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2. Bluffton Golf Cart / UTV

   Permit Application

   
   

   Per Bluffton City Ordinance 1563, any golf cart or UTV operated on a City street or property must be registered annually at the City's Police Department.

   Permit fees are $30 and can be paid online or in-person at the Police Department office. Once a payment is made and application approved, a permit will be issued.

4. OWNER INFORMATION

6. Name:*
7. Address:*
9. Phone Number:*
10. Date of Birth:*
    Date of Birth:

12. GOLF CART / UTV INFORMATION

14. Model Year:*
15. Make / Model:*
17. Color:*
18. VIN#:*
20. Equipment on Vehicle - All Required If Driven at Night:

    1. Head Lights
    2. Tail Lights
    3. Brake Lights
    4. Turn Signals

22. PLEASE READ CAREFULLY

24. With the signature below, the owner is certifying that:

    1. The information provided is correct, and
    2. They have read and agree to the following:

    I have received and understand the rules and regulations for the City of Bluffton Golf Cart Ordinance. I acknowledge that I will assume all liability, and am fully responsible for the operation of the above golf cart/UTV on the designated streets of the City of Bluffton, Indiana. I also acknowledge that, as a provided privilege, the City of Bluffton and Bluffton Police Department can revoke this golf cart permit and ticket the registered golf cart owner for any violation of the City Golf Cart Ordinance. I understand that I will obtain and keep liability insurance on the above golf cart/UTV and accept both legal and civil responsibility for any actions committed during the operation and use of the golf cart/UTV. I agree and indemnify and hold harmless the City of Bluffton for any liability arising from the use of this golf cart/UTV.

26. Date:*
    Date:
27. Owner's Digital Signature:*
29. Information Consent:*

    1. I consent to the City of Bluffton, Indiana storing my submitted information so they can respond to my inquiry.

33. FOR OFFICE USE ONLY

35. Date of Issue:
    Date of Issue:
36. Issued By:
37. Permit #:
38. For Year:
40. Receipt #:
41. Payment Type:
Leave This Blank:


43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit

* indicates a required field