Renewal Application Motor Vehicle, Mobile Home, Or Recreational Vehicle Dealers - Florida Highway Safety And Motor Vehicles
Download a blank fillable Renewal Application Motor Vehicle, Mobile Home, Or Recreational Vehicle Dealers - Florida Highway Safety And Motor Vehicles in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Renewal Application Motor Vehicle, Mobile Home, Or Recreational Vehicle Dealers - Florida Highway Safety And Motor Vehicles with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4STATE OF FLORIDA
DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
DIVISION OF MOTORIST SERVICES
NEIL KIRKMAN BUILDING, TALLAHASSEE, FLORIDA 32399-0500
RENEWAL APPLICATION
OFFICE USE ONLY
Entered by
MOTOR VEHICLE, MOBILE HOME, OR RECREATIONAL VEHICLE DEALERS
Approved by
ANNUAL RENEWAL
BIENNIAL (TWO YEARS) RENEWAL
PLEASE SUBMIT THIS APPLICATION TO THE REGIONAL OFFICE RESPONSIBLE FOR YOUR DEALERSHIP
LICENSE NUMBER
IF THERE ARE NO CHANGES FROM LAST YEAR, YOU MAY FILE THIS FORM TO RENEW YOUR LICENSE.
THIS FORM MAY ALSO BE USED FOR THE FOLLOWING:
ISSUE DATE
Change of Mailing Address (Please Check Box if Mailing Address Needs Updating)
Do not use white-out or correction tape on this application.
Date Application
Current or last License Number (Include suffix if Additional Location):
Was Received In
Regional Office
Licensee Name:
Sole Proprietor
Corporation
Limited Liability Company/Partnership (LLC/LLP)
Limited Liability Limited Partnership (LLLP)
Partnership
Dealer Application
Fictitious (DBA) Name:
Completion Date
Dealership Physical Address:
DATE MAILED TO
Street Address
HEADQUARTERS
City
County
State
Zip Code
Mailing Address:
Enter Mailing Address Even if Same as Physical Address
DATE RECEIVED IN
City
County
State
Zip Code
DEALER LICENSE
Federal Employer’s Identification Number (FEID): _____________________________________
Florida Sales Tax Number:
Business E-Mail Address:
CHECK
Business Telephone Number: (
)
Fax Number: (
)
CHECK NUMBER
Cell Phone Number: (
)
Who is your ETR vendor?
AMOUNT
GLI Company E-mail Address:______________________________________________________
Surety Bond Company E-mail Address:_______________________________________________
CASH
Proof of Identification, if Sole Proprietor or Partnership:
CREDIT CARD
Acceptable Proof of Identification includes:
PAYMENT NUMBER
● A Florida driver license or identification card (please include number in appropriate space above);
● An out of state driver license or identification card;
● A US passport;
FRVIS CUSTOMER
● A Canadian driver license, identification card, or passport;
NUMBER
● A driver license or identification card from any US Territory (American Samoa, Guam, Mariana,
Puerto Rico, and the US Virgin Islands); and
DIVISION CORP
● An out of country passport.
ACTIVE
A copy of the proof of identification must be submitted with your renewal form to the Department, unless the
INACTIVE
proof of identification submitted is a Florida driver license or identification card (please include driver
Dealer Training School
license/identification number in appropriate space above).
Continuing
Education
COMPLETION OF THIS SECTION IS MANDATORY FOR PROCESSING:
Pre-Licensing
Have you or any officer/owner been convicted of a felony or equivalent in any jurisdiction since your last
renewal?
Yes
No
DATE:
_
If the answer is “Yes”, please submit the charging document(s) and disposition document(s).
SURETY BOND/
I/We hereby agree that all documents, orders, notices or related correspondence will be served by e-mail at the e-mail address provided.
CONTINUATION CERT.
I/We agree to add
dealerservices@flhsmv.gov
as a contact so that email from the Division of Motorist Services is not classified as junk
mail. If no e-mail address is provided, all documents shall be served by First Class U.S. Mail.
GARAGE LIABILITY
“Under penalty of perjury, I do swear to affirm that all the information contained in this application is true and correct and that
applicant will abide by all laws of Florida, including Chapters 319 and 320, Florida Statutes, and all applicable rules and procedures of
Zone #_________
the Department of Highway Safety and Motor Vehicles. I further certify that I am authorized to bind the application with my signature.”
Insp #__________
Original Signature of the Officer_______________________________________________________
Insp Name:
__
_________________
Print Name_________________________ Title____________________ Date
I
____________
HSMV 86720 (Rev 5/16) PLEASE SUBMIT THIS APPLICATION TO THE REGIONAL OFFICE FOR YOUR DEALERSHIP
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Hsmv 83090 - Application By Florida Motor Vehicle, Motorcycle, Mobile Home Or Recreational Vehicle Dealer For Temporary License Plates
Legal
Form Hsmv 84200 - Application For A Temporary "supplemental" License For An Off-premises Sale By A Motor Vehicle, Mobile Home Or Recreational Vehicle Dealer
Legal
Power Of Attorney For A Motor Vehicle, Mobile Home Or Vessel - Florida Department Of Highway Safety And Motor Vehicles
Legal
Form Hsmv 83039 - Application For Disabled Person Parking Permit - Florida Department Of Highway Safety And Motor Vehicles - 2013
Legal
Form Hsmv 83039 - Application For Disabled Person Parking Permit - Florida Department Of Highway Safety And Motor Vehicles - 2015
Legal
Form Hsmv 84491 - Additional Sheet To Statement Of Builder - Florida Department Of Highway Safety And Motor Vehicles
Legal
Related Categories
Parent category: Legal