Form Mvd-350-Dealer License Application
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2Office Use
Bureau of Motor Vehicles
Application for a Dealer License
Type:
New Application
Additional License Type
Annex Location
Other (Specify)
Change of Status
Change of Location
Secondary Location
_____________
Owner Name _________________________________________________Phone Number__________________
Business Name _______________________________________________ Phone Number_________________
Business Physical Location ___________________________________________________________________
City or Town _________________________________________________ Zip Code______________________
Business Mailing Address ____________________________________________________________________
City or Town _________________________________________________ Zip Code ______________________
Franchise(s) Held___________________________________________________________________________
Sales Tax Number ______________________
Federal ID Number__________________________________
E-mail Address: ____________________________________________________________________________
Website Address:___________________________________________________________________________
Please list any annex or secondary location(s) where business will be conducted under same license:
LOCATION(S) ______________________________________________ Phone Number__________________
In the columns below please check off the types of licenses you are applying for and enter the appropriate fee. Total
the far right column and enter the amount at the bottom.
Types of Licenses
License
License Fee
Total Fee
New Car Dealer License
@150.00 ea.
Used Car Dealer License
@150.00 ea.
Loaner License
@150.00 ea.
Equipment Dealer License
@150.00 ea.
Transporter License
@150.00 ea.
Recycler License
@150.00 ea.
(no fee if licensed as new, used, or equipment dlr.)
Auction License
@150.00 ea.
Heavy Trailer License
@150.00 ea.
(over 3,000 lbs.)
Light Trailer License
@ 50.00 ea.
(3,000 lbs. or less)
Motorcycle Dealer License
@ 50.00 ea.
Annex License
@150.00 ea.
Secondary Location
@100.00 ea.
Filing Fee - If you are applying for a new license, changing a business
location, or changing ownership or corporate structure.
Add $150.00
TOTAL (Total Amount from Back and Front)
Please list below the name, address, date of birth, and title of each owner, partner, or officer in your business.
______________________________________________________________________________
Name
Address
Date of Birth
Title
______________________________________________________________________________
Name
Address
Date of Birth
Title
MVD-350 (Rev. 07/15)
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