Free Salvage Vehicle Agent Employment Certification - Michigan



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Clear Form STATE OF MICHIGAN Terri Lynn Land, Secretary of State MICHIGAN DEPARTMENT OF STATE LANSING, MICHIGAN 48918 SALVAGE VEHICLE AGENT EMPLOYMENT CERTIFICATION I certify that __________________________________________________________________, (Agent's Name Printed) driver license or personal identification number _______________________________________ is a bona fide employee of: ______________________________________________________ (Name of Dealership) __________________________, (Dealer License Number) and that the dealer takes responsibility for this employee's actions in the course of employment. Should the employment be terminated, the dealership agrees to surrender the photo identification card and notify the Michigan Department of State, Bureau of Regulatory Services, Licensing Unit within five days. ____________________

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STATE OF MICHIGAN

Terri Lynn Land, Secretary of State

MICHIGAN DEPARTMENT OF STATE
LANSING, MICHIGAN 48918

SALVAGE VEHICLE AGENT EMPLOYMENT CERTIFICATION
I certify that __________________________________________________________________,
(Agent's Name Printed)

driver license or personal identification number _______________________________________ is a bona fide employee of: ______________________________________________________
(Name of Dealership)

__________________________,
(Dealer License Number)

and that the dealer takes responsibility for this employee's actions in the course of employment. Should the employment be terminated, the dealership agrees to surrender the photo identification card and notify the Michigan Department of State, Bureau of Regulatory Services, Licensing Unit within five days.

___________________________________________________________
(Signature of Dealer)

_________________
(Title)

___________________________________________________________
(Printed Name of Dealer)

_________________
(Date)

03/2005

File Size: 38.4 kB
Pages: 1
File Format: PDF
State: Michigan
Category: Secretary of State
Author: MI Dept of State
Word Count: 102 Words, 1,066 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.michigan.gov/documents/svaempcert_19862_7.pdf