STATE OF NEW JERSEY
USE FOR
MFT-7 R (02-00, R-3)
Division of Taxation
RENEWAL
MOTOR FUEL TAX
Application Required by
ONLY
PO Box 189
NJ Motor Fuel Tax Law
Trenton, NJ 08695-0189
APPLICATION FOR RENEWAL OF WHOLESALE DEALER’S LICENSE
Complete this application to request a renewal of a Wholesale Dealer’s License which is needed for each establishment, wherever located, operated by such
person out of which wholesale sales in New Jersey are made.
Every Wholesale Dealer’s license is subject to payment of a renewal fee of $450.00 for a three year period which should accompany this application. Make
check or money order payable to: STATE OF NEW JERSEY-MFT, on or before April 1.
Make any necessary changes below for 1 - 5
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-
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1. FID #
OR
Soc. Sec. # of owner
2. Name________________________________________________________________________________________________________________
(If INCORPORATED - give Corp. Name; IF NOT - give Last Name, First Name, MI of owner(s))
3. Trade Name__________________________________________________
5. Mailing Name and Address -
(if different from farm address)
4. Business Location:
Name________________________________________________
Street_______________________________________________________
Street________________________________________________
City__________________________________________ State
City____________________________________ State
-
Zip Code
Zip Code
-
(Give 9-digit Zip)
(Give 9-digit Zip)
Please fill in all information below:
6. Type of ownership (check one):
¨ NJ Corporation
¨ Sole Proprietor
¨ Partnership
¨ Out-of-State Corporation
¨ Limited Partnership
¨ Other - explain___________________________________________________________________________________________________
7. Telephone Numbers: Contact Person ___________________________________________
Title__________________________________
Daytime: (
) ________ - __________________Ext_________
Evening: (
) ________ - _________________Ext_________
8. Provide the following information for ALL owners, partners or responsible corporate officers. (If more space is needed, attach rider).
%
NAME
SOCIAL SECURITY NUMBER
HOME ADDRESS
(Last Name, First, M.I.)
OWNED
TITLE
(Street, City, Zip)