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Utah State Tax Commission
TC-756
Application for Motor Vehicle Temporary Permits
Rev. 6/12
(office use only)
Dealer Number: __ __ ____ _ _ _
Dealer name: ______ ___ __ __ __ ___ __ __ __ ___ __ __ _ _ _ _
I hereby make application to the Utah State Tax Commission, Motor Vehicle Enforcement Division, for the following amount of temporary
vehicle permit books (check ONE only):
1 book (25 permits), $304.00
2 books (50 permits), $608.00
3 books (75 permits), $912.00
4 books (100 permits), $1,216.00
5 books (125 permits), $1,520.00
6 books (150 permits), $1,824.00
7 books (175 permits), $2,128.00
8 books (200 permits), $2,432.00
9 books (225 permits), $2,736.00
10 books (250 permits), $3,040.00
11 books (275 permits), $3,344.00
12 books (300 permits), $3,648.00
Attached is my payment of $__ _ __ _ __ _ __ . I am the owner, partner or corporate officer of the above-noted dealership, or I
have been authorized by the dealership to place this order.
__ _ _ ___ ___ __ ___ _ __ _ __ _ __ _ _ _
______ __ __ ___ __ __ __ ___
_ __ __ _ _ _ _ _ _ _
Signature of authorized representative
Print name
Date of application
IMPORTANT: To protect your privacy, use the "Clear form" button when you are finished.
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Save valuable time and money by using the Internet.
Temporary permits can be purchased and temporary permit
audits can be cleared online at mved.utah.gov.
Payments can be made online using Visa, MasterCard,
America Express and Discover.
Call MVED at (801) 297-2600 to get a password for your
dealership so you can take advantage of these services.
Utah State Tax Commission
Motor Vehicle Enforcement Division
210 N 1950 W
Salt Lake City, UT 84134
801-297-2600
mved.utah.gov