MrruHrsorn Drpnnr,tarr.tr
or Narunll
Rtsouncrs
PRINT ALL OWNERS NAMES BELOW:
RE: Yr.
/ Make:
HIN:
Length:
-'
Reg. #:
complete the following Statement of Facts regarding the above referenced watercraft.
Note that all owners must sign this form below.
Please
The only proof of clwnership that I have for this watercraft is:
From whom was it purchased?
When and where was it purchased?
What happerred to the Manufacturer's Statement of Origin or the Certificate of Title from another
state?
Provide a brief history of the watercraft: (lf more space is needed please continue on the back of this form.)
To the best of my (our) knowledge, the above statements are true. I (we) agree to defend and
protect the State of Minnesota against any and all claims of ownership that may arise against this
watercraft after | (we) have been issued a Minnesota Certificate of T itle.
Signed:
Alt owNrns
Date:
MUST SICN
PLEASE
REF:
ATTACH THIS STATEMENT TO YOUR APPLICATION FOR TITTE
5o.om6