Form Hsmv 87231 - Application For "Governmental" Vessel Registration Number
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1
2APPLICATION FOR “GOVERNMENTAL” VESSEL REGISTRATION NUMBER
SUBMIT THIS FORM TO YOUR LOCAL TAX COLLECTOR OFFICE
AGENCY NAME APPLYING FOR GOVERNMENT STATUS: _______________________________________________________________
___________________________________________________________________________________________________________
CITY
STATE
ZIP
STREET ADDRESS
ADDRESS TO MAIL DECALS ANNUALLY
(If Different)
____________________________________________________________________________________________________________
STREET ADDRESS
CITY
STATE
ZIP
_____________________________________________ __________________________________________
TELEPHONE NUMBER
FAX NUMBER
_____________________________________________
AGENCY F.E.I.D NUMBER
I hereby certify that the following vessel is currently owned and operated by this organization for other than recreational purposes
and is entitled to receive a government vessel registration pursuant to Section 328.48, F.S.
Under penalties of perjury, I declare that I have read the foregoing document and that the facts stated in it are true.
SIGNATURE OF APPLICANT _________________________________________________________________________________
PRINTED NAME ____________________________________________________________________________________________
POSITION OF APPLICANT __________________________________________________________________________________
VESSEL INFORMATION:
___________________________________
______________
MANUFACTURER OF VESSEL
AGENCY’S PROPERTY #
____________
__________
___________________________________
MODEL YEAR
LENGTH
HULL ID NUMBER
HULL
PROPULSION
FUEL
TYPE
1. Wood
1. Outboard
1. Gas
1. Open Motorboat
5. Houseboat
2. Aluminum
2. Inboard
2. Diesel
2. Cabin Motorboat
6. Pontoon
3. Steel
3. Sail
3. Other ___________ 3. Auxiliary Sailboat
7. Personal Watercraft
4. Fiberglass
4. Inboard/Outboard
4. Inflatable
8. Other ______________
5. Wood/Fiberglass
5. Air Propelled
6. Other _____________ 6. Other _____________
IF VESSEL WAS PREVIOUSLY TITLED OR REGISTERED, PLEASE COMPLETE THE FOLLOWING:
___________________ _
_________________________
_________________________________________________________
TITLE NUMBER
FLORIDA REGISTRATION #
PREVIOUS OWNER’S NAME
PLEASE INDICATE BELOW, THE DOCUMENTATION WHICH IS ENCLOSED WITH YOUR APPLICATION:
Manufacturer’s Statement of Origin (MSO) – Required if new vessel purchased in Florida (
See reverse for other states).
Certified copy of applicable COURT ORDER or JUDGMENT
Previous title signed over to agency
(Please see the reverse side for additional information.)
HSMV 87231 (Rev.10/11)
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