Free TC-305, Utah Motor Vehicle Salvage Buyer Application - Utah

Print Form
Utah State Tax Commission

Clear form
TC-305
Rev. 7/09

Motor Vehicle Salvage Buyer Application

Start here
New - $203 Renewal - $203
First name Middle name

Buyer license number

THIS BOX FOR MVED USE ONLY

This application will not be considered unless completed and accompanied by the correct license fee and photograph of the applicant.
Last name City Citizenship Race Date of birth Eye color State of issue Alias/maiden name State ZIP Code Social Security Number Hair color

Home address (physical address, not P.O. box) Home telephone number Gender Male Place of birth Female Work telephone number Height ft. in. Driver's license number Weight

1. Have you ever been the holder of a motor vehicle salvage buyer, salesperson, dealer, dismantler or body shop license? Yes No If yes, name of business: ________________________________ If business was not in Utah, please list state: ______________________ 2. Has the license mentioned above been denied, suspended or revoked? Yes No If yes, please explain:__________________________________

__________________________________________________________ 3. During the past 10 years, have you been convicted of any misdemeanors or felonies in Utah or in any other state? (You are not required to disclose simple traffic infractions) Yes No Failure to disclose any of the requested information may result in suspension of this license. A criminal conviction for a motor vehicle or drug-related crime, fraud or registered sex offense can be grounds for denial.

If yes, please list each conviction: _____________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ __________________________________________________________ 4. Are you currently on probation or parole? Yes No

5. Have you ever had business experience in buying, selling or otherwise working with salvage vehicles? Yes No If yes, please explain: _____________________________________

_ _ _ _ _ _ _ _ _ _ _ _ _ _______________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _______________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Applicant and employer must complete the reverse side.

TC-305, page 2
6. Are you engaged in, or do you intend to engage in, any business or occupation other than that of selling motor vehicles? Yes No If yes, what kind of business? ______________________________ MV business name: ___________________

7. Employing MV business number: __________

To Be Completed by Employee
A. Under state and federal law we cannot issue a license to any person who does not provide this residency information: Check one: I am a U.S. citizen. SSN: ________________ I qualify under 8 U.S.C. 1641 and I am present in the U.S. lawfully. I-94# or SSN: ________________ Alien #: ________________
The Alien Registration Number (A#) and the I-94 (arrival/departure) number are issued by the U.S. Citizenship and Immigration Service.

B. I am in compliance with the Motor Vehicle Business Regulation Act, Salvage Buyer Law, and other laws of Utah governing the conduct of motor vehicle salvage buyers and will cooperate with the Utah State Tax Commission to eliminate abuse and unfair trade practices. I am in compliance with all laws and regulations regarding the disposal of hazardous material under Hazardous Substances, and will provide evidence of compliance to MVED upon request. I hereby state that I will engage in the business of purchasing salvage motor vehicles for the designated dealer, body shop or dismantler shown below during the license period for which this application is made. I do solemnly swear (or affirm) that the statements contained in the foregoing application are true and correct. Applicant's signature:_________________________________________________ Complete the rest of this form by hand after it has been printed. Printed name of applicant: ________________________________________________________________ Date: ______/_______/________

To Be Completed by Employer
I hereby certify that _________________________________________________
Applicant's name (please print)

is employed as a salvage buyer by the undersigned who has been duly licensed as a motor vehicle dealer, body shop or dismantler by a U.S. state or jurisdiction.

IMPORTANT: I/we certify that the statements contained in the foregoing application are true and correct to the best of
my/our knowledge and belief. I/we recommend the applicant to be licensed to purchase salvage motor vehicles. ____________________________
Business name

____________________________
Address

____________________________
Signature of owner, partner or corporate officer*

____________________________
Printed name of signer*

____________________________
Date * The signer must be on file with MVED as an owner, partner, corporate officer or POA.

This application will be rejected if it is incomplete or does not include the correct license fee and a photograph of the applicant.
Make check or money order payable to: Utah State Tax Commission Motor Vehicle Enforcement Division 210 North 1950 West Salt Lake City, UT 84134

Print Form

IMPORTANT: To protect your privacy, use the "Clear form" button when you are finished.

Clear form