Form Rev-336 - Application For Pennsylvania Boat Registration And/or Boat Title (Page 4 of 5) in pdf

REV-336 EP (03-10)

Application for Pennsylvania

PA Registration Number

Boat Registration and/or Boat Title

Mail To:

PA Fish & Boat Commission

Please check proper block:

Registration & Title

Registration Only

Title Only

Licensing & Registration Section

PO BOX 68900

Documented Vessel

Registration Upgrade

Harrisburg, PA 17106-8900

(717)705-7940

TYPE OR PRINT ALL INFORMATION. ATTACH PROOF OF OWNERSHIP.

TAX AND FEES

Last Name

First Name

M.I.

Date of Purchase

Mailing Address

Date of Birth

Line 1

Purchase Price

City

State

ZIP Code

County #

Phone Number

Line 2

Buyer’s Email Address

Trade-In Value

Co-Buyer Last Name

First Name

M.I.

Trade-In Boat PA State Registration #

Mailing Address

Co-Buyer’s Date of Birth

(S)

Trade-In Boat Hull ID # (HIN)

City

State

ZIP Code

Co-Buyer’s Phone Number

Line 3

Taxable Total - Subtract Line 2 from Line 1

Co-Buyer’s Email Address

Allegheny County residents multiply Line 3 by 0.07.

When applying for title with a co-owner other than your spouse, check one of the blocks below. If no block is

Philadelphia residents multiply Line 3 by 0.08.

checked, title will be issued as “Tenants in Common.”

Residents of other counties multiply by 0.06

and show amount on Line 4 below.

Joint Tenants with Right of Survivorship (on death of one owner, title goes to the surviving owner).

Tenants in Common (on death of one owner, interest goes to his or her heirs or estate).

Line 4

Total Sales Tax Amount

B D

Hull Identification Number (HIN)

Make of Boat

Model Name/Number

Line 5

O A

Tax Credit (paid to another state or dealer)

Ft.

In.

A T

T A

Year

Boat Length

Type

Hull Material

Prop

Fuel

Use

Line 6

Sales Tax Due - Subtract Line 5 from Line 4

Capacity Plate Information:

Must be filled out.

CAP

Line 7

(# of Dup Cards)

x $3 ea.

See instruction page.

Horsepower

# of Persons

Total Weight Capacity

Persons Weight Capacity

PLATE

M D

Optional: Complete only if your lienholder requires outboard motor data on the title.

O A

Line 8

T T

Registration Fee (see instructions)

Outboard Motor #1

O A

Outboard Motor Serial Number

Manufacturer

Horsepower

Line 9

Title Fee ($15)

IS THERE A LIEN ON THIS BOAT?

YES

NO (If yes, you MUST complete this section)

Line 10

Lien Encumbrance Fee ($5)

Name of Lienholder

Line 11

Grand Total - Add Lines 6, 7, 8, 9 & 10

Mailing Address

Date of Lien

MAKE CHECK PAYABLE TO:

PA Fish & Boat Commission

City

State

ZIP Code

Phone Number

I AM THE (CHECK ONE BLOCK):

Registered or Titled Owner

Seller who is NOT the Registered or Titled Owner

Boat Dealer

Applicant or Dealer Sales Tax License Number

Last Name

First Name

M.I.

PA Sales Tax Exemption Code

(See Instructions)

Mailing Address

Date of Birth

Was this boat ever registered or titled

City

State

ZIP Code

Phone Number

in PA or another state?

YES

AGENT

Temporary Decal #

Decal Expires (mm/yy)

Issuing Agent Number

Name of Agency

Current Boat Registration or Title Number

I/We certify under penalty of law the statements made herein are true and correct to the best of

my/our knowledge, information and belief.

Official Use Only

Signature of Buyer

Signature of Seller/Owner/Dealer

Signature of Co-Buyer

Signature of Co-Owner

Date:

OWNER

Form Rev-336 - Application For Pennsylvania Boat Registration And/or Boat Title Page 4

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