Salvage Vehicle Agent Employment Certification

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SALVAGE VEHICLE AGENT
EMPLOYMENT CERTIFICATION
I certify that __________________________________________________________________,
(Agent’s Name – Printed)
driver license or personal identification number _______________________________________
is a bona fide employee of:
______________________________________________________
(Name of Dealership)
__________________________,
(Dealer License Number)
and that the dealer takes responsibility for this employee’s actions in the course of employment.
Should the employment be terminated, the dealership agrees to surrender the photo
identification card and notify the Michigan Department of State, Bureau of Driver and Vehicle
Programs, Business Licensing Section within five days.
___________________________________________________________ _________________
(Signature of Dealer)
(Title)
___________________________________________________________ _________________
(Printed Name of Dealer)
(Date)
12/2015

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