Form Mv1a - Montana Certificate Of Title For A Vessel

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Application for

Certificate

of Title for a

Vessel

Title and Registration Bureau

1003 Buckskin Drive, Deer Lodge, MT 59722-2375

Phone (406) 846-6000 Fax (406) 846-6039

mvdtitleinfo@mt.gov

Fee: $10. Additional fees and taxes may be due upon

Title Number:

registration.

Applicant

Applicant's Legal Name (first, middle, last) or Firm Name:

DL/FEIN/Tribal ID/Corp ID*:

Section

Co-Applicant's Legal Name (first, middle, last):

DL/FEIN/Tribal ID/Corp ID*:

Mailing Address:

City:

State:

Zip Code:

County:

P.O. Box 1840

Helena

59624

L & C

Residential Address:

City:

State:

Zip Code:

County:

1076 N. Ewing

Helena

59601

L & C

Vehicle

Year:

Make:

Model:

Color:

Section

MT#:

Hull ID#:

Length:

Feet _____ Inches ______

Use:

Propulsion:

Fuel:

Vessel Material:

Vessel Type:

Motor No. 1 ID# _______________________________________________ Year ________ Make _________________________________ HP ______

Motor No. 2 ID# _______________________________________________ Year ________ Make _________________________________ HP ______

Is there a security interest or

No - go to Section D

lien against this vehicle?

Yes - complete this section and submit a filing fee of $8 for each security interest or lien

Date of First Security

Amount

Name of First Secured Party or Lienholder:

DL/FEIN/Tribal ID/Corp ID*

Interest: _________

Mailing Address of First Secured Party or Lienholder:

City:

State:

Zip Code:

Date of 2nd Security

Amount

Name of Second Secured Party or Lienholder:

DL/FEIN/Tribal ID/Corp ID*

Interest: __________

Mailing Address of Second Secured Party or Lienholder:

City:

State:

Zip Code:

Statement of

I certify under penalty of law (MCA 45-7-203 Unsworn Falsification to Authorities) that:

Sale Section

•

The vessel described above was sold new

used

to the applicant named in Section A on (date) _____________________ by (printed name of

seller) _____________________________________ Seller's Address:_____________________________________________________________

•

The statements made and information contained on this form are true and correct to the best of my knowledge, information and belief.

•

If signing for a commercial entity, I have full authority to do so.

Dated this

day of

___

DL/FEIN/Tribal/Corp ID*

Signature of Dealer’s Agent (this is my legal signature)

Dealer’s Firm Name

Printed Name of Dealer’s Agent

DL/FEIN/Tribal ID/Corp ID *

Applicant's

I certify under penalty of law (MCA 45-7-203 Unsworn Falsification to Authorities) that:

Acknowledgement

•

I am one of the applicants named in Section A;

•

The statements made and information contained on this form are true and correct to the best of my knowledge, information and belief and, if signing

for a commercial entity, I have full authority to do so.

Dated this

day of

Signature - this is my legal signature (only one signature is required)

If Applicant is a Commercial Entity, Give Full Name

Printed Name of Applicant

* DL=Driver License number; FEIN=Federal Employer Identification Number; Tribal ID=Tribal Identification card; Corp ID=Corporate Identification number.

Montana county and state authorities reserve the right to reject any form that has been altered

MV1A (04/09)

This form is available in alternate formats for people with disabilities