AFFIDAVIT FOR BOATS PLACED IN A REGISTERED REPAIR FACILITY
I, the undersigned, affirm that the hereinafter described boat is under the below repair facility's care, custody, and control for repairs, alterations, refitting, or modifications, and that the owner does not use the boat while in this facility.
NAME OF REPAIR FACILITY: _______________________________________________________________________________
ADDRESS OF REPAIR FACILITY: _____________________________________________________________________ (Street)
__________________________________________________ (City) ____________________________________________ (State)
REPAIR FACILITY'S SALES & USE TAX REGISTRATION NUMBER: _____________________________________________
DATE BOAT PLACED IN REPAIR FACILITY FOR REPAIRS, ALTERATIONS, REFITTING, OR
MODIFICATIONS: _______________________________ (Month) (Day) (Year)
NAME OF BOAT OWNER: __________________________________________________________________________________
BOAT OWNER'S PERMANENT ADDRESS: __________________________________ (Street)
__________________________________________________ (City) ____________________________________________ (State)
DESCRIPTION OF BOAT
Name of Boat ____________________________ Make ___________ Model _________ Year _____
Serial Number ____________ Hull I.D. Number _______________________________
DESCRIPTION OF REPAIRS, ALTERATIONS, REFITTING, OR MODIFICATIONS TO BE MADE
__________________________________________________________________________________________________________
Under penalties of perjury, I declare that I have read the foregoing affidavid and the facts stated are true to the best of my knowledge and belief.
Signature of Dealer: _________________________________________________________________________________________
Under penalties of perjury, I declare that I have not used the above described boat while it was in the care, custody, and control of the repair facility.
_________________________ ____________
Signature of Boat Owner Date
The repairs, alterations, refitting, or modifications to the above described boat are completed and the boat was released:
_______ ____ _____
(Month) (Day) (Year)
_________________________ ____________
Signature of Dealer Date
SEA TRIALS OF BOATS PLACED IN A REGISTERED REPAIR FACILITY
NAME OF THE REPAIR FACILITY:___________________________________________________________________________
ADDRESS OF REPAIR FACILITY: __________________________________________ (Street)
__________________________________________________ (City) ____________________________________________ (State)
REPAIR FACILITY'S SALES & USE TAX REGISTRATION NUMBER: _____________________________________________
DATE BOAT PLACED IN REPAIR FACILITY FOR REPAIRS, ALTERATIONS, REFITTING, OR
MODIFICATIONS: ______________________________ (Month) (Day) (Year)
NAME OF BOAT OWNER: __________________________________________________________________________________
BOAT OWNER'S PERMANENT ADDRESS: ____________________________________ (Street)
__________________________________________________ (City) ____________________________________________ (State)
DESCRIPTION OF BOAT
Name of Boat __________________________________ Make ______ Model _____ Year ______
Serial Number ______________ Hull I.D. Number _______________________
DESCRIPTION OF REPAIRS, ALTERATIONS, REFITTING, MODIFICATIONS, OR SEAWORTHINESS TO BE TESTED, INCLUDING THE TIME REQUIRED TO PERFORM SEA TRIAL:
__________________________________________________________________________________________________________
Under penalties of perjury, I declare that the sea trial, as specified above, is necessary to test the repairs, alterations, refitting, modifications, or seaworthiness of the vessel specified, and that I have not used or permitted any use of the above described vessel for purposes other than those specified above.
__________________________ ________________________________ ______________________
(Signature of Boat Owner) (Title) (Date)
__________________________ ________________________________ ______________________
(Signature of Dealer) (Title) (Date)
The testing of the repairs, alterations, refitting, modifications, or seaworthiness of the above described vessel was performed during the following time period and we affirm the length and scope of the voyage were reasonably necessary to test the repairs or modifications:
Beginning: ___________________________ / ______________
(Month) (Day)
___________________________ / ______________
(Year) (Time)
Ending: ___________________________ / ______________
(Month) (Day)
___________________________ / ______________
(Year) (Time)
___________________________ _______________
(Signature of Boat Owner) (Date)
___________________________ _______________
(Signature of Dealer) (Date)
Fla. Admin. Code Ann. R. 12A-1.0071
Rulemaking Authority 212.18(2), 213.06(1) FS. Law Implemented 212.02(25), 212.05(1), 212.06(8), (12), 212.08(7)(t), 213.37 FS.
New 12-8-87, Amended 8-10-92, 3-17-93, 5-18-94, 3-20-96, 3-25-20, 12-31-20.