Vessel Ownership Affidavit STX FILL 2020 Fillable
Propulsion Outboard Aux Sail Inboard Water Jet Sail Manual Other Gas Diesel Other INSTRUCTIONS: 1. Complete in blue or black ink or print form. 2. All applicants claiming ownership must sign this affidavit. I,____________________________________, a Notary Public in the District of St. Croix, United States Virgin Islands aforesaid hereby certify that the above name herein personally known to me to be the affiant in the foregoing affidavit, personally appeared before me this day and having been by duly sworn deposes and says that the facts set forth in the above is true and correct. Witness my hand and official seal this _____day of _____________. My Commission expires: ____________/___________/_________. …
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Propulsion Outboard Aux Sail Inboard Water Jet Sail Manual Other Gas Diesel Other INSTRUCTIONS: 1. Complete in blue or black ink or print form. 2. All applicants claiming ownership must sign this affidavit. I,____________________________________, a Notary Public in the District of St. Croix, United States Virgin Islands aforesaid hereby certify that the above name herein personally known to me to be the affiant in the foregoing affidavit, personally appeared before me this day and having been by duly sworn deposes and says that the facts set forth in the above is true and correct. Witness my hand and official seal this _____day of _____________. My Commission expires: ____________/___________/_________. (SEAL) Owner’s Name (last, first, middle initial or company name) Owner’s Legal Address (number and street) City State ZIP Code Owner’s Name (last, first, middle initial or company name) Owner’s Legal Address (number and street) City State ZIP Code HULL IDENTIFICATION NUMBER (HIN): Make Vessel # Year Model Name and/or Number Length (feet and inches) Horsepower VESSEL OWNERSHIP AFFIDAVIT DEPARTMENT OF PLANNING AND NATURAL RESOURCES DIVISION OF ENVIRONMENTAL ENFORCEMENT OWNER INFORMATION VESSEL INFORMATION Check Appropriate Box Hull Material Aluminum Wood Fiberglass Plastic Steel Other Vessel Type Open Cabin Sailboats Commercial Hydroplane Pontoon Cruiser Jet-Ski Houseboat Utility Yacht Amphibious Other Fuel Watercraft Use Pleasure Fishing Livery Commercial Recreational AFFIRMATION AND SIGNATURE This Affidavit is submitted to request the Division of Environmental Enforcement issue a Certificate of Registration. I agree to indemnify and hold harmless the Division of Environmental Enforcement from any liability arising from this transaction. I certify that I am the owner of said vessel listed herein and the information contained in this report, to the best of my knowledge is true and correct. I understand that making a false statement may constitute the crime of perjury. Printed Name of Owner Signature of Owner Date Signed (mm/dd/yyyy) Printed Name of Owner Signature of Owner Date Signed (mm/dd/yyyy) Reason for Affidavit: