Form Dlb-6a - Application For Motor Vehicle Auction Dealer License - 2010
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2FEE $ 225.00
DLB-6A Revised 2010
(collected after inspected and approval)
STATE OF NEBRASKA
BOARD
NEBRASKA MOTOR VEHICLE INDUSTRY LICENSING
301 Centennial Mall South, PO Box 94697, Lincoln NE 68509
(402) 471-2148
Application for MOTOR VEHICLE AUCTION DEALER LICENSE
Application of ___________________________________________________________________________________________for a license to
(Firm name under which business is conducted)
engage in the business of selling motor vehicles by auction
in accordance with the Motor Vehicle Industry Regulation Act, the rules and regulations
and in connection herewith makes the
adopted and promulgated by the Board, and any amendments to the act and the rules and regulations, to date;
following Material Statements:
1.
Address of Auction dealership:
_______________________________________________________________________________________________________
(Street)
(PO Box)
(Town or City)
(Zip Code)
(County)
If the above address is a rural location, please give directions to find the auction
_______________________________________________________________________________________________________________
2.
Does the above location conform to applicable zoning laws?
3.
Auction Phone Number: (_______)__________________
Facsimile number : (_______)__________________
Indicate your declared office hours: from _________A.M. to _________P.M.
4.
Describe fully the building and actual premises where the business is to be operated (include square feet of building and display area):
_______________________________________________________________________________________________________________
Owned
Leased
5.
Indicate whether the proposed location is owned or leased by the applicant:
If the location is leased, a copy of the lease not ending before December 31 of the current year must accompany this application.
6.
Will there be one contiguous area for the display of ten or more motor vehicles, trailers or motorcycles in a presentable manner where this
business is to be operated?
Yes
No
7.
Will all Auction records be kept separately and apart from other business or personal records?
Yes
No
8.
Submit with this application a photograph of the place of business, showing the permanently erected dealership sign in the photo. The
dealership name must be in letters at least 8 inches in height.
9.
Ownership of the auction dealership (check only one):
___ Individual Owner: Name and address ___________________________________________________________________________
Social Security Number: ______________________________________
___ Partnership: Names and Addresses of all Partners __________________________________________________________________
_______________________________________________________________________________________________________________
___ Corporation or Limited Liability Company ______________________________________________________________________
(Registered with the Nebraska Secretary of State)
Names, addresses, and titles of principal officers of the corporation or names and addresses of members of the Limited Liability Company:
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
10.
(a) Have any of the above persons ever been found guilty of any felony that has not been pardoned?
Yes ____ No ____
(b) Have any of the above persons ever been found guilty of any misdemeanor concerning fraud or conversion?
Yes ____ No ____
(c) Have any of the above persons suffered any judgment in any civil action involving fraud, misrepresentation or conversion? Yes ____ No ____
(d) Are any felony charges pending against any of the above persons at the present time?
Yes ____ No ____
If answer is YES, please give details. _________________________________________________________________________________
A corporate surety bond in the amount of $100,000 must accompany this application.
IMPORTANT:
THE OATH ON THE REVERSE SIDE MUST BE SIGNED.
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