Dmv Form 841 PDF Details

Dmv Form 841 is a form used to request an exemption from the motor vehicle emissions inspection program. The form must be completed and submitted by the registered owner of the vehicle, or their agent. There are a number of reasons why you might need to submit a Dmv Form 841, including if your car is too old, has all original parts, or you have a medical condition that prevents you from completing an emissions test. If you're unsure whether or not you need to submit a Dmv Form 841, contact your local Department of Motor Vehicles for more information.

QuestionAnswer
Form NameDmv Form 841
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesgeorgia boat registration, boat registration in ga, boat registration form, B1

Form Preview Example

STATE OF ALASKA

DIVISION OF MOTOR VEHICLES

BOAT REGISTRATION APPLICATION

Notice: A copy of this application may be used as a temporary registration for up to 60 days. The temporary registration becomes invalid when a certificate of number is issued by DMV.

BASIC BOAT INFORMATION - MUST BE COMPLETED IN FULL ON ALL APPLICATIONS

PRESENT AK BOAT NUMBER

REASON FOR APPLICATION

 

 

 

 

o NEW

o TRANSFER OF OWNERSHIP

o

DUPLICATE DECAL ($5)

AK

o RENEWAL

 

 

 

o

DUPLICATE CERTIFICATE ($5)

BOAT NAME (IF APPLICABLE)

CLASS OF BOAT

o

POWER BOAT

(B1)

$24

 

 

o

NON-POWER BOAT

(B2)

$10 (Registration is optional for non-powered)

 

 

 

 

 

 

 

COMPLETE FOR NEW BOATS, TRANSFERS, OR WHEN INFORMATION HAS CHANGED

HULL IDENTIFICATION NUMBER (HIN)

ADF&G # (IF ANY)

LENGTH (FT)

YEAR

MAKE/BUILDER OF BOAT

 

 

 

 

 

 

 

 

 

 

 

 

BOAT TYPE

 

PROPULSION

USE

FUEL TYPE

HULL MATERIAL

o A. RUNABOUT/SKIFF

 

o A. OUTBOARD

o A. PLEASURE

o A. GAS

o A. ALUMINUM/METAL

o B. CABIN CRUISER

 

o B. INBOARD

o B. COMMERCIAL PASSENGER

o B. DIESEL

o B. FIBERGLASS/PLASTIC

o C. PWC (i.e. JET SKI)

 

o C. INBOARD/OUTDRIVE

o C. COMMERCIAL FISHING

o C. OTHER

o C. WOOD

o D. HOUSEBOAT

 

o D. SAIL ONLY

o D. RENTAL

o D. NONE

o D. INFLATABLE

o E. SAILBOAT

 

o E. OARS/PADDLES

o E. OTHER

 

o E. OTHER

o F. OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HULL COLOR

 

TRIM COLOR

CABIN COLOR

CONTACT TELEPHONE NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

OWNER NAME AND ADDRESS INFORMATION - MUST BE COMPLETED IN FULL ON ALL APPLICATIONS

MAILING

STREET/PO BOX

CITY

STATE

ZIP CODE

ADDRESS:

 

 

 

 

 

 

 

 

 

RESIDENCE

PHYSICAL LOCATION (NO PO BOX OR MAIL CACHE)

CITY

STATE

ZIP CODE

ADDRESS:

 

 

 

 

 

 

 

 

 

OWNER

FULL NAME (FIRST, MIDDLE, LAST, SUFF.) OR COMPANY NAME

SSN*

DOB

DRIVER LICENSE #

#1

 

 

 

 

 

 

 

 

 

#2

 

 

 

 

 

 

 

 

 

#3

 

 

 

 

 

 

 

 

 

#4

 

 

 

 

 

 

 

 

 

I certify under penalty of law that I am the legal owner of the boat described in this application, that this boat is used primarily in Alaska and that all statements in this application are true and correct. I also acknowledge that I must notify DMV within 15 days of change of address or if the boat is destroyed, abandoned or becomes documented.

PRINTED NAME AND SIGNATURE OF APPLICANT

DATE

 

 

DMV USE ONLY

PREV. STATE

STICKER NUMBER

BATCH

AMVC

DOCS. ACCEPTED:

 

AK REG

MCO

CARP. CERT.

BOS

OWNER AFF.

TITLE

FEES:

$5 $10 $24

PAYMENT TYPE: CA CC CK

DATE

*The Social Security Number (SSN) will be used only for DMV purposes and will not be disclosed as part of a boat record. Disclosure of the SSN is not required by law.

Form 841 (Rev. 10/2009)

Alaska.gov/dmv

This application may be submitted in person or mailed to any DMV for processing.

Division of Motor Vehicles

ATTN: Correspondence Unit

1300 W Benson Blvd., STE 200

Anchorage AK 99503-3600

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boat registration form conclusion process shown (part 1)

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