Form Mv-82b - Boat Registration Title Application Page 2

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6
CHANGES (To change information on your current boat registration and/or title.)
For a change of name, print your former
name exactly as it appears on your present
registration.
For all changes other than name, explain
what the change is, and the reason for the
change.
7
REGISTRANT CERTIFICATION:
I certify that the registration information presented is true, and that the registration is not currently under suspension or
revocation in any jurisdiction. If I am using a credit card for payment of any fees in connection with this application, I understand that my signature
below also authorizes use of my credit card.
±
Print Name Here
(Print Name in Full - if registering for a corporation, print your full name and title)
±
Sign Here
(Sign Name in Full)
Additional Signature
±
SIGN HERE
(Sign Name in Full -Additional signature required for a partnership or if registering this boat in more than one name.)
IMPORTANT:
Making a false statement in any registration application, or in any proof or statements in connection with it, or deceiving or substituting in
connection with this application, is a misdemeanor under Section 392 of the Vehicle and Traffic Law, and may also result in the revocation or suspension of the
registration pursuant to regulations established by the Commissioner. The department makes no representation that it will issue a certificate of title until the
Commissioner is satisfied that the applicant is entitled to a certificate of title or transferable registration, and until all documentation required to establish
ownership of the boat is submitted and deemed to be satisfactory. Pending review of this application, neither the Commissioner of the Department of Motor
Vehicles nor any of his or her employees, deputies or agents assumes any liability or responsibility for repairs performed, improvements made or work done to
the boat referenced in this application.
CREDIT CARD AUTHORIZATION IF CARDHOLDER IS NOT THE APPLICANT:
My signature authorizes ____________________________________________ to use my credit card for payment of any fees in connection with this application.
±
Sign Here
(Cardholder - Sign Name in Full)
TO BE COMPLETED ONLY BY A REGISTERED NEW YORK STATE BOAT DEALER
ADDITIONAL LIENHOLDERS - List any lienholders in addition to the one specified on page 1 of this form.
Lien Filing Code _____________________________ Lienholder Name _______________________________________________________________
D
(Assigned by DMV)
E
Mailing Address ___________________________________________________________________________________________________________
Number and Street
City
State
Zip Code
A
L
Lien Filing Code _____________________________ Lienholder Name _______________________________________________________________
(Assigned by DMV)
E
Mailing Address ___________________________________________________________________________________________________________
R
Number and Street
City
State
Zip Code
DEALER TRANSFER INFORMATION – Please complete the information below. For new boats, attach a Manufacturer’s Statement or Certificate of Origin
(MSO or MCO) and a bill of sale. For used boats, attach a signed title or transferable registration, along with bills of sale for any subsequent transactions.
Boat was
O
obtained from
________________________________________________________________________________________
_____________ ___________________
Name and Address
Date of Purchase
N
L
Boat was
sold by
Y
Name and Address of your dealership
Facility No.
Date of Sale
DEALER CERTIFICATION:
±
I certify that all information provided on this application is true. I take
responsibility for the integrity of the papers delivered to the
Signature of Dealer or Authorized Representative
Department of Motor Vehicles.
PAGE 2 OF 2
MV-82B (6/07)
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