Name(s): _______________________________ Phone #: _______________ Email (
optional): _________________________
***All documents that are signed must be Original or emailed with an acceptable computer-generated signature, no copies.***
No cross outs, white out, or write overs will be accepted on any form.
Requested Original Certificate of Title from Lienholder (contacted our office by phone or in person) -OR-
Out of State or Florida Certificate of Title -OR- Original Manufacturer’s Statement of Origin -OR-
Original USCG Release from Documentation
Application for Certificate of Title With/Without Registration (Form 82040 VS). Complete all applicable areas and
all owners/lessees must sign section 12.
Copy of all applicants’ current driver license or valid passport.
If the HIN is not 12 properly formatted characters as shown below provide a pencil tracing of the HIN or
contact FWC for inspection.
For Reduced Fee, Emergency Beacon: Provide unexpired NOAA Proof of Registration letter or Registration Form
1.
2.
EPIRB (Emergency Position Indicating Radio Beacon)
PLB (Personal Locator Beacon)
Registration Period: Expires midnight of 1
st
owner’s birthday (not prorated) 1 Year
2 Year 2 Year+
(25-27mths)
Fee: $__________ This consists of sales tax, title, registration, mail, and late (if applicable) fees
.
Payment by Credit Card: 2.5% fee with a $2.50 minimum Charged Amount Not to Exceed $_________(USD)
Name as it appears on Credit Card:_________________________________ Card Holder Phone #:____________
Credit Card Number:________________________________ 3 Digit Security Code: _______ Exp Date: ____/____
Payment by Check: Make payable to the Charlotte County Tax Collector in a U.S. bank check.
Payment by Phone: Will call for credit card (2.5%) or e-check (no fee), must pay by 4pm on processing day.
Additional Info:
Return using our Drop Boxes at any of our four locations or via Mail to the address below:
CHARLOTTE COUNTY TAX COLLECTOR
Processing & Imaging Department, Attn: Cherie
18500 Murdock Circle | Port Charlotte, FL 33948
Phone: 941.743.1350 | Fax: 941.623.1089 | Email: taxpi@charlottecountyfl.gov
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Charlotte County Tax Collector
Fee Chart & Worksheet
CHARLOTTE COUNTY TAX COLLECTOR
Processing & Imaging Department, Attn: Cherie
18500 Murdock Circle | Port Charlotte, FL 33948
Phone: 941.743.1350 | Fax: 941.623.1089 | Email: t[email protected]
CLASS
Regular Fees Reduced Fee w/EPIRB or PLB
1 Year 2 Year 1 Year 2 Year
$______________ (1)
$______________ (2)
$______________ (3)
1. Registration Fee:
From the amounts listed on the rate chart above
2. Title Fee:
Vessel Title Fee $5.75
Add $4.00 if previously registered in another state
Add $2.00 if there is a lien on the vessel (MAKING PAYMENTS)
3. Title Options:
Electronic Title – A paper title is NOT issued (no additional fee) or
Paper Title – A paper title is mailed in approximately 20 day (NOT AVAILABLE W/LIEN) add $ 2.50
Fast Title – A paper title is mailed immediately (NOT AVAILABLE W/LIEN & FAST TITLE RELEASE REQ’D) add $ 5.00
4. Late Fee:
If completed application not received in our office within 30 days from purchase date add $ 10.00
$______________ (4)
5. Sales Tax: Not applicable if the vehicle has been
owned for more than six (6) months and sales tax was paid.
$_______________ A
$_______________ B
$_______________ C
$_______________ D
$_______________ E
$_______________ F
A. Purchase Price
B. Trade In
C. Taxable Value (A - B)
D. County Sales Tax (1% of taxable value) not
to exceed $50
E. State Sales Tax (6% of taxable value)
F. Less Sales Tax paid in another state (attach proof)
G. Total Florida Sales Tax (D + E - F) - Enter on Line 5 ($18,000 state tax maximum)
6. Additional Fee(s):
If returning by mail: Add $.95 (CALL FOR EXPRESS MAIL FEES)
7. TOTAL AMOUNT DUE: (ADD LINES 1 THROUGH 6)
$______________ (5)
$______________ (6)
$______________ (7)
Payment by Credit Card: 2.5% fee with a $2.50 minimum fee Charged Amount Not to Exceed $____________(USD)
Name as it appears on Credit Card:_________________________________ Card Holder Phone #:_____________
Credit Card Number:_________________________________ 3 Digit Security Code: _______ Exp Date: ____/____
Payment by Check: Make payable to the Charlotte County Tax Collector in a U.S. bank check.
Payment by Phone: Will call for credit card (2.5%) or e-check (no fee), must pay by 4pm on processing day.
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CLASS A-1
All vessels less than 12 feet in length, and motorized canoes $13.50 $27.00 $10.95 $21.90
CLASS A-2
12 feet or more and less than 16 feet in length $29.63 $59.26 $24.38 $48.76
CLASS 1
16 feet or more and less than 26 feet in length $48.38
$96.76 $40.03 $80.06
CLASS 2
26 feet or more and less than 40 feet in length $122.63 $245.26 $101.88 $203.76
CLASS 3
40 feet or more and less than 65 feet in length $196.88 $393.76 $164.08 $328.16
CLASS 4
65 feet or more and less than 110 feet in length $234.38 $468.76 $195.03 $390.06
CLASS 5
110 feet or more in length $289.88 $579.76 $241.28 $482.56
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FLORIDA DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
APPLICATION FOR CERTIFICATE OF VESSEL TITLE
Please submit this form to your local tax collector office or license plate agency.
https://www.flhsmv.gov/locations/
Note: All fields are required unless otherwise stated or not applicable.
Application Type: ☐ Original ☐ Transfer
Request to print Certificate of Title: ☐ No ☐ Yes: In office ☐ Yes: Mailed
I I I
I I I
I
I
I
I I I
I
I I I
Section 1: OWNER/APPLICANT INFORMATION
Fleet Number
Unit Number
Owner's County of Residence
Owner Details:
Are you a Florida Resident? ☐ YES ☐ NO
Are you a US Citizen? ☐ YES ☐ NO
Are you deaf or hard of hearing? (Voluntary) ☐ YES ☐ NO
When joint ownership, please indicate if “or” or “and” is to be shown on title when issued.
☐ OR ☐ AND (If neither box is checked, the title will be issued with "and.")
Select, if applicable:
☐
Life Estate/Remainder Person
☐Tenancy by the Entirety ☐With Rights of Survivorship
Owner’s Name as It Appears on Driver License
(First, Full Middle/Maiden, & Last Name)
Owner’s Phone Number
(Voluntary)
Owner’s Email
(Voluntary)
Sex
Date of Birth
FL DL/ID or FEID/Suffix Number
Owner’s Mailing Address
City
State
Zip Code
Owner’s Residential Street Address
City
State
Zip Code
Mail To Customer Name
(If different from above owner)
Mail To’s Phone Number
(Voluntary)
Mail To’s Email
(Voluntary)
Sex
Date of Birth
FL DL/ID or FEID/Suffix Number
Mail To’s Address (If different from above mailing address)
City
State
Zip Code
Co-Owner Details:
Are you a Florida Resident? ☐ YES ☐ NO
Are you a US Citizen? ☐ YES ☐ NO
Are you deaf or hard of hearing? (Voluntary) ☐ YES ☐ NO
☐
Co-Owner or
☐
Lessee’s Name as It Appears on Driver License
(First, Full Middle/Maiden, & Last Name)
Co-Owner’s Phone Number
(Voluntary)
Co-Owner’s Email
(Voluntary)
Sex
Date of Birth
FL DL/ID or FEID/Suffix Number
Co-Owner’s/Lessee’s Mailing Address
City
State
Zip Code
Co-Owner’s/Lessee’s Residential Street Address
City
State
Zip Code
For all vessels 26’ or more in length and all sailboats.
ft. in.
Length
ft. in.
I
Section 2: VESSEL DESCRIPTION
Hull (Vessel) Identification Number (HIN)
☐ HIN is needed
(Vessel does not
have a HIN)
Florida Title Number
FL/DO Number
Renewal of Number
☐
YES
☐
NO
State of
Principal Use
Model
Year
Weight
Draft of Vessel (The depth of water a vessel draws.)
☐ I certify the vessel listed above has previously been branded as a damaged hull. I certify the vessel hull is damaged.
☐ I certify the vessel listed
above has previously been branded as: Specify: ______________________________________
State of brand assignment
(If known)
Vessel Type
☐ Air Boat
☐ Inflatable Boat
☐ Pontoon
☐ Auxiliary Sailboat ☐ Open Motorboat ☐ Rowboat
☐ Cabin Motorboat ☐ Paddle Craft ☐ Sailboat
☐ Houseboat
☐ Personal Watercraft
☐
Other:
___________________________
(Specify)
Hull Material
☐ Rubber/Vinyl/Canvas
☐ A
lum
inum ☐ Steel
☐ Fiberglass ☐ Wood
☐ Plastic
☐ Other:
________
(Specify)
Propulsion Type
☐ Air Thrust ☐
Manual
☐ Propeller ☐ Sail
☐ Water Jet
☐ Other:
_________
(Specify)
Engine Drive Type
☐ Inboard
☐ Outboard
☐ Pod Drive
☐ Sterndrive
☐ Other: _____
(Specify)
Fuel
☐ Electric
☐ D
ies
el
☐ Gas
☐ Other:
______
(Specify)
Primary Operation
☐ Commercial Blue Crab
☐
Commercial Charter Fishing
☐ Commercial Spiney Lobster ☐ Exempt ☐ Recreational Rent or Lease
☐ Commercial Live Bait
☐ Commercial Passenger Carrying ☐ Commercial Sponge ☐ Government ☐ Commercial Other:
☐ Commercial Mackerel
☐ Commercial Shrimp Non-Recip. ☐ Commercial Stone Crab ☐ Hire (Livery)
________________
☐ Commercial Oyster
☐
Commercial Shrimp Recip.
☐
Dealer/Manuf. Demonstration
☐
Recreational (Pleasure)
(Specify)
Section 3: OUT-OF-STATE/OUT-OF-COUNTRY CERTIFICATION
If checked, the following certification is made by the applicant:
(Please list each state/country previously titled/registered, if known)
☐ The vessel listed above has previously been titled or registered out-of-state. ☐ The vessel listed above has previously been titled or registered out-of-country.
Previous State of Issue
Previous Registration Number
Previous State of Issue
Previous Registration Number
Section 4: DOCUMENTED/FOREIGN-DOCUMENTED VESSEL CERTIFICATION
☐
I certify the vessel listed above is not currently a documented vessel or foreign-documented vessel. (If selected, one of the documents listed below is required.)
☐ U.S. Coast Guard Release Documentation Form is attached or ☐ Copy of Canceled Documentation Papers/Record is attached
HSMV 82040 VS – Rev. 07/23 https://www.flhsmv.gov RULE 15C-21.001, FAC
FLORIDA DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
APPLICATION FOR CERTIFICATE OF VESSEL TITLE
Section 5: LIENHOLDER INFORMATION (If applicable)
ELT Customer
☐
YES
☐
NO
☐ FEID/Suffix # ☐ DMV Account # ☐ DL/ID #, Sex and DOB
Lienholder’s Phone Number (Voluntary)
Lienholder’s Email (Voluntary)
Date of Lien
Lienholder’s Mailing Address
City
State
Zip Code
Lienholder’s Name
(If box is not checked, title will be mailed to the first lienholder.)
☐ Check this box if you, lienholder representative, authorize the Department to send
the vessel title to the owner and sign here: _______________________
I I I I
I
Section 6: SECURITY INTEREST
☐
I certify that the vessel listed above has security interests. (More than one form HSMV 82040 may be used for additional secured parties.)
Secured Party’s Name
Secured Party’s Mailing Address
City
State
Zip Code
I
Section 7: TRANSFER TYPE (If applicable)
If ownership has transferred, how and when was the vessel acquired?
☐
Inheritance
☐ Sale (Price: $__________ . ____ ) ☐ Gift ☐ Repossession ☐ Court Order ☐ Other
(Specify)
: ____________________
Date Acquired:
_____/_____/_______
Section 8: DEALER SALES TAX REPORT AND VESSEL TRADE IN INFORMATION (If applicable)
Florida Sales Tax Registration Number
Dealer License Number
Date of Sale
Amount of Tax
Dealer/Agent Signature
Year of Trade In
Make of Trade In
Title Number of Trade In (If known)
Vessel Identification Number of Trade In
Section 9: SALES TAX EXEMPTION CERTIFICATION (If applicable)
I certify the recreational vessel described has been purchased and is exempt from the sales tax imposed by Chapter 212, Florida Statues, by:
☐
Purchaser (state agencies, counties, etc.) holds valid exemption certificate
Consumer’s Certificate of Exemption Number:
__________________
☐
Vessel will be used exclusively for rental.
Sales Tax Registration Number:
_________________________
I hereby certify that ownership of the vessel described on this application, is not subject to Florida Sales and Use Tax for the following reason:
☐
Inheritance
☐
Gift
☐
Divorce Decree
☐
Transfer between a married couple
☐
Other:
_________________________
☐ Even trade or trade down _____________________________________________________________________
(State the facts of the even trade or trade down and the transferor information, including the transferor’s name and address.)
Section 10: REPOSSESSION DECLARATION
☐ I certify that this vessel was repossessed upon default in the terms of the lien instrument and is now in my possession.
Section 11: NON-USE AND OTHER CERTIFICATIONS
If checked, the following certifications are made by the applicant:
☐ I certify that the certificate of title is lost or destroyed.
☐ The vessel identified will not be operated on the waters of this state until properly registered.
☐
Other: (explain)
_____________________________________________________________________________
Section 12: APPLICATION ATTESTMENT AND SIGNATURES
I/We physically inspected the HIN. (More than one form HSMV 82040 may be used for additional signatures.)
Under penalties of perjury, I declare that I have read the foregoing document and that the facts stated in it are true.
Full Name of Applicant, Owner
Signature of Applicant, Owner
Date
Full Name of Applicant, Co-Owner
Signature of Applicant, Co-Owner
Date
Section 13: RELEASE OF SPOUSE OR HEIRS INTEREST (If applicable)
The undersigned person(s) state(s) that ____________________________________________________________________ died on
_______________
.
(Name of deceased) (Date)
☐
Testate (with a will)
☐
Intestate (without a will) and left the surviving heir(s) named below.
☐ When applicable, the heir(s) (named below) certifies that the certificate of title is lost or destroyed.
Under penalties of perjury, I declare that I have read the foregoing document and that the facts stated in it are true.
(More than one form HSMV 82040 may be used for additional signatures.)
Full Name of
☐
Spouse,
☐
Co-Owner or
☐
Heir(s)
Signature of Spouse, Co-Owner or Heir(s)
Date
Full Name of
☐
Spouse,
☐
Co-Owner or
☐
Heir(s)
Signature of Spouse, Co-Owner or Heir(s)
Date
That at the time of death the decedent was owner of the vessel described in section 2 of this form. The person(s) signing above hereby releases all of
his/her/their right, title, interest and claim as heir(s) at law, legatee(s), devisee(s), or otherwise to the aforesaid vessel to:
Full Name of Applicant
Signature of Applicant
Date
Full Name of Applicant
Signature of Applicant
Date
HSMV 82040 VS – Rev. 07/23 https://www.flhsmv.gov RULE 15C-21.001, FAC