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Please enter your hull identification number
You may find it at the bottom of the capacity label on the stern of the boat.
Example: CN-XEE 12345J405
{{formValidation.message}}
MANUFACTURER'S CERTIFICATE OF ORIGIN FOR A BOATDESCRIPTION OF BOAT |
Hull ID: | XEE-{{form.hullID}} | ||
Trade Name: | {{boatCertificateData.trade_name}} | Model Name: | {{boatCertificateData.model_name}} |
Hull Material: | {{boatCertificateData.hull_material}} | Type of Boat: | {{boatCertificateData.type_of_boat}} |
Propulsion: | {{boatCertificateData.propulsion}} | Fuel: | {{boatCertificateData.fuel}} |
Length (L): | {{boatCertificateData.length}} | BEAM (W): | {{boatCertificateData.beam}} | DRAFT (H): | {{boatCertificateData.draft}} |
U.S. Coast Guard Capacity Plate Information (where applicable):
Place of Construction: {{boatCertificateData.place_of_construction}} The manufacturer further certifies that this was the first transfer of such new boat, and that all information given herein is true and accurate to the best of his knowledge. |
Company Name: | Intex Recreation Corp. |
Street Address: | 4001 Via Oro Ave., Suite 210 |
City, State, Zip: | Long Beach CA 90810 |
Manufacturer's Certification |
Authorized Signature |
ASSISTANT GENERAL MANAGER |
FIRST ASSIGNMENT
For Value Received, the undersigned hereby transfers this Statement of Origin and the boat described therein to:
Name: |
|
Address: |
|
and certifies that the boat is new and has not been registered in this or any other state; he also warrants the title of said boat at time of delivery, subject to the liens and encumbrances, if any, as set below:
Amount of Lien | Date | To Whom Due | Address |
|
Dated | ,20 | at |
Transferer (Firm Name) |
Sign Here |
Position |
SECOND ASSIGNMENT
For Value Received, the undersigned hereby transfers this Statement of Origin and the boat described therein to:
Name: |
|
Address: |
|
and certifies that the boat is new and has not been registered in this or any other state; he also warrants the title of said boat at time of delivery, subject to the liens and encumbrances, if any, as set below:
Amount of Lien | Date | To Whom Due | Address |
|
Dated | ,20 | at |
Transferer (Firm Name) |
Sign Here |
Position |