Register Form

Mary Conlin Company - Vessel Documentation Mary Conlin Company Boat Documentation Services

Online Order Form

Have You Registered With Us Before?: No Yes

Your Email Address:

Estimated Closing Date (00/00/000):

Official Documentation Number:

State Registration Number:

Hull Identification Number:

Vessel Type: Sail Power Length:

Present Name of Vessel:

New Name of Vessel (If Applicable):

Hailing Port:

Boat Purpose: Recreation Coastwise Fishery

Please include the Builder's Certificate, Certificate of Documentation, or State Title and/ or Registration.

If vessel is currently state registered, has it ever been documented?:
No Yes

Order Abstract of Title or Lien Search?: No Yes
(Abstract will arrive approximately 2 business days after placing your order)

Broker Name:

Broker Contact Person:

Broker Telephone Number:

Broker Fax Number:

Seller Information (Present Owner)

Name(s) 1:

Name(s) 2:

Name(s) 3:

Address:

City: State: Zip Code:

Seller Telephone Number Contact:

Home: Work: Fax:

Payoff Bank:

Account Number:

Bank Phone: Contact Name:

Buyer Information (Must be a U.S. Citizen to Document Your Vessel w/ The USCG)

Name (As You Would Like It To Appear On Your Certificate Of Documentation):

Vesting Type: (Vesting Descriptions)

Sole Owner
Joint Tenants w/ Right of Survivorship
Husband & Wife as Community Property
Tenants in Common Each Owning A Specific Percentage (Please specificy %'s)
      Tenant 1:       %
      Tenant 2:       %
      Tenant 3:       %
      Tenant 4:       %
      Tenant 5:       %
Trust (Must have 1st full page and signature page, of the Trust referring to the name of Trust, Trustees, and date signed by the Trustees, or Summary of Trust).
Corporation (Must have a copy of the Articles of Incorporation and the Number of Directors that constitute a Quorum). Number of Directors
Limited Liability Company (Must have a copy of Articles of Organization).
Limited Partnership (Must have a copy of Partnership Agreement)

Social Security Number(s) or FEIN Number of Each Buyer:

Address:

City: State: Zip Code:

Buyer Telephone Number Contact:

Home: Work: Fax:

List Name/ SS# / Phone#/ Address / State / Zip of all Additional Buyers Here:

Lender Name (If Applicable):

Loan Amount:

Contact Person:

Lender Telephone: Fax:

Notes:

I Ceritify That All The Information Provided Above is Correct and Valid To The Best of My Knowledge.
Buyer's Initials: Today's Date:

We are an Active/Founding Member of AVDA (American Vessel Documentation Association), an Affiliate Member of California Yacht Brokers Association (CYBA), and a member of the Newport Harbor Chamber of Commerce.

Method of Payment: Personal Credit Card Company Credit Card
I Will Be Mailing in a Check/ Money Order/ Cashier's Check

Card Type: Visa Master Card

Credit Card Number:

Exp. Date:

Exact Name on Credit Card:

Credit Card Complete Billing Address:

How did you hear about us?:

UPON RECEIPT OF YOUR REGISTRATION FORM YOU WILL BE RETURNED TO OUR HOME PAGE. You will be contacted within 2 working days and receive a verification of your order form.

You May Also Print & Fax This Form To: 949-646-6025

Verify Code :

Mary Conlin Company - Vessel Documentation Experts

The Mary Conlin Company, Inc.
833 Dover Drive, Suite 15, Newport Beach, CA 92663
Tel: 949-646-5917 | Fax: 949-646-6025

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