DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES …

1 DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES . DIVISION OF MOTORIST SERVICES. SUBMIT THIS FORM TO YOUR LOCAL TAX COLLECTOR OFFICE. APPLICATION FOR VESSEL DUPLICATE REGISTRATION, REPLACEMENT DECAL. AND change OF CLASSIFICATION. (SEE APPLICATION INSTRUCTIONS ON REVERSE SIDE). (1) TYPE OF REQUEST. DATE: TELEPHONE #. I (We) hereby make application for the following: Duplicate Certificate of Registration Replacement Decal change of Vessel Classification (2) VESSEL INFORMATION. Make of Vessel Hull Identification Number Model Year Title # Reg. #. Date of Current Registration Previous Decal Issued Decal Expires (3) CERTIFICATION. A. The current original certificate of registration to the above described vessel was: Lost Defaced Damaged Never Received B. The original decal to the above vessel was: Lost Stolen Defaced Damaged Never Received C. I (We) hereby request that the use of my (our) vessel registered as FL/DO.

2 Be changed from: Commercial to Recreational Craft Recreational Craft to Commercial*. *Please circle one of the following to indicate the intended commercial use of the vessel: Blue Crab (BC) Charter (CC) Fish (CF) Live Bait (LB) Mackerel (CM) Other (OT) Oyster (OY). Shrimp (SH Reciprocal, SN Non-Reciprocal) Spiny Lobster (CL) Sponge (SP) Stone Crab (SC). NOTE: See Item 3 & 4 under "Instructions to Apply for a change of Class" on the reverse side of this form for non- resident/alien commercial licensing requirements. (NAME OF OWNER) (NAME OF CO-OWNER). (OWNER DL NUMBER) (DATE OF BIRTH) (CO-OWNER DL NUMBER) (DATE OF BIRTH). (ADDRESS) (ADDRESS). (CITY) (STATE) (ZIP) (CITY) (STATE) (ZIP). (4) ATTESTMENT. (CHECK WHEN APPLICABLE). Decal was reported stolen to the: Police DEPARTMENT or Sheriff's Office I hereby certify under the penalty of perjury that the decal for the vessel listed in Section 2, is no longer or has never been in my possession for the reason checked in Section 3.

3 All information herein is true and correct to the best of my knowledge. (Owner/Co-Owner's Signature) (Date). Complete the following, if applicable: was surrendered to the tax collector: (Decal) (County) ( agency ). (Signature of agency Personnel) (Date). HSMV 87015 (Rev. 07/11) S INSTRUCTIONS TO APPLY FOR VESSEL DUPLICATE REGISTRATION. OR REPLACEMENT DECAL. 1. Complete Sections 1, 2, 3 and 4 (where applicable) on the reverse side of this form. 2. When applying for a replacement decal, ensure that the "previous decal issued" is indicated on the reverse side of this form in Section 2. If the decal was stolen a copy of the police report must be submitted and the decal may be replaced at no charge. 3. Submit this completed form along with applicable service fees to any county tax collector's office or license plate agency in Florida. INSTRUCTIONS TO APPLY FOR A VESSEL change OF CLASS. 1.

4 Complete Sections 1, 2, 3 and 4 (where applicable) on the reverse side of this form. 2. Attach the original copy of your current certificate of registration OR specify in Section 3 (A), on the reverse side of this form, why your current registration is not available. 3. If you (non-resident/alien) currently have a sojourner registration and are changing the classification of your vessel from a recreational craft to commercial craft, an additional $50 commercial vessel fee is required. A Saltwater Products License is required of all individuals who sell saltwater products in Florida. Contact the Commercial Saltwater License Section (850-487-3122) of the Florida Fish and Wildlife Conservation Commission to obtain cost of any required licenses or permits. 4. Please note that a non-resident/alien is a person who has not maintained a continuous residence in Florida for a period of one year and has not actually resided in a given county for a period of six months immediately preceding the making of application for a license.

5 An alien is a person who is not a citizen of the United States, although such a person may be a resident of Florida. 5. Submit this completed form along with applicable service fees to any county tax collector's office or license plate agency in Florida. Check your local phone book government pages or visit the following website for current mailing addresses: HSMV 87015 (Rev. 07/11) S