Form BRT-021 "Application for Supplemental Lien or Transfer of Lien" - Virginia

What Is Form BRT-021?

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

Form Details:

  • Released on March 22, 2019;
  • The latest edition provided by the Virginia Department of Wildlife Resources;
  • 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 BRT-021 by clicking the link below or browse more documents and templates provided by the Virginia Department of Wildlife Resources.

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Download Form BRT-021 "Application for Supplemental Lien or Transfer of Lien" - Virginia

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BRT-021
(03/22/2019)
APPLICATION FOR
SUPPLEMENTAL LIEN OR TRANSFER OF LIEN
Please complete entire application or go online to www.dgif.virginia.gov/GetBoating
To record a lien after the original certificate of title has been issued, please submit the following:
A. This application for Supplemental Lien completed and signed by the titled owner(s) whose name(s) appear on the face of the
Certificate of Title to a Vessel.
B. The original Certificate of Title to a Vessel.
C. Fee of $10.00 – Please make check or money order payable to: “Treasurer of Virginia”.
1.
NAME OF TITLED OWNER(S):
DGIF Customer ID:
DGIF Customer ID:
Legal Name:
Legal Name:
First
MI
Last
First
MI
Last
Address:
Address:
City
State
Zip
City
State
Zip
Daytime Telephone Number
Daytime Telephone Number
VA Registration Number: VA _______________________
2.
BOAT DESCRIPTION:
/
Hull Identification Number
Make
Model Year
Length ft / inches
3.
DESCRIPTION OF MOTOR(S) TO BE RECORDED ON CERTIFICATE OF TITLE:
Motor Make
Serial Number
Horsepower
Motor Make
Serial Number
Horsepower
4.
PROPULSION (check one):
___ Air Thrust
___ Sail
___ Manual
___ Water Jet
___ Propeller
___ Other (specify): ________
5.
FUEL (check one):
___ Gasoline
___ Diesel
___ Electric
___ Other
6.
LIEN INFORMATION:
Date of Lien:
Name of Lienholder:
Mailing Address:
City
State
Zip
Signature of all titled owners: X
X
Please mail the completed application with the appropriate fees and supporting documentation to:
Department of Game and Inland Fisheries – Client Services
PO Box 9930
Henrico, VA 23228-9930
BRT-021
(03/22/2019)
APPLICATION FOR
SUPPLEMENTAL LIEN OR TRANSFER OF LIEN
Please complete entire application or go online to www.dgif.virginia.gov/GetBoating
To record a lien after the original certificate of title has been issued, please submit the following:
A. This application for Supplemental Lien completed and signed by the titled owner(s) whose name(s) appear on the face of the
Certificate of Title to a Vessel.
B. The original Certificate of Title to a Vessel.
C. Fee of $10.00 – Please make check or money order payable to: “Treasurer of Virginia”.
1.
NAME OF TITLED OWNER(S):
DGIF Customer ID:
DGIF Customer ID:
Legal Name:
Legal Name:
First
MI
Last
First
MI
Last
Address:
Address:
City
State
Zip
City
State
Zip
Daytime Telephone Number
Daytime Telephone Number
VA Registration Number: VA _______________________
2.
BOAT DESCRIPTION:
/
Hull Identification Number
Make
Model Year
Length ft / inches
3.
DESCRIPTION OF MOTOR(S) TO BE RECORDED ON CERTIFICATE OF TITLE:
Motor Make
Serial Number
Horsepower
Motor Make
Serial Number
Horsepower
4.
PROPULSION (check one):
___ Air Thrust
___ Sail
___ Manual
___ Water Jet
___ Propeller
___ Other (specify): ________
5.
FUEL (check one):
___ Gasoline
___ Diesel
___ Electric
___ Other
6.
LIEN INFORMATION:
Date of Lien:
Name of Lienholder:
Mailing Address:
City
State
Zip
Signature of all titled owners: X
X
Please mail the completed application with the appropriate fees and supporting documentation to:
Department of Game and Inland Fisheries – Client Services
PO Box 9930
Henrico, VA 23228-9930
BRT-021
(03/22/2019)
TRANSFER OF LIEN – (For Lienholder’s Use Only)
To transfer an existing lien to a new lienholder after the original certificate of title has been issued, please submit the following:
A. This application for Supplemental or Transfer of Lien completed and signed by the lienholder(s) that appear on the face of the
Certificate of Title to a Vessel.
B. The original Certificate of Title to a Vessel
C. Fee of $10.00 – Please make check or money order payable to: “Treasurer of Virginia”.
NEW LIENHOLDER INFORMATION:
Date of Lien:
Name of New Lienholder:
Mailing Address:
The undersigned lienholders acknowledge this to be their free and voluntary act.
Name of Current Lienholder
Signature and Title
Date
Name of New Lienholder
Signature and Title
Date
Please mail the completed application with the appropriate fees and supporting documentation to:
Department of Game and Inland Fisheries – Client Services
PO Box 9930
Henrico, VA 23228-9930
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