Form B-122 "Marine Dealer's Application to Assign Vessel Numbers and Issue Temporary Certificates" - Connecticut

What Is Form B-122?

This is a legal form that was released by the Connecticut Department of Motor Vehicles - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2018;
  • The latest edition provided by the Connecticut Department of Motor Vehicles;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form B-122 by clicking the link below or browse more documents and templates provided by the Connecticut Department of Motor Vehicles.

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Download Form B-122 "Marine Dealer's Application to Assign Vessel Numbers and Issue Temporary Certificates" - Connecticut

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MARINE DEALER'S APPLICATION TO ASSIGN VESSEL
STATE OF CONNECTICUT
$1,500 Surety Bond must
DEPARTMENT OF MOTOR VEHICLES
accompany this application.
NUMBERS AND ISSUE TEMPORARY CERTIFICATES
On The Web At ct.gov/dmv
DEALER'S AUTHORIZATION NO.
B-122 REV. 4-2018
TO: Department of Motor Vehicles, Marine Vessel Section, 60 State Street, Wethersfield, CT 06161-3032
MARINE DEALER'S STATEMENT
BUSINESS AND SURETY INFORMATION
DEALER'S BUSINESS NAME
I DECLARE UNDER THE PENALTIES
OF A FALSE STATEMENT THAT I AM
DEALER'S BUSINESS ADDRESS
(Number and Street)
(City or Town)
(State)
(Zip Code)
ENGAGED IN THE BUSINESS OF
MANUFACTURING
AND
SELLING
NAME OF SURETY
NEW VESSELS OR SELLING NEW
OR USED VESSELS, OR BOTH, AND
ADDRESS OF SURETY
(Number and Street)
(City or Town)
(State)
(Zip Code)
HAVE AN ESTABLISHED PLACE OF
SIGNATURE OF AUTHORIZED AGENT
TITLE
APPLICATION DATE
BUSINESS FOR THE SALE, TRADE
AND DISPLAY OF SUCH VESSELS.
X
BELOW FOR DMV USE ONLY
APPLICANT'S SIGNATURE
APPLICATION APPROVED
APPROVED BY
DATE CHECKED
IF NOT APPROVED STATE WHY
X
MARINE DEALER'S APPLICATION TO ASSIGN VESSEL
STATE OF CONNECTICUT
$1,500 Surety Bond must
DEPARTMENT OF MOTOR VEHICLES
accompany this application.
NUMBERS AND ISSUE TEMPORARY CERTIFICATES
On The Web At ct.gov/dmv
DEALER'S AUTHORIZATION NO.
B-122 REV. 4-2018
TO: Department of Motor Vehicles, Marine Vessel Section, 60 State Street, Wethersfield, CT 06161-3032
MARINE DEALER'S STATEMENT
BUSINESS AND SURETY INFORMATION
DEALER'S BUSINESS NAME
I DECLARE UNDER THE PENALTIES
OF A FALSE STATEMENT THAT I AM
DEALER'S BUSINESS ADDRESS
(Number and Street)
(City or Town)
(State)
(Zip Code)
ENGAGED IN THE BUSINESS OF
MANUFACTURING
AND
SELLING
NAME OF SURETY
NEW VESSELS OR SELLING NEW
OR USED VESSELS, OR BOTH, AND
ADDRESS OF SURETY
(Number and Street)
(City or Town)
(State)
(Zip Code)
HAVE AN ESTABLISHED PLACE OF
SIGNATURE OF AUTHORIZED AGENT
TITLE
APPLICATION DATE
BUSINESS FOR THE SALE, TRADE
AND DISPLAY OF SUCH VESSELS.
X
BELOW FOR DMV USE ONLY
APPLICANT'S SIGNATURE
APPLICATION APPROVED
APPROVED BY
DATE CHECKED
IF NOT APPROVED STATE WHY
X