Sd Eform 1736 V6 - South Dakota Organization/first Responder Decal Application
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2SD EForm -
1736
V6
Complete and use the button at the end to print for mailing.
HELP
South Dakota Organization/First Responder Decal Application
MV-1100
South Dakota Department of Revenue
Revised
Division of Motor Vehicles
07/09
445 E. Capitol Avenue | Pierre, SD 57501-3185 | 605-773-3541
A
:
Y
N
B
:
D
:
FOR OFFICE USE ONLY
PPROVED
ES
O
Y
ATE
Form Instructions
Upon approval of an application for the organization decal and approval of the design of the decal, the department shall furnish the decals to the
organization or authorize the organization to use a decal produced by the organization. If purchased from the department, the organization shall
purchase a minimum of 100 sets (200 decals) of the organization decals. The organization shall reimburse the department for the cost of the
decals, plus a fifteen percent administrative fee. The organization is responsible for determining who qualifies for the decal and the fee to be
charged. The organization is also responsible for administration and issuance of the decals.
Organization Information
N
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Decal Requirements
(To qualify for an organization decal, you must meet the following requirements.)
) 1
s I
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QUALIFYING ORGANIZATION OR GROUP OF ORGANIZATIONS AND A FIRST RESPONDER ORGANIZATION SHALL MEET THE FOLLOWING
.
REQUIREMENTS
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,
N ADDITION TO THE COMPLETED APPLICATION
THE ORGANIZATION OR GROUP OF ORGANIZATIONS MUST PROVIDE THE FOLLOWING
. A
#
. 4
DOCUMENTS
FIRST RESPONDER ORGANIZATION MUST COMPLY WITH REQUIREMENT
. 1
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Contact Signature________________________________________________________________________________
Date__________________________________
C
S
D
ONTACT
IGNATURE
ATE
CLEAR FORM
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