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Mississippi Boat Bill of Sale


Mississippi Boat Bill of Sale
Mississippi Boat Bill of Sale
FORM PROVIDED BELOW IS A VALID BILL OF SALE WHEN PROPERLY WITNESSED OR NOTARIZED
Buyer: (Print) _________________________ _____________________ ___________
Last Name First Name Initial
Seller: (Print) _________________________ _____________________ ___________
Last Name First Name Initial
Co-Seller: (Print) ______________________ _____________________ ___________
Last Name First Name Initial
____________________________________ _____________________ ____ ___________
Seller’s Street Address City State Zip Code
___________________________ _______ ____________________________ ________
Seller Signature Date Co-Seller Signature Date
___________________________ _______ ____________________________ ________
Witness Signature Date Witness Signature Date
IF WITNESSED DOES NOT HAVE TO BE NOTARIZED.
SELLER(S) CERTIFY THAT STATEMENTS PROVIDED ON THE FRONT OF THIS APPLICATION FOR CERTIFICATION
OF REGISTRATION ARE TRUE AND ACCURATE TO THE BEST OF SELLER(S) KNOWLEDGE.
STATE OF: ________________________ COUNTY OF: ___________________________
This day personally came and appeared before me, the undersigned stated that all of the matters,
things and facts set forth are true and correct as therein stated.
SWORN TO AND SUBSCRIBED BEFORE ME, this the ___________________ day of __________, 20 _________.
______________________________________ My Commission expires __________________
Notary Public
INSTRUCTIONS
1. Type or print in ink, except the signature.
2. Owner of boat must sign this application.
3. All blanks MUST be completed with the following exceptions:
a. Rental boats need not indicate propulsion, fuel and horsepower unless the engine is rented as part of the boat.
b. Dealer’s do not complete boat identification. One registration number is assigned per dealer.
4. If vessel is presently numbered, enter number in space provided on front.
5. If vessel is registered in your name, in another state, please send copy of registration from that state in lieu of a bill of sale.
Return Application with check or money order with the appropriate fee to :
Mississippi Department of Wildlife, Fisheries & Parks
Boat Registration Division
1505 Eastover Drive • Jackson, MS 39211-6374
This stub is to serve as your receipt until you receive your Certificate of Number.
This must be kept with the vessel and available for inspection by Law Enforcement Officers.
Upon payment of fee this stub authorizes use of your vessel. Its validity may be verified at any time by Enforcement Officers.
Make check payable to the Department of Wildlife, Fisheries & Parks. Record your check or money order number here________________
SUBSCRIBE TO MISSISSIPPI OUTDOORS MAGAZINE : 1-888-874-5785
1 YEAR $6 / 2 YEARS $11
Make of Boat Year Built Hull # MI # Length
Mississippi Boat Bill of Sale
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