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DEALERSHIP
MOTOR VEHICLE BUREAU
FORM
DEALER’S REPORT DESK
385
STREET ADDRESS
P O BOX 43, JEFFERSON CITY MO 65105-0043
(573) 526-3669
CITY, STATE, ZIP
(REV. 4-2010)
DEALER’S MONTHLY SALES REPORT
INSTRUCTIONS
DEALER NUMBER
BOAT DEALER
WHOLESALE
TRAILER NUMBER
RV NUMBER
NUMBER
DEALER NUMBER
1. Sales may be filed electronically. If average sales are 20 or more per month, the dealer must file electronically and
D
M
W
T
RV
cannot use this report.
SALES MONTH
SALES YEAR
TELEPHONE NUMBER
2. Complete in full, sign, and mail to the above address.
(
)
3. Due by the 15th of the following month. Example: January sales must be reported by February 15th.
TOTAL UNITS SOLD THIS MONTH
Late Penalties: A $300 penalty is due for each report that is not filed by the due date as noted above.
TOTAL TEMPORARY PERMITS ISSUED THIS
TOTAL TEMPORARY PERMITS ISSUED THIS MONTH
4. Submit a separate report for each month. If no sales, enter "NO SALES."
MONTH BY M.V. DEALERS:
BY BOAT DEALERS:
5. Report all motor vehicle, trailer, powersport units, and boat sales. Powersport units include cycles, all-terrain vehicles,
and personal watercraft. Do not report outboard motor or mobile home sales.
MOTOR VEHICLE DEALERS ONLY
MARINE DEALERS ONLY
(Motor Vehicles, trailers, wholesale, RV
6. Attach a completed Notice of Sale (DOR-5049 or 5049A) for each retail sale made to a Missouri resident
(Boats and boat trailers)
and powersport units)
(electronic filers are exempt).
QTY. OF NEW UNITS SOLD
QTY. OF NEW UNITS SOLD
7. Attach Secure Power of Attorney forms and copies of corresponding titles (front and back) for each vehicle sold, if
applicable.
QTY. OF USED UNITS SOLD
QTY. OF USED UNITS SOLD
8. Retain copies of each report and the above documents for your records.
TOTAL SALES
TOTAL SALES
9. Call (573) 526-3669 if questions.
TEMPORARY
NAME OF BUYER
YEAR
MODEL
TYPE:
DATE
VEHICLE/BOAT ID NUMBER
ODOMETER
NET
NEW USED
PERMIT NUMBER
SOLD
FROM MSO OR TITLE
DOC
SETTING
PRICE
ADDRESS OF BUYER
MAKE
STYLE
MV
TRL
BOAT
ATV
(IF APPLICABLE)
VES
1.
2.
3.
4.
5.
6.
7.
SIGNATURE
TITLE
DATE
AS AN OFFICER, PARTNER OR OWNER OF THE DEALERSHIP,
I HEREBY CERTIFY UNDER PENALTY OF PERJURY THAT THE
X
INFORMATION IN THIS REPORT IS TRUE AND ACCURATE.
MO 860-0334 (4-2010)