Application For Act 539 Regulatory License Form - Alabama Page 2
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25. The questions in part 5 must be answered by ALL APPLICANTS. Note: Only retailers are required to answer question
(5)(e)(5).
Yes
No
a. Have you ever knowingly dealt in stolen vehicles or accessories? . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b. Have you disconnected, turned back, or reset the odometer of any
motor vehicle in violation of state or federal law since September 1, 1991?. . . . . . . . . . . . . . . . . . . . .
c. Have you skipped title assignments or accepted open assignments of title
or bill of sale during the last year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
d. Section 40-12-395, Code of Alabama 1975, states in part: “Only one licensed dealer
shall operate at the same place of business; provided, that a motor vehicle reconditioner
or motor vehicle rebuilder may operate on the premises for which he is licensed to
operate as a motor vehicle dealer.” Do you acknowledge awareness of this statement? . . . . . . . . . .
e. Regarding the location(s) listed in part 3 of this application:
1) Is/ Are the location(s) permanent and owned or leased by the sole proprietor,
a partner, LLC member or the corporation as listed on the application? . . . . . . . . . . . . . . . . . . . .
2) Is there sufficient space to adequately display/store on each location one or more
vehicles offered for sale? (Space must be exclusive.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3) Does/Do the location(s) have a suitable place from which a motor vehicle dealer can,
in good faith, carry on the business of a motor vehicle dealer, keep and maintain
books and records necessary to conduct such a business? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4) Does/Do the location(s) listed in part 3 have operable landline telephone(s) listed
with the telephone company under the name of the licensed business?. . . . . . . . . . . . . . . . . . . . .
5) Does/Do the location(s) listed in part 3 each have the required sign designating
that the location is a place of business of a motor vehicle dealer? (Retailers only.) . . . . . . . . . . .
The information provided in this application will be cross-checked for compliance with Alabama Sales Tax and Income Tax Laws.
Under penalties of perjury, the undersigned hereby certify that all
Retailers only
information contained in this application for a regulatory license is
true and correct in every respect; furthermore, that the undersigned
Attach Photo(s) Here
through 40-12-400, Code of Alabama 1975, and is/are aware of all
is/are aware of all requirements provided by Sections 40-12-390
Photo(s) must show Sign and Location
applicable penalties for code violations.
labeled for each separate location.
A new photo is required each license year.
__________________________________________________
Digital photos are only acceptable on photographic paper.
Name of Business
NOTE: Multiple Member Limited Liability Company must complete
authorization form on page 12 if only one member signs this form.
____________________________ _____________________
Signature of Owner, Partner, Member, Officer or Director
(Type or Print Name)
____________________________ _____________________
Signature Partner, Member, Officer or Director
(Type or Print Name)
____________________________ _____________________
Signature of Partner, Member, Officer or Director
(Type or Print Name)
____________________________ _____________________
Signature of Partner, Member, Officer or Director
(Type or Print Name)
___________________
____________________
State of
County of
Subscribed and sworn to before me this
_______
_________________
_________
day of
,
.
__________________________________________________
Notary Public
____________________________________
My Commission Expires:
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