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Texas Limited Power of Attorney for Vessels and/or Outboard Motors Form


Texas Limited Power of Attorney for Vessels and/or Outboard Motors Form
Texas Limited Power of Attorney for Vessels and/or Outboard Motors Form
PWD 1055–A0900 (11/05) Texas Parks and Wildlife Department • 4200 Smith School Road, Austin, TX 78744 • www.tpwd.state.tx.us
Limited Power of Attorney (PWD 1055)
For Vessels and/or Outboard Motors
This is to certify that I,
Company Name (if applicable):
Name:
Address:
City, State, Zip:
Phone Number: (Day time)
owner of the following described vessel and/or outboard motor, do hereby appoint, as my
true and lawful attorney,
Company Name (if applicable):
Name:
Address:
City, State, Zip:
Phone Number: (Day time)
to sign and execute for me any and all papers in connection with the sale, transfer, or
registration specifically limited to the vessel and/or outboard motor listed below:
Vessel Description (complete all):
TX # or Title #: Year Built:
Hull ID/Serial #: Make:
Outboard Motor Description (complete all):
Horse Power: Year Built:
Serial #: Make:
WARNING: Falsifying information on documents is a punishable offense – Texas Penal Code Chapter 37, Section 37.10. Any person
who knowingly makes a false entry in, or false alteration of a governmental record is guilty of a felony of the third degree, punishable by
confinement in jail for any term of not more than 10 years or less than 2 years and punishable by a fine not to exceed $10,000. I hereby
certify that all statements in this document are true and correct to the best of my knowledge and belief.
Company Name (if applicable):
Printed Name:
Signature of Owner:
(The owner’s signature must be notarized. Forms without notary will not be accepted.)
Subscribed and sworn to before me this day of (month), (year).
Signature of Notary:
Notary Stamp/Seal Printed Name of Notary:
County, State of Texas
Texas Parks and Wildlife Department maintains the information collected through this form. With few exceptions, you are entitled to be informed about the information we collect. Under
Sections 552.021 and 552.023 of the Texas Government Code, you are also entitled to receive and review the information. Under Section 559.004, you are also entitled to have this information
corrected.
Texas Limited Power of Attorney for Vessels and/or Outboard Motors Form