Application For Certificate Of Number Kansas Boating Act Form printable pdf download

APPLICATION FOR CERTIFICATE OF NUMBER KANSAS BOATING ACT

1. KDWPT#____________________or SS#_____________________

4.Present No. on Boat:

5.Yr. Boat Built:

6. Boat Length (in ft.):

Driver License #________________DLState_____

7. Boat Make:

8. Hull ID No.:

Name(s)__________________________________

10. Propulsion

11. Fuel

12. Use

13. Type

9. Hull Material

( )Outboard

( )Jet

( )Aluminum

( )Steel

( )Gasoline

( )Pleasure

( )Open

( )Inboard

( )Air

( )CabinCruise

_______________________________________

( )Wood

( )Cloth

( )Electric

( )Livery

( )In-Outboard

( )Row

( )Houseboat

( )Rubber

( )Other

( )Diesel

( )Sail

( )Sailboard

( )Jet Ski

( )Fiberglass

Address__________________________________

( )None

( )Aux/Sail

( )Canoe

( )Sailboard

14. Motor Hp:

Motor Year:

Trailer Length:

Trailer Yr.:

City_______________State______ Zip_________

15. Cap HP Rating:

16.Toilet ( )yes ( )no

17. Date Purchased Boat:

18. Purchased From: ( )Out of State Dealer ( )Kansas Dealer

( )Private Individual

Phone____________________________________

PROVIDE SALES TAX RECEIPT

STD8 #:

Name:

19.County Boat Stored:

20. State of Principal use:

2.Height_______Weight_____Eye Color__________

rect.

I certify the above information is true and cor

3. Birthdate of Owner _______________________

21. Sign Here:

___________________________________________________

Signature

(DO NOT PRINT)

APPLICATION FOR CERTIFICATE OF NUMBER KANSAS BOATING ACT

INSTRUCTIONS FOR PREPARATION OF FORM

(1-3) Print appropriate information. (4) If the boat bears registration number or has been registered with any state including Kansas, insert the number. If the boat

has an existing Kansas number, please include the previous owner’s certificate of number or a letter stating boat was sold, when application is remitted

to Pratt. (5) Insert year boat was built. (6) Insert length of boat in feet. Drop the inches. Do not round off to the next foot. (7) Insert name of company that built the

boat. If boat was built by owner or builder is unknown, please specify. (8) Insert Hull Identification number. All boats manufactured after November 1972 are re-

quired by Federal law to have a 12 digit Hull ID #. (9 - 13) Mark appropriate box. (14) Insert appropriate information on motor and trailer. If unknown leave blank.

(15) Insert horsepower rating from the boat capacity plate. These plates were not required before 1972. If unknown, leave blank. (16) Toilet: mark appropriate box.

(17) Enter the date the boat was purchased. (18) Fill in where the boat was purchased. If the boat was purchased from a KANSAS DEALER submit with a form

STD8 or bill of sale showing sales tax paid. If bought from an OUT OF STATE DEALER submit application with bill of sale showing sales tax paid in an-

other state, or if no taxes paid, go to your county treasurer, pay the Kansas sales tax and submit with a receipt form you receive there. PRIVATE INDI-

VIDUAL SALES ARE TAX EXEMPT. Submit application with bill of sale showing individual sale. (19) Insert the county in which the boat is stored, parked,

or garaged. (20) Enter state of principal use. (21) Applicant must sign the application.

If you want to pay by credit card, please fill inthe information below.

After completing form, MAIL TO: KS DEPT OF WILDLIFE, PARKS &

CREDIT CARD INFORMATION:

VISA

MASTERCARD

Fee and proof of pay-

TOURISM, 512 SE 25TH AVE PRATT, KS 67124.

ment of Sales or Compensating taxes must accompany each applica-

Card Number ________________________________________________

tion. (see item #18 to clarify)

PLEASE ALLOW AT LEAST 2 TO 3 WEEKS FOR PROCESSING