Boat Transfer Form - Department Of Transport
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1
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4Recreational Boat Registrations
Boat Transfer Form
Department of
Transport
Notification of change of ownership
OFFICE USE ONLY
BOAT TRANSFER – PURCHASER’S COPY
•
The
seller/s must complete all red sections
of this form and the purchaser/s must complete all blue sections.
•
If the vessel is owned and/or is to be purchased in joint names then all sellers and/or purchasers must sign.
•
If the purchaser intends to submit this form by mail they must have their WA drivers licence shown in the required field below under the purchaser details section.
(Please find more information on the back of this form)
•
The purchaser must submit this copy and payment to the Department within fifteen (15) days of the date of purchase.
VESSEL DETAILS (Mandatory)
Registration Number:
Hull Identification Number:
SELLER DETAILS (if in joint names: please complete details of all joint owners on the additional owners form and submit with this application)
Organisation: (if applicable)
ACN:
Surname:
Other names:
Date of birth:
WA Driver’s Licence No:
(dd mm yyyy)
Residential address: (PO Box No is not acceptable)
Suburb:
State:
Postcode:
Telephone - Private:
Telephone - Business or Mobile:
PURCHASER DETAILS (if in joint names: please complete details of all joint owners on the additional owners form and submit with this application)
Organisation: (if applicable)
ACN:
Surname:
Other names:
Date of birth:
WA Driver’s Licence No:
(dd mm yyyy)
Residential address: (PO Box No is not acceptable)
Suburb:
State:
Postcode:
Telephone - Private:
Telephone - Business or Mobile:
Email address:
Postal address: (if different to residential)
Suburb:
State:
Postcode:
Town/Suburb where the vessel is normally kept:
�
�
Is this boat kept on a trailer:
Yes
No
�
�
�
�
�
Vessel’s storage facility:
Home
Pen
Boat Yard/Stacker
Mooring
Private Jetty
DECLARATION
I hereby declare that the information contained in this form is accurate. I understand that if any information is omitted or is found to be
incorrect this registration may be cancelled without notice.
Seller’s Declaration (all joint sellers must sign)
Purchaser’s Declaration (all joint purchasers must sign)
_________________________
________________________
________________________
_________________________
seller’s name
seller’s signature
purchaser’s name
purchaser’s signature
_________________________
________________________
________________________
_________________________
joint seller’s name
joint seller’s signature
joint purchaser’s name
joint purchaser’s signature
Date of sale: _________________________________
Date of sale: ________________________________________
Dealers: please ensure that the Agents Authority section on the reverse side of this form is completed if acting on behalf of the customer.
Mar_BR_NBR0816
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