Application Packet For Powersports Dealer Adding Franchise License(S) Form (Page 2 of 4) in pdf

Rev (10-2011)

OKLAHOMA MOTOR VEHICLE COMMISSION

APPLICATION FOR POWERSPORTS DEALER ADDING NEW POWERSPORTS

PLEASE TYPE.

1. DBA Name _____________________________________ 2. Legal Name ___________________________________

(if different)

3. Physical Address___________________________________________________________________________________

Street Address

City

State

Zip

County

4. Mailing Address __________________________________________________________________________________

(if different)

P.O. Box

City

State

Zip

5. Dealership Phone _________________________________ Dealership Fax ___________________________________

Name

Direct Phone #

E-Mail

6. Dealer Principal ________________________________ _____________________ __________________________

Exec Manager __________________________________ _____________________ __________________________

(if different)

Contact Person _________________________________ ______________________ __________________________

(filling out this form)

7. Website Address: ___________________________________________________________

⁭

⁭ Partnership

⁭ Corporation

⁭ LLC

⁭ LP

8. Type of Ownership:

Individual

9. Complete for each Owner, Officer and Executive Manager (including date of birth and percent of ownership):

NAME

COMPLETE HOME ADDRESS

TITLE

D.O.B.

____________________ _____________________________________________ _________ ________ _____%

10. Have you or any of the principals ever had a Motor Vehicle Dealer or Salesperson License denied, revoked or

suspended in this or any other state? ⁭ Yes

⁭ No

If Yes, explain:

_______________________________________________________________________________________________

⁭ Yes

⁭ No

11. Have you or any of the principals ever been convicted of a felony?

If Yes, complete below:

Who? ________________________________ Where?_________________________ When? ________________

(circle one) Federal or State Charge

Convicted of: ______________________________________________

Attach copy of a Criminal History Background Report relating to the felony charge(s). The Application will

not be processed without this documentation. This Commission has the authority to verify, independently, the

accuracy of your response.

Application Packet For Powersports Dealer Adding Franchise License(S) Form Page 2

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