Form Rev 87 1006 - Commercial Vessel Seller'S Report Of Sale
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1
2State of Washington
COMMERCIAL VESSEL SELLER’S
Department of Revenue
Special Programs Division
REPORT OF SALE
Miscellaneous Tax Section
PO Box 47477
Olympia WA 98504-7477
DOR Use Only
CVT No:
OID No:
Close Date:
Listing Sent:
Yes
No
N.O.V. Sent:
Yes
No
A. Seller Information
(
)
Seller’s Name
(Last)
(First)
( Middle)
Home Phone
(
)
Home Address
(Street or Route, PO Box)
Business Phone
(City)
(State)
(Zip Code)
B. Purchaser Information
(
)
Purchaser’s Name (Last)
(First)
( Middle)
Home Phone
(
)
Home Address
(Street or Route, PO Box)
Business Phone
(City)
(State)
(Zip Code)
C. Vessel Information
Vessel Name
Document No.
Commercial Vessel Tax No.
Owner Identification No.
Make/Model
Year Built
WN
Department of Licensing No.
Length
Department of Fish and Wildlife Vessel Registration No.
Hull Identification No.
D. Sale Information
Purchase Price Detail:
Date of Sale:
Ship or Vessel Price: $
Broker:
Motor/Price: $
Accessories/Price: $
Title/Documentation Service:
Total Purchase Price: $
(Exclude Fees, Licenses, Taxes)
E. Vessel Use Type
After sale, did vessel leave the state permanently?
Yes
No
After sale, was vessel converted to personal use and watercraft excise tax paid?
Yes
No
After sale, is vessel to continue commercial service in Washington?
Yes
No
F. Signature
The undersigned hereby states, to the best of their knowledge, that the above information is true and correct.
(Print Name)
(Signature)
(Date)
To inquire about the availability of this document in an alternate format for the visually impaired or a language other than English,
please call (360) 753-3217. Teletype (TTY) users may call (800) 451-7985. You may also access tax information on our Internet
home page at
REV 87 1006 (01-05-98)
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