3616 Colby Ave., PMB 335 Everett, WA 98201 Office: 360-444-6611 FAX: 360-444-6614 www.hatisland.org VEHICLE REGISTRATION FORM

It is Island policy that all motorized vehicles that utilize Island roads are registered with the Island Office. Cars, trucks and vans cost a one time registration, , sale, transfer, re-registration fee of $10 per vehicle. All other vehicles, including construction equipment, must be registered, but require no fee. Vehicles that utilize Island roads must have Division and Lot number clearly affixed on the vehicle. Use this form to register or change the registration on your vehicles.

Registration Tags are issued from the office only, not mailed. VIN Number is normally located on the driver’s side at the base of the windshield or on the driver’s door post. LAST NAME: ______FIRST NAME: ______DIVISION AND LOT NUMBER: _____ HOME PHONE: (____) ____-______CELL PHONE: (____) ____-______E-MAIL: ______ISLAND BUSINESS NAME:______FEE ENCLOSED: $______( $10 per car or truck)(Make Checks payable to HIC)

VEHICLE # 1 TYPE: Car / Truck / ATV / Golf Cart / Motor Bike MAKE: ______MODEL: ______VIN or SERIAL NUMBER: ______COLOR: ______VEHICLE # 2 TYPE: Car / Truck / ATV / Golf Cart / Motor Bike MAKE: ______MODEL: ______VIN or SERIAL NUMBER: ______COLOR: ______VEHICLE # 3 TYPE: Car / Truck / ATV / Golf Cart / Motor Bike MAKE: ______MODEL: ______VIN or SERIAL NUMBER: ______COLOR: ______CONTINUE ON REVERSE IF NECESSARY

C: My Documents/Forms/Vehicle Registration From.doc VEHICLE # 4 TYPE: Car / Truck / ATV / Golf Cart / Motor Bike MAKE: ______MODEL: ______VIN or SERIAL NUMBER: ______COLOR: ______VEHICLE # 4 TYPE: Car / Truck / ATV / Golf Cart / Motor Bike MAKE: ______MODEL: ______VIN or SERIAL NUMBER: ______COLOR: ______VEHICLE # 5 TYPE: Car / Truck / ATV / Golf Cart / Motor Bike MAKE: ______MODEL: ______VIN or SERIAL NUMBER: ______COLOR: ______VEHICLE # 6 TYPE: Car / Truck / ATV / Golf Cart / Motor Bike MAKE: ______MODEL: ______VIN or SERIAL NUMBER: ______COLOR: ______VEHICLE # 7 TYPE: Car / Truck / ATV / Golf Cart / Motor Bike MAKE: ______MODEL: ______VIN or SERIAL NUMBER: ______COLOR: ______VEHICLE # 8 TYPE: Car / Truck / ATV / Golf Cart / Motor Bike MAKE: ______MODEL: ______VIN or SERIAL NUMBER: ______COLOR: ______

C: My Documents/Forms/Vehicle Registration From.doc