: Horsepower:________________
Serial #:__________________________
Model #:_________________________
TRAILER
Manufactured
Make:____________________________________
Serial #:__________________________________
Homemade
Color:____________________
TN VIN# (Issued by Dept. of Safety):____________________________
OWNER INFORMATION
Name:_____________________________________
DOB:____________________
TWRA ID #:________________________
Address:_______________________________________ City:__________________________
ST:_____
ZIP:______________
Phone:________________________________________
County:________________________
ATTENTION OWNER
By signing this document, you are stating that all information is correct and accurate. You also state, to the best of your knowledge,
that the vessel above, all parts and trailer (if identified), are not stolen. Falsifying this document is a criminal offense.
This Hull Identification Humber is for vessel identification only. By issuing this number, TWRA does not certify the proper con-
struction or safety of the vessel.
Owner Signature:______________________________________
Officer Signature:______________________________________
TO BE COMPLETED BY OFFICER/INVESTIGATOR
Remarks/Comments:
_________________________________________________________________________________________
___________________________________________________________________________________________________________
Name of Officer/Investigator (print):___________________________________________
ID #:___________________________
Phone:___________________________
WR-0777 (Rev. 11/05)
ORIGINAL (BOATING DIVISION)
YELLOW (OWNER)
PINK (OFFICER)
BillofSale.net
RDA S836.3
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