Application for Confidential Registration
Obtaining confidential status by an agency requires the use of this form when applying. The person representing that agency has to complete this form and send it along with all the necessary information.
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DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES DIVISION OF MOTOR , 6 7 S ( 5 9 , & ( 6
BUREAU OF , 6 6 8 $ 1 & ( 2 9 ( 5 6 , * + 7
2900 APALACHEE P A
RKWAY
NEIL KIRKMAN BUILDING
TALLAHASSEE, FLORIDA 32399-0518
APPLICATION FOR “CONFIDE NTIAL” REGISTRATION
NAME AND ADDRESS OF AGENCY APPLYING FOR “CONFIDENTIAL” STATUS:
__________________________________________ STATE OF FLORIDA – COUNTY OF ______________________
__________________________________________ Sworn to and Subscribed before me this _______________ day of
__________________________________________ ______________________________________, 2 __________ .
__________________________________________ Signature of Notary: ___________________________________
Telephone Number: ______________________________ Print, Type or Stamp Notary Name ___________________________________
Signature of Applicant: ____________________________ Personally Known or Produced __________________________
Title of Applicant: ___________________________ ____ My Commission Expires: __________________________________________
VESSEL INFORMATION
Manufacturer of Vessel : ___________________________________________________________________________
Model Year: ________________ Length: ___________ Hull ID Number: ___________________________________
HULL PROPULSION FUEL
1. Wood 1. Outboard 1. Gas
2. Aluminum 2. Inboard 2. Diesel 3. Steel 3. Sail 3. Other
4. Fiberglass 4. Inboard/Outboard
5. Wood/Fiberglass 5. Air Propelled
6. Other 6. Other
PLEASE INDICATE BELOW, THE DOCUMENTATION WHIC H IS ENCLOSED WITH YOUR APPLICATION:
Manufacturer’s Statement of Origin
Title Number _______________________
Florida Registration Number ___________________________
Certified Copy of Applicable Court Order or Final Order of Judgement
FICTITIOUS NAME AND ADDRESS TO BE PLACED ON THE REGISTRATION
NAME: ______________________________________________________ BIRTHDATE: ____________________
ADDRESS: ___________________________________________________________________________________
CITY: _________________________________________ STATE __________ ZIP CODE ___________________
(Please see the reverse side for application requirement information.) HSMV 87307 (Rev. 12/11) www.flhsmv.gov
FOR OFFICE USE ONLY
Florida Registration Number Issued
FL ______________________________________ Title Number _____________________________
Please submit as much documentation on vessel as available.
REQUIRED DOCUMENTATION:
1. If a new vessel, please provide:
A. A properly completed Manufactur er’s Statement of Origin, if purchased in one of
the following states:
District of Columbia Minnesota South Carolina
Florida Montana South Dakota
Hawaii New Jersey Texas
Illinois New Mexico Utah
Indiana New York Vermont
Iowa North Carolina Virginia
Kentucky Ohio Washington
Maryland Oklahoma West Virginia
Massachusetts Rhode Island Wisconsin
Michigan
B. If purchased in a state othe r that the states indicated in “A” above, please provide
a bill of sale or its equivalent.
2. If a used vessel, please provide as much of the following documentation as is available:
A. Florida registration.
B. Hull identification number.
C. Previously issued title (if applicable) properly assigned.
D. Certified copy of court order.
E. Previous owner’s name.
HSMV 87307 (Rev.12/11) www.flhsmv.govRelevant article from our knowledge database At the least, it's going slow off your application and prevent you from getting to work as rapidly as possible. Our application does not need on-site IT resources and solutions. The internet application includes four steps. A similar technology application was developed and the primary aim of this application is to give advantages to the education market.
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