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pdfDEPARTMENT OF HOMELAND SECURITY
OMB No: 1625-0027
U.S. Coast Guard
Expires:
BILL OF SALE BY GOVERNMENT ENTITY PURSUANT TO COURT ORDER OR
ADMINISTRATIVE DECREE OF FORFEITURE
1. VESSEL NAME
04/30/2023
2. OFFICIAL NUMBER OR OTHER UNIQUE
IDENTIFIER
3. PERSON EXECUTING INSTRUMENT
NAME: ______________________________________________________ TITLE: _________________________________________________
NAME AND ADDRESS OF AGENCY REPRESENTED (AND DISTRICT, IF APPLICABLE)
4. COURT OR FORFEITURE INFORMATION
VESSEL SOLD PURSUANT TO
ADMINISTRATIVE FORFEITURE
(COPY OF DECREE ATTACHED)
VESSEL SOLD PURSUANT TO COURT ORDER
NAME OF COURT
TITLE OF ORDER
5. NAME(S) AND ADDRESS(ES) OF BUYER(S) AND INTEREST TRANSFERRED TO EACH
5A. TOTAL INTEREST TRANSFERRED (100% UNLESS OTHERWISE SPECIFIED): _______________%
5B. MANNER OF OWNERSHIP. (CHECK ONLY ONE, IF APPLICABLE). UNLESS OTHERWISE STATED HEREIN, THIS BILL OF SALE CREATES A
TENANCY IN COMMON, WITH EACH TENANT OWNING AN EQUAL UNDIVIDED INTEREST.
JOINT TENANCY WITH RIGHT OF SURVIVORSHIP
TENANCY BY THE ENTIRETIES
COMMUNITY PROPERTY
OTHER (DESCRIBE)
6. CONSIDERATION RECEIVED (ONE DOLLAR AND OTHER VALUABLE CONSIDERATION UNLESS OTHERWISE STATED)
7. BY VIRTUE OF THE AFORESAID COURT ORDER, A COPY OF WHICH IS ATTACHED HERETO, OR DECREE OF ADMINISTRATIVE FORFEITURE
ATTACHED HERETO, I DO HEREBY GRANT, BARGAIN, AND SELL THE VESSEL DESCRIBED HEREIN, TOGETHER WITH ITS TACKLE, APPAREL,
AND FURNITURE, TO THE BUYER(S) NAMED ABOVE.
8. SIGNATURE OF PERSON EXECUTING INSTRUMENT
9. DATE SIGNED
10. ACKNOWLEDGMENT
ON _______________________________ THE PERSON(S) NAMED
(DATE)
ABOVE ACKNOWLEDGED EXECUTION OF THE FOREGOING INSTRUMENT
IN THEIR STATED CAPACITY(IES) FOR THE PURPOSE THEREIN CONTAINED.
STATE: ___________
COUNTY: _________________________________
NOTARY PUBLIC:
_____________________________________________
CG-1356 (05/20)
MY COMMISSION EXPIRES: _________________________________
(DATE)
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(COMPLETE THIS SECTION ONLY IF VESSEL HAS NEVER BEEN DOCUMENTED AND DOES NOT HAVE A HULL IDENTIFICATION NUMBER.)
VESSEL DATA
A. BUILDER
B. BUILDER’S HULL NUMBER
C. FORMER NAME(S)
D. FORMER MOTORBOAT NUMBERS
E. FORMER ALIEN REGISTRATIONS
F. DIMENSIONS
L=
G. PERSON FROM WHICH SELLER OBTAINED VESSEL
B=
D=
SIGNATURE OF SELLER
INSTRUCTIONS
1. INDICATE CURRENT DOCUMENTED NAME. (IF VESSEL HAS NEVER BEEN DOCUMENTED SELLER MUST COMPLETE AND SIGN DATA SECTION ABOVE.)
2. INDICATE OFFICIAL NUMBER AWARDED TO VESSEL OR HULL IDENTIFICATION NUMBER ASSIGNED BY MANUFACTURER. (IF THE VESSEL HAS NO HULL
IDENTIFICATION NUMBER AND HAS NEVER BEEN DOCUMENTED, SELLER MUST COMPLETE AND SIGN THE VESSEL DATA SECTION ABOVE.)
3. INSERT NAME AND ADDRESS OF ALL PERSONS EXECUTING INSTRUMENT AND THEIR CAPACITY. LIST THE NAME AND ADDRESS OF THE AGENCY IF
APPLICABLE.
4. SELF-EXPLANATORY.
5. LIST THE LEGAL NAME(S) AND ADDRESS(ES) OF THE BUYERS.
5A. LIST THE INTEREST TRANSFERRED TO THE BUYER(S) NAMED ABOVE.
5B. CHECK THE MANNER OF OWNERSHIP. UNLESS OTHERWISE STATED, THIS BILL OF SALE CREATES A TENANCY IN COMMON WITH EACH TENANT OWNING AN
UNDIVIDED INTEREST.
6. SELF-EXPLANATORY. USE “REMARKS” SECTION ABOVE IF VESSEL IS NOT SOLD FREE AND CLEAR, OR TO LIST VESSEL APPURTENANCES WHICH ARE NOT
SOLD WITH THE VESSEL.
7., 8., 9. SELF-EXPLANATORY.
10. THIS SECTION MUST BE COMPLETED BY A NOTARY PUBLIC OR OTHER PERSON AUTHORIZED TO TAKE ACKNOWLEDGMENTS OF DEEDS UNDER THE LAW S OF
A STATE OR THE UNITED STATES. IF THERE ARE MULTIPLE SIGNATORIES TO THIS BILL OF SALE, EACH MUST MAKE AN ACKNOWLEDGMENT BEFORE A NOTARY.
ATTACHMENTS SHOWING THOSE APPEARANCES ARE PERMITTED.
NOTE: THIS INSTRUMENT WILL BE INELIGIBLE FOR FILING AND RECORDING IF ALTERED AFTER EXECUTION AND ACKNOWLEDGMENT. ANY ALTERATIONS MADE
PRIOR TO EXECUTION MUST BE ATTESTED BY THE PERSON TAKING THE ACKNOWLEDGMENT.
PRIVACY ACT STATEMENT
1.
AUTHORITY: 46 U.S.C. CHAPTER 313, COMMERCIAL INSTRUMENTS AND MARITIME LIENS AND 46 CFR PART 67, DOCUMENTATION OF
VESSELS.
2.
PURPOSE: TO PUBLISH AND PROVIDE A PUBLIC RECORD (AVAILABLE FOR PUBLIC INSPECTION/COPYING) OF THE SALE OR CHANGE
OF OWNERSHIP OF A VESSEL WHICH IS DOCUMENTED, WILL BE DOCUMENTED, OR HAS BEEN DOCUMENTED PURSUANT TO 46
U.S.C. CHAPTER 121.
3.
ROUTINE USES: AUTHORIZED USCG PERSONNEL WILL USE THIS INFORMATION TO VALIDATE THE SALE AND TO DEVELOP
STATISTICAL DATA RELATED TO DOCUMENTED VESSELS. ANY DISCLOSURES OF DATA WITHIN THIS RECORD WILL BE MADE IN
ACCORDANCE DHS/USCG-013, MARINE INFORMATION FOR SAFETY AND LAW ENFORCEMENT (MISLE), 74 FEDERAL REGISTER (FR)
30305, JUNE 25, 2009.
4.
CONSEQUENCES OF FAILURE TO PROVIDE INFORMATION: VOLUNTARY. HOWEVER, FAILURE TO PROVIDE THE REQUESTED
INFORMATION COULD PREVENT THE BILL OF SALE FROM BEING FILED. FURTHERMORE, BILLS OF SALE WHICH ARE NOT FILED ARE
DEEMED INVALID AGAINST ANY PERSON EXCEPT THE GRANTOR OR A PERSON HAVING ACTUAL KNOWLEDGE OF THE SALE.
AN AGENCY MAY NOT CONDUCT OR SPONSOR, AND A PERSON IS NOT REQUIRED TO RESPOND TO A COLLECTION OF INFORMATION UNLESS IT DISPLAYS A
VALID OMB CONTROL NUMBER.
THE COAST GUARD ESTIMATES THAT THE AVERAGE BURDEN FOR THIS FORM IS 20 MINUTES. YOU MAY SUBMIT ANY COMMENTS CONCERNING THE ACCURACY
OF THIS BURDEN ESTIMATE OR MAKE SUGGESTIONS FOR REDUCING THE BURDEN TO: U.S. COAST GUARD, NATIONAL VESSEL DOCUMENTATION CENTER, 792
TJ JACKSON DRIVE, FALLING WATERS, WEST VIRGINIA 25419 OR OFFICE OF MANAGEMENT AND BUDGET, PAPERWORK REDUCTION PROJECT (1625-0027),
WASHINGTON, DC 20503.
CG-1356 (05/20)
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File Type | application/pdf |
Author | KSMANOR |
File Modified | 2020-06-04 |
File Created | 2013-07-03 |