Form 2686 - Application For Boat/vessel Or Outboard Motor Registration And Replacement Decal

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MISSOURI DEPARTMENT OF REVENUE
MOTOR VEHICLE BUREAU
PO BOX 2046, JEFFERSON CITY MO 65105-2046
(573) 526-3669
APPLICATION FOR BOAT/VESSEL OR OUTBOARD MOTOR
REGISTRATION AND REPLACEMENT DECAL
ANY FALSE STATEMENT IN THIS APPLICATION IS A VIOLATION OF THE LAW AND
MAY BE PUNISHED BY FINE OR IMPRISONMENT OR BOTH.
WATERCRAFT
OUTBOARD MOTOR
TYPE OF APPLICATION (CHECK ONE):
RENEWAL
REGISTRATION ONLY
REPLACEMENT DECAL
REPLACEMENT CERTIFICATE OF REGISTRATION
VALIDATION ONLY
OWNER’S NAME
(LAST)
(FIRST)
(MIDDLE)
STREET ADDRESS, R.R. OR P.O. BOX NUMBER
COUNTY
CITY
STATE
ZIP CODE
TITLE NUMBER
__ __
YEAR
MAKE
MANUFACTURER’S IDENTIFICATION NUMBER
MODEL NUMBER
__ __
__ __ __ __ __ __ __ __ __ __ __ __
HORSEPOWER
COLOR
LENGTH
MATERIAL
BOAT TYPE
PROP
__ __ __
__ __
__ __
__ __ __ __ __
__ __ __
__ __ __
FT.
IN.
TYPE OF USE (CHECK ONE)
FEE DUE
PURCHASE DATE
COMMERCIAL PASSENGER
COMMERCIAL FISHING
PLEASURE
RENTAL
$
__ __ /__ __ / __ __ __ __
COMMERCIAL OTHER
OFFICIAL
EXPIRATION YEAR
__ __ __ __ __ __
MISSOURI BOAT LICENSE ID NUMBER: MO
__ __ __ __
WATERCRAFT/OUTBOARD MOTOR DECAL NUMBER:
REASON FOR REPLACEMENT, IF APPLICABLE:
LOST
STOLEN
MUTILATED
DESTROYED
NEVER RECEIVED
I certify that the statements herein are true to the best of my knowledge. As the owner of the above mentioned
vessel or outboard motor, I consent to any inspection necessary to determine compliance with provision
306.060, RSMo.
SIGNATURE OF OWNER OR AGENT
DATE
X
__ __ /__ __ / __ __ __ __
NOTARY INFORMATION — APPLICATION FOR REPLACEMENT DECAL
STATE
COUNTY (OR CITY OF ST. LOUIS)
SUBSCRIBED AND SWORN TO ME THIS
DAY OF
NOTARY PUBLIC NAME (TYPED OR PRINTED)
NOTARY PUBLIC SIGNATURE
MY COMMISSION
EXPIRES
USE RUBBER STAMP IN CLEAR AREA BELOW.
NOTARY PUBLIC EMBOSSER SEAL OR BLACK
INK RUBBER STAMP SEAL.
DOR-2686 (2-2012)

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