Form Itd 3170 - Application For Vehicle Or Vessel Dealership License Page 3

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ITD 3170 (Rev. 07-17)
Idaho Code 49-1610 requires appointment of the
itd.idaho.gov
Director of the Idaho Transportation Department
as a legal agent for the dealership.
Complete Section I if the business is an individual; Section II if it is a partnership or Section III if it is a corporation or LLC. All
owners, partners, members, or a majority of corporate officers must sign and all signatures must be notarized.
Section I Individual
I certify under Penalty of Perjury that I am the sole owner of (Name of Business) __________________________________________
______________________________________ and that all answers and information contained in this application are true and correct.
I hereby appoint the Director of the Idaho Transportation Department as my true and lawful agent for the purpose of the service of
process(es) in any action(s) that may hereafter be commenced against me and/or my dealership for alleged violations of Chapter 16 Title 49
Idaho Code. This agency shall continue during the period covered by any license that may be issued to me and so long thereafter as I may be
made to answer for any violations of the aforementioned Idaho Code.
(Husband and wife must sign in this section as an "individual")
Signature
Signature
Section II (Check One)
Partnership
Limited Partnership (LP)
Limited Liability Partnership (LLP)
We certify under Penalty of Perjury that we are co-partners or members in (Name of Business)
______________________________
___________________________________________________________________and that no other person is associated in the ownership of
the business, and that all answers and information contained in this application are true and correct.
We hereby appoint the Director of the Idaho Transportation Department as our true and lawful agent for the purpose of the service of
process(es) in any action(s) that may hereafter be commenced against us and/or our dealership for alleged violations of Chapter 16 Title 49
Idaho Code. This agency shall continue during the period covered by any license that may be issued to us and so long thereafter as we may
be made to answer for any violations of the aforementioned Idaho Code.
Signature
Signature
Signature
Signature
Signature
Signature
Section III (Check One)
Corporation
Limited Liability Company (LLC)
I/We certify under Penalty of Perjury that (Name of Business) _________________________________________________________
________________________________________________ is incorporated in the state of Idaho and is authorized to transact business in
Idaho, and that all answers and information contained in this application are true and correct.
I/We, as Officer(s)/Member(s) of the Corporation or LLC, hereby appoint the Director of the Idaho Transportation Department as my/our
true and lawful agent for the purpose of the service of process(es) in any action(s) that may hereafter be commenced against my/our
dealership for alleged violations of Chapter 16 Title 49 Idaho Code. This agency shall continue during the period covered by any license that
may be issued to the corporation and so long thereafter as I/we may be made to answer for any violations of the aforementioned Idaho Code.
Officer's/Member’s Signature
Officer's/Member’s Signature
Officer's/Member’s Signature
Officer's/Member’s Signature
Officer's/Member’s Signature
Officer's/Member’s Signature
STATE OF
)
) §:
COUNTY OF
)
On this
day of
, before me, the undersigned, a Notary Public in and for said state,
personally appeared
, known to me or
proved to me to be the person(s) who executed the instrument and acknowledged to me that he/she/they executed the same.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal the day and year the certificate was first above written.
Notary Public for the State of Idaho
(SEAL)
Residing at
My commission expires
,
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