08/2018 cmc IOWA DEPARTMENT OF NATURAL RESOURCES DNR Form 542-8067

Title #: APPLICATION Registration # (IA #):

REGISTRATION ─ Owner Information ─ The 1st applicant will be listed as the primary owner shown on the registration.

If a Business/Trust: Use Entity Name as Full Name, Date of Inception as Birth Date, and Tax ID Number/FEIN as SSN.

Required

Iowa Resident Nonresident

#1 Full Name: Birth Date:

Address: City/State/Zip Code:

DNR Number: DL Number: Social Security Number: If sent electronically leave blank.

Gender: Male Female Height: Weight: Eye Color:

Phone: Email:

Iowa Resident Nonresident

#2 Full Name: DL Number: Birth Date:

Address: City/State/Zip Code:

Gender: Male Female Height: Weight: Eye Color:

Iowa Resident Nonresident

#3 Full Name: DL Number: Birth Date:

Address: City/State/Zip Code:

Gender: Male Female Height: Weight: Eye Color:

All owners can be listed as And- requires all parties to sign upon sale, title or transfer Or- requires one party to sign upon sale, title or transfer

APPLICATION DATE: COUNTY OF REGISTRATION:

IOWA APPLICATION FOR: 1 BOAT 2 ATV 3 SNOW 4 ORV 5 ORM

TYPE: 6 New Number/Registration 8 Duplicate 10 Renewal of Number 12 Transfer of Ownership 14 Other

7 Title 9 Duplicate Title 11 Bond 13 Lien 15 Subsequent Lien

BOAT Previous Title No (if any): Registration No (if any):

Boat Name: Port Name: Make Model Homemade

State of Primary Operation:

Color Model Year Overall Length Boat Width HIN

FT. IN. FT. IN.

Primary Operation: 1 Pleasure 2 Dealer or

Manufacturer Demonstration

3 Rent or Lease 4 Official 5 Commercial

Passenger Carrying

6 Commercial Fishing

7 Other Commercial Operation

8 Charter Fishing

Vessel Type: 1 Cabin Motorboat 2 Paddlecraft/Canoe 3 Personal

Watercraft 4 Houseboat 5 Pontoon 6 Rowboat 7 Open Motorboat 8 Sail Only 9 Other: 10 Paddlecraft/Kayak 11 Auxillary Sail 12 Air Boat 13 Inflatable Boat

Hull Material: 1 Aluminum 2 Fiberglass 3 Wood 4 Steel 5 Plastic 6 Other: 7 Rubber/

Vinyl/ Canvas

Propulsion Type: 1 Propeller 2 Water Jet 3 Sail 4 Manual 5 Air Thrust 6 Other:

Engine Drive Type: 1 Inboard 2 Outboard 3 Pod Drive 4 Sterndrive 5 Other: 6 None

Fuel: 1 Gas 2 Diesel 3 Other: 4 Electric

Capacity (from plate, if any): persons

Horsepower: h.p.

Toilet Yes No

ATV/SNOWMOBILE/ORM/ORV Electric DOT Titled

Previous Title No (if any): Registration No (if any):

Make Color Model VIN

Antique Snowmobile Model Year: CC: Dry Wt. in Lbs: No. of Wheels:

(OVER FOR TITLING, DEALER SALES INFORMATION, BONDING, AND SIGNATURES)

08/2018 cmc IOWA DEPARTMENT OF NATURAL RESOURCES DNR Form 542-8067

COUNTY RECORDER USE ONLY:

1 Transfer Without 4 Tax Paid Dealer 7 Casual Sale 9 No Exemption

Consideration 5 Tax Paid Other State 8 Other 10 Tax Exempt

2 Homemade 6 Purchase for Resale

3 Government, Nonprofit

SELLER Name Address Purchase Date

EVIDENCE OF OWNERSHIP

I present the following evidence of ownership:

Manufacturer’s Statement Operation of Law Affidavit

Foreign Title Certificate Specially Constructed/Homemade

Reconstructed/Rebuilt Registration Certificate

LIEN/SUB LIEN Does this vehicle/vessel have a lien? Yes No

1st Lienholder Street Address City/State/Zip

2nd Lienholder Street Address City/State/Zip

BOND (Use this section only if you have purchased a bond)

Book Value: $

(can be obtained from an Iowa registered dealer or current NADA value.)

Bond Amount: $

(minimum of 1 1/2 times book value)

Dealer No. Dealership Name Dealership Signature

I have visually examined this vehicle/vessel and have checked for wants/stolen.

Officer Signature: Date:

Iowa DNR

DEALER USE ONLY: Sale Price $ Registration Fee Collected $ Date Acquired:

Less Trade-In $ Sales Tax Collected $

Equals Tax Price $

Tax Previously Paid $

I certify under penalty of perjury that the foregoing is true and correct.

DNR Dealer No. Dealership Name Dealership Signature

SIGNATURES Important: Be certain that dates and other information given are correct. Any person who uses a false or fictitious name, makes a false statement or otherwise commits a fraud upon this application is punishable by imprisonment and possible fine per Iowa Code Section 462A.23.

I attest that the Hull Identification Number (HIN) or Vehicle Identification Number (VIN) is correct and permanently affixed to the vessel or vehicle for which I am making application. I have reviewed all information above and acknowledged that it is accurate and true.

Signature of: Owner/ Security Holder #1: Date:

Signature of: Owner/ Security Holder #2: Date:

Signature of: Owner/ Security Holder #3: Date:

Title: Registration IA: Iowa Resident: OffNonresident: Off1 Full Name: Birth Date: Address: CityStateZip Code: DNR Number: DL Number: Social Security Number: Gender: OffHeight: Weight: Eye Color: Phone: Email: Iowa Resident_2: OffNonresident_2: Off2 Full Name: DL Number_2: Birth Date_2: Address_2: CityStateZip Code_2: Gender_2: OffHeight_2: Weight_2: Eye Color_2: Iowa Resident_3: OffNonresident_3: Off3 Full Name: DL Number_3: Birth Date_3: Address_3: CityStateZip Code_3: Gender_3: OffHeight_3: Weight_3: Eye Color_3: Andrequires all parties to sign upon sale title or transfer: OffOrrequires one party to sign upon sale title or transfer: OffAPPLICATION DATE: COUNTY OF REGISTRATION: BOAT: OffATV: OffSNOW: OffORV: OffORM: OffNew NumberRegistration: OffDuplicate: OffRenewal of Number: OffTransfer of Ownership: OffOther: OffTitle_2: OffDuplicate Title: OffBond: OffLien: OffSubsequent Lien: OffPrevious Title No if any: Registration No if any: Boat Name: Port Name: State of Primary Operation: Homemade: OffOverall Length: Boat Width: Model Year: Pleasure: OffDealer or: OffRent or Lease: OffOfficial: OffCommercial: OffCommercial_2: OffOther Commercial: OffCharter Fishing: OffCabin Motorboat: OffPaddlecraftCanoe: OffPersonal: OffHouseboat: OffPontoon: OffRowboat: OffOpen Motorboat: OffSail Only: OffOther_2: OffPaddlecraftKayak: OffAuxillary Sail: OffAir Boat: OffInflatable Boat: OffGas: OffDiesel: OffOther_3: OffElectric: OffAluminum: OffFiberglass: OffWood: OffSteel: OffPlastic: OffOther_4: OffRubber: OffPropeller: OffWater Jet: OffSail: OffManual: OffAir Thrust: OffOther_5: OffInboard: OffOutboard: OffPod Drive: OffSterndrive: OffOther_6: OffNone: Offhp: Toilet: OffElectric_2: OffDOT Titled: OffPrevious Title No if any_2: Registration No if any_2: Color_2: Model: VIN: Antique Snowmobile: OffModel Year_2: CC: Dry Wt in Lbs: No of Wheels: Transfer Without: OffTax Paid Dealer: OffCasual Sale: OffNo Exemption: OffTax Paid Other State: OffTax Exempt: OffHomemade_2: OffGovernment Nonprofit: OffPurchase for Resale: OffSELLER: Address_4: Purchase Date: Manufacturers Statement: OffForeign Title Certificate: OffReconstructedRebuilt: OffOperation of Law Affidavit: OffSpecially ConstructedHomemade: OffRegistration Certificate: OffDoes this vehiclevessel have a lien: Off2nd Lienholder: Street Address: CityStateZip: undefined_9: undefined_10: undefined_11: undefined_12: undefined_13: Dealer No: Dealership Name: I have visually examined this vehiclevessel and have checked for wantsstolen: OffDate: Sale Price: Registration Fee Collected: Date Acquired: Less TradeIn: Sales Tax Collected: Equals Tax Price: Tax Previously Paid: DNR Dealer No: Dealership Name_2: Date_2: Owner: OffOwner_2: OffOwner_3: OffSecurity Holder 1: OffSecurity Holder 2: OffSecurity Holder 3: OffDate_3: 1: 2: 3: Date_4: Make: Boat Make: Color: Boat Length Ft: Boat Length In: Boat Width Ft: Boat Width In: HIN: Vessel Type Other: Fuel Other: Hull Material Other: Engine Drive Type Other: Propulsion Type Other: Capacity: Other_8: OffCO Rec Other: