Vehicle Dealer License Change Of Name And Change Of Address Application Page 5
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508/2009
MUNICIPALITY APPROVAL
:
Name
of Dealership
:
D
ealership Address
(street)
(city)
(zip)
Dealer License Number (if applicable): ______________________
Class A - New Vehicle Dealer
Class B - Used Vehicle Dealer
Class C - Used Vehicle Parts Dealer
Class D - Broker
Class E - Distressed Vehicle Tr
ansporter
Class F - Vehicle Scrap Metal Proces
sor
Class G - Vehicle
Salvage Pool
Class R - Automotive Recycler
Class W - Automotive Wholesaler
Municipal Authority:
The lic
e
nse(s) being applied for (checked ab
ove) would permit, but not require, all business
a
ctivitie
s described above. Please check the appropriate category below, complete the
signature portion of t
his form, and return this completed form to the applicant.
If you have any questions or concerns, contact the Michigan Department of State, Licensing
Unit, at 1-888-SOS-MICH (1-888-767-6424).
T
hank you.
Municipality
requirements may include; local building code requirements, land use
r
equirements
, sign ordinances, local licensure, etc…
Location MEETS all the municipal requirements for dealer classification(s) c
hecked
above.
Location DOES NOT MEET all the municipal requirements for dealer classification(s
)
checke
d above. Please list the reason(s).
Reaso
n:
There are NO MUNICIPAL REQUIREMENT
S in this jurisdiction for dealer
clas
sification(s) checked above.
(
)
Signature of Municipal Authority
Date
Telephone
Number
Printed Name of Municipal Authority
Jurisdiction (City, Township, etc.)
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