vessel data/use tax - department of licensing · vessel data/ use tax use this form, along with the...

X Vessel Data/ Use Tax Use this form, along with the Vessel Title Application, when applying for a vessel title for the first time or for a recently acquired vessel. Vessel purchase price (or value if gift/trade/inheritance) Boat trailer purchase price Trailer plate/VIN Vessel description Registration number Model year Manufacturer name Model name Hull Identification Number (HIN) Length of vessel (in feet) Coast Guard documentation number, if applicable Date acquired Date vessel entered Washington (if from out of state) County of moorage Check applicable boxes Type of boat Airboat Auxiliary sail Cabin motorboat Houseboat Inflatable boat Open motorboat Paddlecraft Personal watercraft (jetski) Pontoon boat Row boat Sail only Other Hull material Aluminum Fiberglass Plastic Rubber/Vinyl/ Canvas Steel Wood Other Prop type Air thrust Manual Propeller Sail Water jet Other Fuel Diesel Electric Gasoline Other Primary use Charter fishing Commercial fishing Com’l passenger Dealer/Mfg demo Other com’l operation Pleasure Rent/Lease Exemptions 1. Excise tax exemption is claimed for this vessel for the following reason: Used exclusively for commercial fishing purposes (attach a copy of commercial fishing license). Owned by a non-profit organization or association engaged in character building of boys and girls under 18 years old, and used only for such purposes identified in RCW 84.36.030 (attach copy of Department of Revenue Certificate of Exemption). Owned by a Washington enrolled tribal member who lives in Indian Country (attach Department of Licensing form TD-420-023). Owned and operated by the United States government, a state of the United States, or any municipality or political subdivision thereof. 2. Use tax exemption is claimed for this vessel for the following reason: Used for commercial fishing predominantly outside Washington territorial waters – three mile limit (attach copy of commercial “outside three mile” fishing license). Used for bare boat rental (provide Washington Unified Business Identifier (UBI) number): Acquired by gift or inheritance (additional documents may be required). Transferred within marital community. Delivered to a Washington enrolled tribal member who lives in Indian Country (attach notarized statement from seller). Condition of vessel (Select one) Condition 1 means your vessel is well maintained. Considerations may include, but are not limited to: • Mechanically sound • Minor repairs needed • May have additional options added • Low to average engine hours Condition 2 means your vessel is in need of repair. Considerations may include, but are not limited to: • Areas are worn and faded even after cleanup • Major repairs needed • Corrosion, dents, cracks, and/or tears evident • Higher than average engine hours I certify under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct. Date and place (city or county) signed Registered owner signature TD-420-162 (R/12/16)WA Engine drive Inboard Outboard Pod drive Sterndrive Other

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Page 1: Vessel Data/Use Tax - Department of Licensing · Vessel Data/ Use Tax Use this form, along with the Vessel Title Application, when applying for a vessel title for the first time or

Vessel Data/ Use TaxUse this form, along with the Vessel Title Application, when applying for a vessel title for the first time or for a recently acquired vessel.

Vessel purchase price (or value if gift/trade/inheritance) Boat trailer purchase price Trailer plate/VIN

Vessel descriptionRegistration number Model year Manufacturer name Model name

Hull Identification Number (HIN) Length of vessel (in feet) Coast Guard documentation number, if applicable

Date acquired Date vessel entered Washington (if from out of state) County of moorage

Check applicable boxesType of boat

Airboat Auxiliary sail Cabin motorboat Houseboat Inflatable boat Open motorboat Paddlecraft Personal watercraft (jetski) Pontoon boat Row boat Sail only Other

Hull material Aluminum Fiberglass Plastic Rubber/Vinyl/

Canvas Steel Wood Other

Prop type Air thrust Manual Propeller Sail Water jet Other

Fuel Diesel Electric Gasoline Other

Primary use Charter fishing Commercial fishing Com’l passenger Dealer/Mfg demo Other com’l operation Pleasure Rent/Lease

Exemptions1. Excise tax exemption is claimed for this vessel for the following reason:

Used exclusively for commercial fishing purposes (attach a copy of commercial fishing license). Owned by a non-profit organization or association engaged in character building of boys and girls under 18 years old, and used only for such purposes identified in RCW 84.36.030 (attach copy of Department of Revenue Certificate of Exemption).

Owned by a Washington enrolled tribal member who lives in Indian Country (attach Department of Licensing form TD-420-023).

Owned and operated by the United States government, a state of the United States, or any municipality or political subdivision thereof.

2. Use tax exemption is claimed for this vessel for the following reason: Used for commercial fishing predominantly outside Washington territorial waters – three mile limit (attach copy of commercial “outside three mile” fishing license).

Used for bare boat rental (provide Washington Unified Business Identifier (UBI) number): Acquired by gift or inheritance (additional documents may be required). Transferred within marital community. Delivered to a Washington enrolled tribal member who lives in Indian Country (attach notarized statement from seller).

Condition of vessel (Select one) Condition 1 means your vessel is well maintained. Considerations may include, but are not limited to:• Mechanicallysound• Minorrepairsneeded• Mayhaveadditionaloptionsadded• Lowtoaverageenginehours

Condition 2 means your vessel is in need of repair. Considerations may include, but are not limited to:• Areasarewornandfadedevenaftercleanup• Majorrepairsneeded• Corrosion,dents,cracks,and/ortearsevident• Higherthanaverageenginehours

I certify under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct.

Date and place (city or county) signed Registered owner signature

TD-420-162 (R/12/16)WA

Engine drive Inboard Outboard Pod drive Sterndrive Other

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