Free Motor Vehicle Dealer Two Year License Application - Wisconsin

MOTOR VEHICLE DEALER TWO YEAR LICENSE APPLICATION
MV2186
Legal Name

FOR OFFICE USE ONLY
Issued Expires

2/2008

Submit in

Ch. 218 Wis. Stats. Amending Current duplicate. License Information

Wisconsin Department of Transportation Dealer and Agent Section P.O. Box 7909 Clear form Madison, WI 53707-7909

Area Code - Telephone Number

Dealer License Number

Trade Name(s) or DBAs

Federal Employer Identification Number

Street Address or RFD

Post Office Box Number

City

State

ZIP Code

County where business located

Type of Vehicles to be Sold

Business Entity

Autos NEVs (Neighborhood Electric Vehicles) Trucks Motorcycles
List makes of new vehicles to be sold

Sole Proprietorship Partnership

Association Corporation LLC

If Corporation or LLC, Date Licensed in Wisconsin

City Name:

Village

Township

State of Incorporation or Organization

E-mail Address

Address of NONADJACENT Sales Location in SAME MUNICIPALITY Branch: Sublot:

Name and Title of Owner, Partners, Association Members, Corporation Officers snd Shareholders, LLC Managers and Members Complete an Entity/Owner Statement (Form MV2844) for each individual listed.

Completely describe other business, if any, engaged in by your firm

Same location? No Yes

License Numbers of Additional Dealerships

Was there a licensed dealer at this same location previously this year? No No No No Number of vehicles sold in last 12 month period Yes, Name dealer ________________________________________ Yes, Same location? No Yes Have you, as an individual and your above-named firm, been licensed as a dealer before? Has your motor vehicle dealer license ever been denied, suspended or revoked? Yes, When and what state? _________________________________ Yes, Give license number __________________________________ New Retail AUTOS Used New TRUCKS Used New Are you licensed as a motor vehicle salvage dealer at same location?

Do you own and operate your own service department? Yes No, Attach completed service agreement Complete ONE of the following (whichever applicable): YES Is business real estate owned by: Owner of sole proprietorship One partner of partnership Corporate dealership LLC MOTORCYCLES Used New OTHERS (specify) Used

NO If no, send copy of lease.

SALES TAX SELLER PERMIT NUMBER

Wholesale

Please check only ONE box that applies to your dealership. Dealer License (Required fee)..................................$40.00 Call 608-261-9555 if you have questions about these fees. Branch License.........................................................$40.00 1. During the next two years our dealership will sell all vehicles Sublot License............................................................$2.00 on a cash only basis. Fee due is $20. Salesperson License(s)......... Number _________ x $8.00 2. Our dealership originates retail installment sales contracts and/or consumer leases. (If test required, pay examiner) a. All of the contracts or leases we originate are sold or 0.00 Wisconsin Buyer's License(s)....... Number ____ x $12.00 transferred to a third party. Fee due is $100. 0.00 Buyer ID Card(s)................ Number __________ x $12.00 b. Some or all of the contracts or leases are retained by Dealer License Plates Required.....First 2 plates = $150.00 our dealership. Fee due is $100. 3. The total amount of installment contracts and/or consumer 0.00 Number of additional plates ________________ @ $10.00 leases originated and retained in the last 12 months was List letters of all missing plates $ ________ , which is $100,000 or less. Fee due is $100. 4. The total amount of installment contracts and/orconsumer Replacement License Plates for lost, damaged, leases) originated and retained in the last 12 months was $ ________ , which is greater than $100,000. Do not or illegible plates........................................each plate $2.00 submit a fee. You will receive a separate bill. 0.00 Does your dealership write credit insurance? No Yes CHECK PAYABLE TO: REGISTRATION FEE TRUST $ CHECK PAYABLE TO: Department of Financial Institutions I, the undersigned, certify under penalty of s.345.17 Wisconsin Statutes, that (1) a lease agreement covering at least the licensing year has been executed, if premises are not owned by applicant, and (2) the answers and statements on this application are true and correct to the best of my knowledge.

See reverse side.

X

(Authorized Dealership Agent, Title)

(Date)

Clear form

Next page

Following Applies To First-time Dealer Applicant Or Application For Amended License Because of Business Relocation or Ownership Change Clear form
Proper local officials must sign below, BEFORE submitting this application. All applicants complete section A. If business is located in a township, complete both sections A and B. Attention Zoning Authorities: The requirements for a retail motor vehicle dealer are as follows: 1. A permanent building, not a residence, tent, or temporary stand. 2. An office within the building. 3. A minimum 12x20 foot area accessible for automobile display, repair and preparation within the building. 4. A repair shop on the premise or a service agreement with a nearby repair shop. 5. An outdoor vehicle display lot for at least one vehicle adjacent to the building or all vehicles kept indoors. 6. An exterior sign with business name as it will appear on the license certificate and any other name used to do business under. The lettering of the sign must be a minimum of 4 inches high, unless smaller dimensions are required by local zoning or sign ordinance. 7. A sign posted on or adjacent to the entrance door describing business hours. Section A
Business Name / Location

1.

Operation of this dealer business at the location(s) stated above is in accordance with local zoning, building code and permit requirements. X
(Print Name) (Signature)

(Official Title)

(Municipality)

2.

Check one box and sign below: A local permit or license is required and has been issued. A local permit or license is not required. X
(Print Name) (Signature)

(Official Title)

(Municipality)

Section B
Business Name / Location

County Zoning Approval - required only if business is located in a township. Operation of this dealer business at the location(s) stated above is in accordance with local zoning regulation. X
(Print Name) (Signature)

(Official Title)

(County)

If business address on the front does not include a specific street number, furnish directions to your business location, including highway numbers or letters and distances.

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