Sd Eform 1674 V11 - South Dakota Dealer License Application Page 5
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5DEALER INFORMATION
THE FOLLOWING INFORMATION IS NEEDED FOR YOUR DEALERSHIP TO OBTAIN ACCESS
TO THE STATE’S DEALER ON-LINE COMPUTER SYSTEM.
PLEASE COMPLETE A SEPARATE FORM FOR EACH DEALERSHIP LOCATION UNLESS
WISHING TO USE ONE LOG-IN.
RETURN COMPLETED FORM TO: DIVISION OF MOTOR VEHICLES, ATTN: DEALER
LICENSING SECTION, 445 EAST CAPITOL AVE, PIERRE, SD 57501.
PLEASE PRINT INFORMATION
Dealership Name:
Address:
Contact Person Name/Telephone Number:
Dealership FEIN (if business is a sole proprietorship, an owner’s SD Drivers License Number or Social
Security Number may be used):
Dealer License Numbers (list all dealer license numbers found at the above location):
Dealer with multiple locations wishing to utilize one log-in (all locations must have same ownership), list
main dealership utilizing the system and the dealer name(s) and number(s) it wants access to:
Main dealership:
____________________________________________________________________________________
Other locations:
_____________________________________________________________________________________
Person Completing Form:
Date
Name
Signature
PRINT FOR MAILING
CLEAR FORM
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Parent category: Financial