Sd Eform 2076 V1 - Dmv Dealer Exit Audit
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SD EForm - 2076
V1
HELP
DMV DEALER EXIT AUDIT
MV900 12/09
Dealer Name and Number: _________________________________________________________________________________
Home Address (Owner): ____________________________________________________________________________________
Home Telephone Number (Owner):__________________________________________________________________________
Out-Of-Business (OB) Date: _____________________
Remaining Inventory:
Year
Make
(complete) VIN
SD Title Number
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
(use reverse side of form or attach additional sheet if needed)
Narrative on disposal of remaining inventory, (i.e., date of upcoming liquidation sale, etc.):
AUTHORIZATION NEEDED IF INVENTORY WILL NOT BE DISPOSED OF WITHIN 14 DAYS OF OB DATE:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
(use reverse side of form or attach additional sheet if needed)
Vehicles to be titled in personal name (transfer to be done within 14 days of OB date): total ___________:
Year
Make
(complete) VIN
SD Title Number
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
(use reverse side of form or attach additional sheet if needed)
On-Line Computer Account Balance (if not previously paid, due at time of exit audit): $_________________
I attest that all vehicle sales have been completed and titles delivered; that sales records will
be retained and available for 5 years from OB date; that any vehicle(s) being titled in my
personal name cannot be offered for sale and will only be used for my personal use; and that I
am responsible for payment of any remaining balance on my dealer on-line computer
account.
____________________________________________________________________________________________________________
Dealer Signature
Date
PRINT FOR MAILING
CLEAR FORM
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