2017-2019 WATERCRAFT REGISTRATION FORM …

1 2017 - 2019 WATERCRAFT REGISTRATION FORMN orth dakota Game and Fish DepartmentLicensing Section SFN 6102 (12/16) FEE SCHEDULE (Note: the fee schedule is prorated and based on length of boat.)ND WATERCRAFT REGISTRATION Number: ND___ ___ ___ ___ ___ Decal Number (Department Use Only): Contact Information (A valid state driver's license number or Social Security Number is required. Organizations must provide a Tax Identification Number.)First Name:Middle Initial:Last Citizen: Yes NoDate of Birth:SSN:ND Driver s License No. or ND Nondriver Photo ID No.:Organization:TIN (Tax Identification Number):Telephone:Email:Address Information (In addition to the primary address, an alternate mailing address or P.)

2 O. Box may be provided under Address 2.)Address:Address 2:City:State:Zip:County:Vessel Information (A Hull ID is required on all vessels. If your vessel does not have a Hull ID, contact the Game and Fish Department.)Make:Year:Hull ID:Length: (from bow to stern): :Manufactured in the US? Yes NoState of principal operation: ( north dakota )Purchased in ND? Yes NoPurchased from: Dealer IndividualVessel Detail (Select from each category below.)Is this a transfer of ownership? Yes No Fee enclosed: $_____By signing this form , you are confirming that all the information is true and valid.

3 Intentionally submitting false information may lead to prosecution under the laws of the state of north :_____ 2017 - 2019 ..$18 2018- 2019 ..$12 2019 ..$6 Boats under 16' (also canoes): 2017 - 2019 ..$36 2018- 2019 ..$24 2019 ..$12 Boats 16'-19'11" (also demonstrators): 2017 - 2019 ..$45 2018- 2019 ..$30 2019 ..$15 Boats 20' and over:1. Pleasure .. 2. Rental .. 3. Public owned .. 4. Demonstrator .. 5. Commercial .. TYPE OF USEVESSEL TYPE 1. Open .. 2. Cabin .. 3.

4 House .. 4. PWC .. 5. Pontoon .. 6. Paddlecraft .. 7. Aux. sail .. 8. Sail only .. 9. Inflatable .. 10. Air boat .. 11. Rowboat .. 12. Other .. 1. Wood .. 2. Aluminum .. 3. Steel .. 4. Fiberglass .. 5. Plastic .. 6. Rubber/vinyl/.. canvasHULL MATERIAL1. Air thrust .. 2. Propeller .. 3. Manual .. 4. Water-jet .. 5. 6. PROPULSION1. 2. Inboard .. 3. Sterndrive .. 4. Pod-drive .. 5. ENGINE DRIVE1. Gas .. 2. 3. Electric .. 4. FUELMail to:ND Game and Fish DepartmentAttn: WATERCRAFT Registrations100 N. Bismarck ExpresswayBismarck, north dakota 58501-5095 Phone: (701) 328-6300 All boats powered by a motor must be registered in the state of their primary use.

5 The current license period ends December 31, 2019 . Submit this REGISTRATION application form and appropriate fee (check/money order) to: north dakota Game and Fish Department WATERCRAFT Licensing address listed above. Registering a used WATERCRAFT purchased or given to you by an individual: Send this form , appropriate fee and proof of transfer of ownership. (Photocopy of the previous owner s REGISTRATION card, can-celed check or a signed note from the previous owner stating they have transferred this boat to you.) Transferring REGISTRATION from another state to north dakota : Send this form , appropriate fee and a copy of the REGISTRATION card from the state where previously registered.

6 New or used WATERCRAFT purchased from an in-state dealer: Send this form , appropriate fee and a copy of the bill of sale indicating payment of taxes. WATERCRAFT purchased from an out-of-state dealer: Send this form , appropriate fee and proof of sales taxes paid. If you did not pay sales tax in the state of purchase, get the One-Time Remittance form located at