Form Mvd-362 - Applicant Questionnaire For Licensing Of Dealers, Transporters, Loaners Or Recyclers Page 2

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These questions ask about your business office:
1. Do you have an office with at least 64 sq. ft. to keep records and conduct business?
Yes
No
2. Is your office heated?
Yes
No
3. Does your office have at least 1 desk, 2 chairs, and a filing cabinet?
Yes
No
4. Is your office completely enclosed by floor to ceiling construction?
Yes
No
5. Is your office separate from any living quarters?
Yes
No
6. Is your office located in or adjoining your business building?
Yes
No
These questions ask about your business sign:
1. Is your business identified by an exterior sign?
Yes
No
2. Is the sign permanently affixed to land or building?
Yes
No
3. Is the sign readable at a distance of 200 feet?
Yes
No
4. Is the sign at least 12 square feet in size?
Yes
No
5. What does the sign say? ____________________________________________
If you are applying for a recycler dealer license, you must also complete the last set of questions by checking
Yes or No to each question below.
1. Is there a storage area in or adjoining the building?
Yes
No
2. Is the business within 1,500 feet of a state or federally owned cemetery?
Yes
No
3. Did your salvage yard exist before December 5, 1983?
Yes
No
If No, what date did your salvage yard begin? ___________________________
4. Is this an expansion of an existing salvage yard?
Yes
No
5. Do you maintain a business inventory of all vehicles, component parts, body, chassis, or
transmissions that are received or disposed of as required by law?
Yes
No
5a. Explain your record keeping procedures: __________________________________________________
__________________________________________________
6. Are you currently a licensed dealer in Maine?
Yes
No
7. Are you currently a licensed dealer in any other state?
Yes
No
Signature of Applicant
Title
Date
Notarization Required
Before me personally appeared ___________________________________, who by me being duly sworn under
oath says that the statements set forth above are true and correct.
Sworn to and subscribed before me at _________________________________, Maine, on this________________
day of ___________________________, 20______.
Notary Public _____________________________________
My Commission Expires: ____________________________
2
MVD-362 Rev. 4-2013

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