Required fields are marked with asterisks (*)

Jaycee Lake Boat License Application

Licenses are valid May 1 the year of purchase until April 30 the following year.
The City gives no guarantee that the lake will be suitable for boating at all times. All applications are subject to approval.

Name of Registered Owner

Street Address, City and State

Phone Number

Email Address

Are you a resident of Jefferson County?

Yes

Do you lease lake property from the city?

Yes

How would you like to receive your sticker?

Please mail to the address listed

Will pick up

Type of Boat

Canoe/Kayak

Motor

Pontoon

Description of boat ( include year, make, length, and color)

State License Number

Trailer Number

Name of Insurance Company (a public liability insurance policy is required)

I certify that the information provided is true, accurate, and complete. (Sign and date)

Payments will be accepted once the application has been approved. Payments can be made over the phone or in person.

For Office Use Only

Date of issue Effective Date License Cost