Form Itd 3170 - Application For Vehicle Or Vessel Dealership License Page 2
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4ITD 3170 (Rev. 07-17)
Application For Vehicle Or
itd.idaho.gov
Vessel Dealership License
Application Date
Dealership EIN
Large
Small Motorcycle
Small Restricted Use
Number of Plates
Requested
Application Type (Check One) (A New Application Must be Completed for Each Type)
New Application
Change of Location
Change of Business Name
Supplemental Lot
Change of Ownership
Change of Officers/Members
License Type (Check One)
Vehicle/Vessel Sales Type (Check All New Sales That Apply OR Check One Used Category)
New Automobile/Truck*
New Trailer*
Used ATV/UTV/MC/Snowmobile Only
Wholesale
New Recreational Vehicle*
New Vessel*
Only Used Vehicles (Including Trailer/
Retail
ATV/UTV/Motorcycle/Snowmobile/Vessel)
New ATV, UTV, Motorcycle or Snowmobile*
*A copy of the franchise agreement for any new vehicle or vessel make must be enclosed with your application.
Dealership Information (Check One) (Complete All the Information Requested Below and see Instructions on Page 1)
Individual
Partnership
Corporation
(Please submit verification of the filing.)
Limited Partnership (LP)
Limited Liability Partnership (LLP)
Limited Liability Company (LLC)
Owner's Name(s) or Corporation/LP/LLP/LLC Name
Idaho Code 53-504 requires any business doing business as (DBA) a name other than the legal owner's name to file a Certificate of
Assumed Business Name with the Secretary of State's Office. Idaho Code 53-504 exempts a corporation from this requirement, unless
the corporation is using an assumed business name.
Dealership or Trade Name (DBA)
Dealership Phone
Fax Number
Cell Number
Street Address
City
State
Zip Code
Mailing Address
City
State
Zip Code
Directions to Dealership (If Other Than a Street Address)
Name of Person or Persons Having Legal Custody of Real Property
Phone Number
Mailing Address
City
State
Zip Code
List the legal name (as shown on their driver’s license) and title of each individual owner, partner, officer, member, or stockholder of
the business. A Personal History form (ITD 3171) is required for each individual listed below (attach a separate sheet, if necessary).
Name
Title
Name
Title
Name
Title
Name
Title
Name
Title
Zoning Authorization
(This section must be signed and stamped by the county or zoning authority with jurisdiction over the dealership location if
this is a new application, a change of location, or a new supplemental location. A separate authorization may be submitted.)
I hereby certify, in accordance with Idaho Code 49-117(15), that the location listed above is in compliance with all county and/or
city zoning and other land-use ordinances for the sale and repair of vehicles/vessels.
Zoning Officer’s Signature
Please Use Official Stamp
(If Available)
County of
City of
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