Affidavit For Boat Inspection - Louisiana Department Of Wildlife And Fisheries

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Revised 08/2015
Louisiana Department of Wildlife and Fisheries
Office of Management and Finance
Licensing and Registration
Post Office Box 14796
Baton Rouge, LA 70898
(225)765-2898
BOAT REGISTRATION
AFFIDAVIT FOR BOAT INSPECTION
AN INSPECTION FEE OF $28.00 IS REQUIRED
.
INSPECTION FEES ARE NON-REFUNDABLE
Effective July 1, 2002, original receipts for materials indicating taxes paid must be provided to the officer at the time
of inspection of all homemade boats. Applicants for inspection of boats other than homemade must provide proof
of ownership and/or the Court Order/Affidavit signed by a Justice of the Peace at the time of inspection. All
Inspected boats must be titled.
Reason for Inspection Request
Owner’s Information
( ) Homemade boat
Name
( ) Illegible/Unable to Locate HIN
Address
( ) Incorrect HIN
( ) Manufacturer with no MIC code
City
( ) Other
State
Zip Code
Notice of Inspection for Homemade Boats
Owner/Buyer/Operator – Notification
The inspection performed on this boat conforms to Title 34, Section 851.20 M (1) & (2). The Department of Wildlife
and Fisheries has made no determination of seaworthiness and does not imply that any boat inspected under this
law is built to safety standard.
It is the responsibility of every boat builder, owner, or buyer to insure that homemade boats inspected under this
law are built to the designated standards and carry the required safety equipment on board. Must be signed by
a notary or in the presence of a LDWF Official.
Signature of Applicant
Date
SWORN TO AND SUBSCRIBED BEFORE ME this
day of
,
Notary Public
Louisiana Department of Wildlife & Fisheries Official
WARNING:
CRIMINAL PROSECUTION
THE FILING OF A FALSE AFFIDAVIT IS A CRIME AND WILL SUBJECT THE OFFENDER TO

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