Boat with Trailer Lien worksheet  -  Submit Electronically
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Today's Date
Facility Phone Number
Facility Address*
Boat/Vessel Information
Type of Boat/Vessel*
Facility FAX Number
Hull Identification Number (HIN)* 
Make of Vessel - ie: Laguna, Kawasaki, Yahama*
Model of Vessel - ie: Cortez, Elite*
Year Model*
License Plate #*
State Issued*
Registration Expiration Date
Month
Year
*  means it is a required field.
If no information is available type NONE
Does the Vessel Have an Engine?
How is the Vessel stored?
Approximate Length of Boat
Tenant Information
Who Stored the Boat and/or Trailer?
Include
Name
Address
City and State
Zip
Phone Numbers
What date was the Vehicle/Boat stored at the facility?
Include
Name
Address
City and State
Zip
Phone Numbers
Alternates Information
Include
Name
Address
City and State
Zip
Phone Numbers
Include
Name
Address
City and State
Zip
Phone Numbers
Include
Name
Address
City and State
Zip
Phone Numbers
Include
Name
Address
City and State
Zip
Phone Numbers
When were the last notifications sent?*
What is owed to date including all fees?*
What is the current Monthly Rental Rate?*
CF Number (or number from other State
Trailer Information
Vehicle Identification Number (VIN)* 
Make of Trailer - ie:  TrailRite, Hauler* 
Model of Trailer?
Feet
Email Address
Approximate value of Vessel?
Additional 
Comments