Form Mf 203 - Application For License As A Retail Motor Fuel Dealer

Download a blank fillable Form Mf 203 - Application For License As A Retail Motor Fuel Dealer in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form Mf 203 - Application For License As A Retail Motor Fuel Dealer with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

Reset Form
MF 203
Rev. 12/08
License number assigned
P.O. Box 530
Columbus, OH 43216-0530
Application for License as a Retail Motor Fuel Dealer
Pursuant to Ohio Revised Code section (R.C.) 5735.02, I/we hereby apply for a motor fuel dealer’s license. For sole owner,
print individual’s name, address, owner’s SSN and FEIN of the business. For a partnership, print full name, address, and
SSN of all partners and the partnership’s FEIN. For an LLC or LLP, print the full name, address and SSN of all members. For
a corporation, print the corporate name, corporation charter number issued by the Secretary of State authorizing business
in Ohio and the corporation’s FEIN. Use a separate piece of paper if necessary.
Under penalties of prosecution, no person shall make a false
or fraudulent statement on this application.
1. Name of applicant
(If you are a corporation, DO NOT use your name, use the corporation name.)
FEIN
SSN
Ohio charter number
Telephone
Fax
E-mail
2. Trade name if other than above
Partnership
Corporation
LLC
LLP
3. Check whether applicant operates as:
Sole owner
 
Association
Other (list)
4. If a corporation, date of qualifi cation
List name, address and SSN of all corporate offi cers and directors
5. If a corporation, state name and address of statutory agent
6. If partnership, list name, address and SSN of all partners. If LLC or LLP, list name, address and SSN of all members.
7. Location detail. List physical address of every retail location in Ohio – P.O. boxes not acceptable.
Also, list the estimated
monthly gallonage disbursement for each location listed (use a separate sheet of paper, if necessary).
8. Mailing address (if other than that shown on line 7)
9. Is your company owned or controlled by any other person or corporation?
Yes
No If yes, give name, address
and FEIN or SSN or the other person/corporation.
10. Do you maintain accurate and detailed records of all bulk motor fuel receipts?
Yes
No If yes, how long are
records kept?

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Financial
Go
Page of 2