OREGON LOST or REPLACEMENT BOAT TITLE APPLICATION

OFFICE USE ONLY: cc / cash / ck / cashiers ck / mo: ______$______

SECTION 1: Applicant MUST complete Oregon boats only OR# Hull Serial Number FEES: circle/write amount see page 2 for additional instructions Length ft. in. Model Year Manufacturer Title NO Change $25 Engine (check one) Primary Propulsion (check one) Title with Changes $75  Outboard  Inboard  Pod  Propeller  Water Jet  Sail  Manual  Other  Other Late Fee $25

Registration (see page 2) $ Fuel (check one) Vessel Type (check one) Material (check one)  Gas  Diesel  Open Motorboat  Cabin Motorboat  Aluminum  Wood Replacement Registration,  Electric  Other  Pontoon Motorboat  Sail  Jet Ski  Fiberglass  Other (check one, registration current) $15  Card Only  Card + Decals SECTION 2: Last Title Holders MUST complete this section with signature verification

I / we certify the title is:Lost Destroyed  Never Received I / we are :  Re leasing Interest  Requesting a New Title (check one) (check one) Print Last Owner Name: Signature: Date:

Print Last Co-Owner Name: Signature: Date:

Lienholder Line Stamp (*See page 2) : Signature: Date:

By signature above, I / we certify the statements above are true and correct and if the boat is sold do hereby release all interest in the vessel described above. I / we will defend the State of Oregon against all claims or assertions of claims it may be subject to arising from this application. Any false statement may result in a fine.

SIGNATURE VERIFICATION: Last owner(s) signature(s) above must be either notarized or include photocopies of each owner’s driver’s license, front and back or other signed photo identification.

NOTARY PUBLIC: State of Oregon, County of ______subscribed before me by ______as owner and if any, ______co-owner on this ______day of ______, 20___. Notary Public Signature ______My commission expires on ______

SECTION 3: All Applicant(s) MUST complete

Owner (print full legal name) Birth Date mm/dd/yyyy Phone Number

Mailing Address, City, State, Zip Email

Co-Owner (print full legal name) Birth Date mm/dd/yyyy

Survivorship: Joint Owners agree that the title will be issued with right of survivorship (ORS 105.920)  Yes  No Lienholder (security interest holder/lender) Name

Lienholder Address, City, State, Zip

I/we certify under penalty of law the information given by me on this application is true, correct and complete to the best of my knowledge and belief and that Oregon is the principal state of use.

Applicant Signatures: ______Date: ______

RETURN APPLICATION TO: Oregon State Marine Board Attn: Title & Registration PO Box 14145 Salem OR 97309-5065

Boat Registration Fee Schedule as of November 1, 2019 All motorboats regardless of motor type and sailboats 12 feet and longer LENGTH (ft = feet) FEE LENGTH (ft = feet) FEE more than 4 ft to 5 ft $34.75 more than 23 ft to 24 ft $147.80 more than 5 ft to 6 ft $40.70 more than 24 ft to 25 ft $153.75 more than 6 ft to 7 ft $46.65 more than 25 ft to 26 ft $159.70 more than 7 ft to 8 ft $52.60 more than 26 ft to 27 ft $165.65 more than 8 ft to 9 ft $58.55 more than 27 ft to 28 ft $171.60 more than 9 ft to 10 ft $64.50 more than 28 ft to 29 ft $177.55 more than 10 ft to 11 ft $70.45 more than 29 ft to 30 ft $183.50 more than 11 ft to 12 ft $76.40 more than 30 ft to 31 ft $189.45 more than 12 ft to 13 ft $82.35 more than 31 ft to 32 ft $195.40 more than 13 ft to 14 ft $88.30 more than 32 ft to 33 ft $201.35 more than 14 ft to 15 ft $94.25 more than 33 ft to 34 ft $207.30 more than 15 ft to 16 ft $100.20 more than 34 ft to 35 ft $213.25 more than 16 ft to 17 ft $106.15 more than 35 ft to 36 ft $219.20 more than 17 ft to 18 ft $112.10 more than 36 ft to 37 ft $225.15 more than 18 ft to 19 ft $118.05 more than 37 ft to 38 ft $231.10 more than 19 ft to 20 ft $124.00 more than 38 ft to 39 ft $237.05 more than 20 ft to 21 ft $129.95 more than 39 ft to 40 ft $243.00 more than 21 ft to 22 ft $135.90 more than 40 ft to 41 ft $248.95 more than 22 ft to 23 ft $141.85 more than 41 ft to 42 ft $254.90 If the watercraft is longer than 42 feet or under 4 feet calculate the fee: $5.95 x feet (rounded up) + $5

Lienholder (Security Interest Holder / Lender): Must include line stamp when available, signature and date or a separate lien release letter on lender letterhead.

SPECIAL INSTRUCTIONS:

1) Certified / Return Receipt Mail:

 Fill in the vessel data information.  Print the former owner, co-owner and lender in the middle section of the form. Make a copy of the form to mail.  Write a letter to the former owner(s) and lender stating you have purchased the boat without a title and need their release of interest signatures on the form.  Mail the letter and form to owner(s) and a second letter to any lender as Certified Mail, Return Receipt Requested at your local post office. If multiple owners letter must be addressed to ALL.  The Post Office will return it to the sender if undeliverable. Send the unopened letter(s), your application as new owner, an original Bill of Sale, and check or money order payable to OSMB for the fees.  If the green Return Receipt card is returned with a signature, but the form is not returned within 30 days, send the Return Receipt with your application as new owner, an original Bill of Sale and a check or money order payable to OSMB for the fees.

2) Any other situations please call Oregon State Marine Board (503) 378- 8587 or email to [email protected]

3) You can also visit our website at: www.boatoregon.com

250-041 10/2019