Anthony J. Dattilio Columbiana County Clerk of Courts Application for Certificate of Title to a Watercraft or Outboard Motor Type or print in ink Check type of application(s) Fee of $5.00 for failure to apply for title within 30 days of assignment Applicants name SSN/EIN Applicants address hereby declares under penalty of perjury that he/she is the lawful (own er/purchaser/lienholder) of the following described watercraft or outboard motor and hereby makes application(s) for the f ollowing: Original Certificate of Title Evidence of ownership Applicant acquired said MCO, Previous title #, Registration, etc.watercraft or outboard motor by state how acquired From (Name of previous owner) (Address of previous owner) The following is a full statement of all liens on said motor vehicle. If no lien, state "none". If more than one lien, attach statement of all liens(Lien holder) (Lien holder address) Duplicate Certificate of Title Applicant states that Certificate of Title # has been ; that (lost, stolen, destroyed) said watercraft or foutboard motor has not been sold or disposed of except as stated below. The vehicle is in the possession of: residing at: and that if said Certificate of Title be hereby recovered by this applicant, he will deliver same to Cle rk of Courts for cancellation. The following is a full statement of all liens on said motor vehicle. If no lien, state "none". If more than one lien, attach statement of all liens(Lien holder) (Lien holder address) Memorandum Certificate of Title for certificate of Title # Salvage Certificate of Title Year Model Length feet inches Watercraft Serial number Motor Motor serial number Purchase Price Trade in Amount Sales/use tax Vendors number Permit number Condition of watercraft or outboard motor (check only one)Good Fair Poor Wrecked Tax exemption Yes Reason Sales credit amount Warning: You are required by law to state the true selling price. A fals e statement is in violation of section 2921.13 of the Ohio Revised Code and is punishable by six months imprisonment and a fine of up to one thousand dollars or both. All trans fers are audited by the Department of Taxation. The seller and the buyer must provide any information requested by the Department of Taxation. The buyer may be assessed any a dditional tax found to be due. Applicants signature Sworn to and subscribed in my presence by: this _____ day of _______,____ SEAL Clerk, Deputy Clerk of Courts, Notary American LegalNet, Inc. www.USCourtForms.com