Form Tc-301 - Utah Bonded Motor Vehicle Business Application (Page 3 of 3) in pdf

Form Tc-301 - Utah Bonded Motor Vehicle Business Application Page 3

TC-301, page 3 of 3

1. List at least five years of employment history, including dates, for each owner. Also include any motor vehicle salesper-

son, dealer, dismantler or auction license you have held and if the license has ever been denied, suspended or

revoked. Attach additional pages if needed.

Owner #1

Owner #2

Owner #3

2. During the past 10 years, have you been charged with, found in violation of, or convicted of any misdemeanors or felonies in Utah or

any other state? You are not required to disclose simple traffic infractions.

Yes

Failure to disclose any of the requested information may result in suspension or revocation of this license. A

charge, violation of or criminal conviction for a motor vehicle or drug-related crime, fraud or registered sex

offense can be grounds for denial, suspension or revocation. Attach additional pages if needed.

If yes, list each conviction:

Owner #1

Owner #2

Owner #3

3. Are you currently on probation or parole?

Yes

If yes, which owner? _____________ ____ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Signature

I am familiar with the motor vehicle dealer licensing law and other laws of Utah governing the conduct of motor vehicle

salespersons and will cooperate with the Utah State Tax Commission to eliminate abuse and unfair trade practices.

I certify under penalty of perjury that the statements contained in this application are true and correct and that I, as owner,

as a member of the partnership, or as an officer of the corporation, have authority to sign this application and to make the

statements set forth herein.

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Firm name

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Signature or owner, partner or corporate officer*

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Printed name of signer

* The signer must be owner, partner or corporate officer, or have POA. Submit copy of POA if applicable.

Form Tc-301 - Utah Bonded Motor Vehicle Business Application Page 3