Form Mv-6 - Dealer, Distributor, Manufacturer & Transporter Tag Application

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DOR USE ONLY

Form MV-6 (Rev. 04-2013)

Permanent (12) Digit Customer ID#

Georgia Department of Revenue – Motor Vehicle Division

Master Tag Number

Dealer, Distributor, Manufacturer & Transporter Tag Application

Please read the instructions that apply to requested tag category before

completing and submitting documents and fees.

Company’s Publicly Listed Phone Number (No cell phone numbers)

State of Georgia Tax ID Number (Attach copy)

State of Georgia Business or Occupational License Number (Attach copy)

State of Georgia Used Motor Vehicle Dealer Number, Used Motor Vehicle

Parts Dealer Number (Attach current copy)

Manufactured Home Dealers Only

Makes of Motor Vehicles, Tractors, Trailers or Motorcycles Sold,

Manufactured, Leased or Transported

State of Georgia Fire Marshal Number (Attach current copy)

TRANSPORTERS (ATTACH COPIES)

Federal Employer Identification Number (FEIN)

U.S. D.O.T. Number

I.F.T.A. Decal Number

In accordance with Georgia Law §40-2-38, I am applying for distinguishing tags for motor vehicles manufactured, distributed, exchanged, sold,

transported or leased by the company, business, firm, corporation or LLC referenced in this application.

Full, Legal Name of Company, Business, Firm, Corporation, LLC

D/B/A Company, Business, Firm, Corporation, LLC Name Under Which

You Do Business, if not the same as the full, legal name

Established Place of Business Street Address

City

State

Zip Code

County

Mailing Address (if different from street address)

City

State

Zip Code

County

TAG CATEGORY

Check box to indicate the tag category you are requesting. Submit a separate MV-6 application for each category or business location.

Dealer

Distributor

Manufacturer

Motorcycle Dealer

Motorcycle Distributor

Motorcycle Manufacturer

Transporter

When applying for dealer tags, check applicable box(es) below:

Master Tag*

$ 62.00

Franchise Dealer (new motor vehicles)

Independent Dealer (used motor vehicles) – An Independent Dealer

Number of additional tags* ________@ $12.00

$_______

also check the app

licable box(es) below:

Franchise Fee/Franchise dealers only (new motor vehicles) $ 25.00

Auction Comp

any

Broker

Mailing Fee*

________# of tags

$_______

Retail Dealer

Total Due:

$_______

Wholesale

Motorcycle Dealer

*See instructions for requirements. Pay all fees with a check or money

order payable to the Department of Revenue. Please do not remit cash

Manufactured Home Dealer

by mail.

Trailer Dealer

By placement of my signature hereon, I do solemnly swear, affirm or certify under criminal penalty of a felony for fraudulent use of a false or fictitious

name or address or making a material false statement punishable by a fine of up to $5,000 or by imprisonment of up to five (5) years, or both, that

statements contained on documents submitted by me are true and accurate. I also swear, affirm or certify that I am the authorized agent to sign for

the company listed above, and shall comply with all state laws, rules and regulations pertaining to these tags.

The person authorized to complete this application must print their name, sign their name and enter their position or job title with the company and the

date signed. Attach a copy of the authorized person’s valid Geo

rgi

a driver’s license or Georgia ID card.

Printed Name of Person Authorized to Complete MV-6, MV-6A

Signature & Position or Job Title of Person Authorized to

Date

MV-6B & MV-6C forms.

omplete MV-6, MV-6A, MV-6B & MV-6C forms.

Mailing Address

In-Person Address

ATTN: Dealer Registration

Department of Revenue