Form Dlr-430-205 - Vehicle, Vessel, Vehicle Manufacturer, Registered Tow Truck Operator, Or Wrecker Bond - Washington Department Of Licensing
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Vehicle, Vessel, Vehicle Manufacturer,
Registered Tow Truck Operator, or Wrecker Bond
Vehicle/ vessel dealers, vehicle manufacturers, registered tow truck operators, or wreckers use this form when a bond is
required for licensing. Send this completed form to: Master License Service, Department of Licensing, PO Box 9034,
Olympia, WA 98507.
Type of bond (check one):
Vehicle
Vessel
Registered tow truck operator
Wrecker
Vehicle manufacturer
Business information
Bond number
Legal entity name and Doing Business As (DBA) name
City of business location
State
Bonding agent information
(if known)
Name of bonding agent
(Area code) Telephone number
Address
City
State
ZIP code
Bonding company information
Name of bonding company
(Area code) Telephone number
Address
City
State
ZIP code
The bonding company organized and existing under the laws of the state of ______________________ and authorized to
transact business in the state of Washington, as surety, are held and firmly bound to a bond in the amount of __________
to be paid to the state of Washington. The conditions the principal, bonding company and the state of Washington agree to
by taking out this bond are as follows:
1. As a precondition to receiving and maintaining a license, the license holder must keep this bond in full force and
effect. If any cancellation, revocation, or withdrawal by the surety/bonding company occurs, or if the entire bond
amount is exhausted, the department will terminate the license until such time as a new bond for
_____________________________________________________________________________________________________________________
Legal entity name and DBA name
is provided to the state of Washington with no lapse in coverage.
2. The bond shall become effective, ___________________, 20_____, and is intended to cover any subsequent
periods for which the Dealer and Manufacturer Services section may issue a license to the principal. This bond is to
be accepted as a continuing obligation until cancelled by the surety with thirty (30) days written notice of cancellation
received by the Department of Licensing of the state of Washington, in accordance with the provisions of the Revised
Code of Washington.
X
____________________________________________________________
Signature of owner/ each partner/ corporate officer/ member/ manager of LLC
Date
Bonding company seal
____________________________________________________________
(Required)
____________________________________________________________
____________________________________________________________
X
____________________________________________________________
Signature of Attorney in Fact
Date
We are committed to providing equal access to our services.
If you need accommodation, please call (360) 902-3600 or TTY (360) 664-0116.
DLR-430-205 (R/9/10)W
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