tax and fees
line 1 $ ,
.
Purchase Price
line 2 $ ,
.
Trade-in Value
2a
Trade-in Boat PA State Registration #
2b
Trade-in Boat Hull iD # (HiN)
Line 3 $ , .
Taxable Total - Subtract Line 2 from Line 1
Allegheny County residents multiply Line 3 by 0.07.
Philadelphia residents multiply Line 3 by 0.08.
Residents of other counties multiply by 0.06
and show amount on Line 4 below.
Line 4 $ , .
Total Sales Tax Amount
line 5 $ , .
Tax Credit (paid to another state or dealer
)
Line 6 $ , .
Sales Tax Due - Subtract Line 5 from Line 4
line 7 (# of dup cards) x $3 ea. .
Line 8 $ .
Registration Fee (see instructions)
Line 9 $ .
Title Fee ($15)
Line 10 $ .
Lien Encumbrance Fee ($5)
Line 11 $ , .
Grand Total - Add Lines 6, 7, 8, 9 & 10
make cHeck payable to:
pa fish & boat commission
applicant or dealer sales tax license number
pa sales tax exemption code
(See i nstructions)
Was this boat ever registered or titled
in pa or another state?
YES
NO
Current Boat Registration or Title Number
Official Use Only
pa registration number
Date of Purchase
Buyer’s Last Name/Company Name First Name M.I.
Mailing Address Buyer’s Date of Birth
City State ZIP Code County # Buyer’s Phone Number
Buyer’s Email Address Buyer’s Driver’s License Number/Company EIN
Co-Buyer Last Name First Name M.I.
Mailing Address Co-Buyer’s Date of Birth
City State ZIP Code Co-Buyer’s Phone Number
Co-Buyer’s Email Address Co-Buyer’s Driver’s License Number
When applying for title with a co-owner other than your spouse, c heck one of the blocks below. If no block is
checked, title will be issued as “tenants in common.”
a.
Joint tenants with right of survivorship (on death of one owner, title goes to t he surviving owner).
b.
tenants in common (on death of one owner, interest goes to his or her heirs or estate).
Hull Identification Number (HIN) Make of Boat Model Name/Number
Ft. In.
Year Boat Length Type Hull Material Engine Drive Fuel Prop Use
Optional: Complete only if your lien holder requires outboard motor data on the title.
outboard motor #1
Outboard Motor Serial Number Manufacturer Horsepower
outboard motor #2
Outboard Motor Serial Number Manufacturer Horsepower
Is tHere a lIen on tHIs boat?
YES
NO (If yes, you MUST complete this section)
Name of Lien Holder
Mailing Address Date of Lien
City State ZIP Code Phone Number
I am tHe (cHeck one block):
Registered or Titled Owner
Seller who is NOT the Registered or Titled Owner
Boat Dealer
Last Name First Name M.I.
Mailing Address Date of Birth
City State ZIP Code Phone Number
Temporary Expires (mm/dd/yy) Issuing Agent Number Name of Agency
/ /
I/We certify under penalty of law (18 P.A. C.S. 4904 (relating to unsworn falsification to authorities)) the
statements made herein are true and correct to the best of my/our knowledge, information and belief.
Signature of Buyer Signature of Seller/Owner/Dealer
Signature of Co-Buyer Signature of Co-Owner
Date: Date:
agent
s
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please check proper block:
Registration & Title
Registration Only
Title Only
Documented Vessel
Registration Upgrade
Reconstructed Title
Application for Pennsylvania
Boat Registration and/or Boat Title
b
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r
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f
REV-336 (EP) 10-18
Mail To:
pa fish & boat commission
division of licensing & registration
po box 68900
Harrisburg, pa 17106-8900
1-866-262-8734
www.fishandboat.com
/ /
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boat regIstratIon
a
type OR prInt ALL INFORMATION. attacH proof of oWnersHIp.
g
J
I
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