AFFIDAVIT OF OWNERSHIP OF A NON-MOTORIZED HOUSEBOAT
STATE OF LOUISIANA
PARISH OF
Before me, the undersigned authority personally came and appeared: ,
residing at , who after first being duly sworn did
depose and say that he/she is the lawful owner of the following described non-motorized houseboat (a vessel
constructed for the primary purpose of a temporary or permanent dwelling without an effective means of
propulsion for safe navigation).
MAKE OF VESSEL: Non-motorized Houseboat
Hull I.D. Number (12 digits): ; or
o
Vessel is Homemade Vessel Length:______ft. _____in. Model year:
Value of Vessel: $ Date of Construction:
o
Taxes paid on vessel
o
Taxes paid on material
o
Casual sale
o
I did not pay taxes and have attached the completed Louisiana Department of revenue (R-1331) form.
The history of the boat’s origin and the circumstance of affiants acquiring possession of this non-motorized
houseboat are as follows (continue on separate page if needed) including the length of ownership per owner.
Enclose pictures of front, back, and both sides with a close-up of the HIN if visible or applicable.
Signed on this ______day of ________________________, 20______.
(Affiant) (Notary Public)
Printed Name:
(Printed Name) Notary ID#: _______________________________
Commission Expires: _______________________
KNOWINGLY PROVIDING FALSE INFORMATION HEREIN IS A CRIME.
I/we UNDER PENALTY or PERJURY, do solemnly swear and affirm, that to the best of my knowledge, information, and belief, I/we
am/are the true and lawful owner(s) of the vessel described herein. I/we understand that any misrepresentation of facts supplied to
this office for the purpose of fraudulently obtaining a boat registration/title will subject the applicant(s) to criminal prosecution as
provided by the law.
