Form Vl-1 - Nc Vessel Registration & Title Application (Page 2 of 2) in pdf

Side 2

SECTION 4 - Vessel Number Information --- Required (if applicable)

Manufacturer’s Hull ID #:

The Hull ID number is the 12 to 15-digit number located on the right rear transom of the hull. If this number contains more than 15-digits or less

than 12-digits, you must submit a pencil-tracing with this application.

−

N.C. Registration #: NC

Out-of-State Registration #:

N.C. Title #:

SECTION 5 – Owner Information

Check One:

Individual

Business

Dealer

Permanent

(Only complete sections 2 and 5. Sign below.)

(government entities only)

Primary Owner Information:

Secondary Owner Information:

Last or Business Name:

Last Name:

First Name:

Middle Name:

Suffix (Jr., Sr., III):

NC Driver License #:

Date of Birth:

Telephone #:

E-mail Address:*

Mailing Address:

Street or PO Box:

City:

State:

Zip:

Resident Address (required if titling):

Street:

City:

State:

Zip:

*Optional

If more than two owners, attach separate sheet listing additional owner information.

SECTION 6 – Vessel Information

Vessel Identification:

First Motor Information

Second Motor Information

(if over 25 HP)

Year:

Make:

Model:

Horsepower:

Manufacturer:

Serial Number:

Exact Length (ft. & in.):

Price:

County where vessel will

be taxed (required):

Hull

Primary Use

Fuel

Propulsion

Type

1-Wood

5-Plastic

1-Pleasure

5-Commercial

1-Gasoline

1-Outboard

5-Aux. Sail/Inboard

1-Open

5-Pontoon

2-Fiberglass

9-Other

2-Commercial

Passenger

2-Diesel

2-Inboard

6-Aux. Sail/Outboard

2-Cabin

9-Other

3-Metal

Fish

6-Other

3-Electric

3-Inboard/

7-Jet Drive

3-Houseboat

(Aluminum)

3-Livery

Commercial

9-Other

Outboard

9-Other

4-Personal

4-Inflatable

4-Demonstration

9-Other

4-Sail Only

Watercraft (Jet ski)

SECTION 7 – Purchase Information

SECTION 8 – Lienholder Information

(

Individual

Business)

Purchased From

Date of Lien:

(full name):

Street or PO Box:

Business Name

Suffix (Jr., Sr., III):

City:

Last Name

(Individual):

State:

First Name:

Zip:

Middle Name:

Telephone:

Purchase Price:

Street or PO Box:

Date Purchased:

City:

State where purchased from:

State:

Zip:

Certification: I/We listed below am/are the rightful owner(s) of the vessel described above and hereby make application for that which is indicated above and

certify that the statements made herein are true and correct, to the best of my/our knowledge, information and belief, and that the vessel is subject to the liens

or encumbrances listed and none other.

Signature(s) of Owner(s):

Primary Owner

Date

Secondary Owner

Date

Signature of Duly Authorized Attorney in Fact (attach Properly Executed Power of Attorney):

Date