Ownership/Lien Holder Information Printout or Ownership ...
[Pages:1]Ownership/Lien Holder Information Printout Or Ownership History Report (PWD 763)
This form is used to: ? Obtain a computer printout, which provides the current owner/lien holder name, address, vessel/boat and/or outboard
motor description. The form PWD 763 must be completed and submitted with appropriate fees to TPWD Headquarters in Austin, a TPWD local law enforcement office, or a participating County Tax Assessor-Collector office. ? Obtain the History, which provides a copy of all documents submitted for transactions on file for a vessel/boat and/or outboard motor. TPWD retains historical documentation for vessels and outboard motors for a period of 10 years. The form PWD 763 must be completed and submitted with appropriate fees to TPWD Headquarters in Austin.
Check if your request is for a vessel/boat, outboard motor or both. Complete multiple forms if you need information for more than one vessel/boat and one outboard motor.
Vessel/Boat Information: Please complete each blank if possible.
TX #:
HIN/Serial#:
Make:
Year Built:
Owner of Record Name and Address:
Outboard Motor Information: Please complete each blank if possible.
M# (if known):
MIN/Serial #:
Make:
Year Built:
Owner of Record Name and Address:
Select the type of information you are requesting on the vessel/boat and/or outboard motor.
Ownership/Lien Holder Information Printout ? fee $0.00 each vessel/boat or outboard motor request I, the undersigned, hereby request the name and address of the owner, name and address of the lien holder (if recorded), vessel/boat registration expiration date, and record status information on the vessel/boat and/or outboard motor described above.
Ownership History Report ? (See Fee Chart) each vessel/boat or outboard motor request I, the undersigned, hereby request the historical transaction information recorded for the vessel/boat and/or outboard motor described above.
Check one: Normal History, or Certified History (letter is provided for court purposes)
Fees: Number of Ownership/Lien Holder Reports Requested: Number of Ownership History Reports Requested:
Total Amount Enclosed: $
x $0 = $ x (See Fee Chart)
I hereby certify that the TPWD vessel/boat and/or outboard motor record obtained will be used for lawful purposes.
WARNING: Falsifying information on documents is a punishable offense ? Texas Penal Code Chapter 37, Section 37.10. Any person who knowingly makes a false entry in, or false alteration of a governmental record is guilty of a felony of the third degree, punishable by confinement in jail for any term of not more than 10 years or less than 2 years and punishable by a fine not to exceed $10,000. I hereby certify that all statements in this document are true and correct to the best of my knowledge and belief.
Signature of Applicant/Requestor:
Print Name:
Business Name (if applicable):
Mail to Address:
City:
State:
Zip:
Daytime Phone Number:
Date:
Texas Parks and Wildlife Department maintains the information collected through this form. With few exceptions, you are entitled to be informed about the information we collect. Under Sections 552.021 and 552.023 of the Texas Government Code, you are also entitled to receive and review the information. Under Section 559.004, you are also entitled to have this information corrected.
PWD 0763 ? A0900 (08/09)
Texas Parks and Wildlife Department ? 4200 Smith School Road, Austin, TX 78744 ? tpwd.state.tx.us
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