Office Use
Is your business: (Check One)
Individual
Partnership
Corporation
If a corporation, what state are you incorporated in? ___________________________________
Within the past (5) five years, have you or any partner, director or officer of your business been found guilty
of any:
1. Felony
Yes ___ No ___ 2. Criminal violation under Title 29-A or Title 17-A Yes ___ No ___
3. Any civil judgment involving fraud, misrepresentation or conversion Yes ___ No ___
If yes to any give location, date and violation______________________________________________________
Write the number of plates you need to match the type of license you applied for on the front of this application.
Multiply the number of plates times the plate fee, enter the amount in the far right column and total the column.
Type of Plate
No. of Plates
Plate Fee
Total Fee
New Car Dealer Plate
@ 20.00 ea.
New Car Dealer Vanity Plate
@ 50.00 ea.
New Car Loaner Vanity Plate
@ 50.00 ea.
Used Car Dealer Plate
@ 20.00 ea.
Loaner Plate
@ 20.00 ea.
Equipment Dealer Plate
@ 20.00 ea.
Transporter Plate
@ 20.00 ea.
Trailer/Mobile Home Dealer Plate
@ 20.00 ea.
(over
3,000 lbs.)
Light Trailer Dealer Plate
@ 5.00 ea.
(3,000 lbs. or less)
Motorcycle Dealer Plate
@ 5.00 ea.
Light Wrecker Plate
@ 50.00 ea.
(26,000 lbs. or less)
Heavy Wrecker Plate
@ 200.00 ea.
(80,000 GVW or less)
Service Vehicle Plate
@ 50.00 ea.
New or used car only
Equipment Service Vehicle Plate
@ 20.00 ea.
TOTAL
(carry total to front side)
Add the total fees on both sides of this sheet and send your check, made payable to the Secretary of State, to:
Bureau of Motor Vehicles, Dealer and Agent Services, 29 State House Station, Augusta, Maine 04333.
Payment may be made by credit card:
Type:
Visa
Mastercard
Number: ______________________
Expiration Date: _________________________________________
Name on Credit Card: _________________________________________
____________________________________________________________________________________
Signature of Owner
Official Title
Dat
If you have any questions, please call Dealer and Agent Services at
(207) 624-9000 Ext. 52143.
(Rev. 9/08)
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