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RECREATIONAL VEHICLE DEALER <br />Wisconsin Department of Transportation <br />Dealer comaenn <br />I VVU YLAK L! IzNSE APPLICATION <br />FOR OFFICE USE ONLY <br />- ----- <br />PO Box 7909 <br />MV2187 3/2005 Ch. 218 <br />Wis. Stats. Issued <br />Expires <br />Do ou own and operate your own service department? <br />Madison, WI 53707-7909 <br />Submit in duplicate. <br />Amending Current <br />D <br />f Yes ❑ No, Attach completed service agreement <br />❑ b. Some or all of the contracts are retained by our <br />Have you, as an individual and your above-named firm, been licensed as a dealer before? <br />1-1 F-1 <br />Complete ONE of the following (whichever applicable): <br />Is business real by: <br />License Information <br />NO <br />No Yes, Same location? FIN o 1:1 Yes <br />Has <br />estate owned <br />Owner of sole proprietorship <br />'_egalName <br />no, <br />❑ <br />I Area Code- Telephone Number <br />One partner of partnership <br />DealerLicenseNumber <br />Trade Name(s) or DBAs <br />and what state? <br />which is greater than $100,000. Do not submit a fee. You <br />or illegible plates........................................each plate $2.00 <br />Federal EmployerldentificafionNumber <br />Street Address or RFD <br />Post Office Box Number City <br />State ZIPCode <br />❑ of lease. <br />County where business located <br />i <br />' <br />Business Entity <br />F-1Association If Corporation or LLC, <br />State of Incorporation or Organization <br />❑ City ❑ Village ❑ Town <br />❑ Sole Proprietorship <br />p p <br />Date Licensed in Wisconsin <br />❑Corporation � <br />Name: <br />❑ Partnership <br />❑ LLC <br />List makes of travel trailers to be sold <br />Address of NONADJACENT Sales Location in SAME MUNICIPALITY <br />Branch: Subiot: <br />Name and Title of Owner, Partners, Association Members, Corporation Officers and Shareholders, LLC Managers and Members <br />Complete an Entity/Owner Statement (Form MV2844) for each individual listed. <br />Completely describe other business, if any, engaged in by your firm <br />Number <br />Same location? I License Numbers of Additional Dealerships <br />- ----- <br />--- 11No -- -❑ Yes i <br />on a cash only basis. Fee due is $20. <br />Salesperson License ............ Number x $8.00 <br />Was there a licensed dealer at this same location previously this year? <br />❑ ❑ <br />Do ou own and operate your own service department? <br />❑ a. All of the contracts we originate are sold or transferred <br />Buyer ID Card(s).................Number x $12.00 <br />No Yes, Name dealer <br />f Yes ❑ No, Attach completed service agreement <br />❑ b. Some or all of the contracts are retained by our <br />Have you, as an individual and your above-named firm, been licensed as a dealer before? <br />1-1 F-1 <br />Complete ONE of the following (whichever applicable): <br />Is business real by: <br />YES <br />NO <br />No Yes, Same location? FIN o 1:1 Yes <br />Has <br />estate owned <br />Owner of sole proprietorship <br />[jIf <br />no, <br />❑ <br />your recreational vehicle dealer license ever been denied, suspended or revoked? <br />❑No ❑ Yes, When <br />One partner of partnership <br />❑ <br />❑ send copy <br />and what state? <br />which is greater than $100,000. Do not submit a fee. You <br />or illegible plates........................................each plate $2.00 <br />will receive a separate bill. <br />Corporate dealership <br />❑ <br />❑ of lease. <br />LC <br />LL'- <br />Number of Nen' Used <br />vehicles sold Retail <br />in last 12 — — — — — — — — — — — — — — — <br />month period <br />Wholesale <br />SALES TAX SELLER PERMIT NUMBER (Not required for consignment sales only) <br />Fllease check only ONE box that applies to your dealership. <br />Call 608-261-9555 if you have questions about these fees. <br />Dealer License (Required fee)...............................$100.00 <br />❑ 1. During the next two years our dealership will sell all vehicles <br />on a cash only basis. Fee due is $20. <br />Salesperson License ............ Number x $8.00 <br />2. Our dealership originates retail installment sales contracts. <br />❑ a. All of the contracts we originate are sold or transferred <br />Buyer ID Card(s).................Number x $12.00 <br />to a third party. Fee due is $100. <br />❑ b. Some or all of the contracts are retained by our <br />dealership. Fee due is $100. <br />Dealer License Plates Required..... First 2 plates = $150.00 <br />❑ 3. The total amount of installment contracts (not including leases) <br />Number of additional plates @ $10.00 <br />originated and retained in the last 12 months was $ <br />List letters of all missing plates <br />which is $100,000 or less. Fee due is $100. <br />❑ 4. The total <br />amount of installment contracts (not including leases) <br />originated and retained in the last 12 months was $ <br />Replacement License Plates for lost, damaged, <br />which is greater than $100,000. Do not submit a fee. You <br />or illegible plates........................................each plate $2.00 <br />will receive a separate bill. <br />Does your dealership write credit insurance? ❑ No ❑ Yes <br />CHECKPAYABLETO: REGISTRATION FEE TRUST $ <br />CHECK PAYABLE TO: Department of Financial Institutions <br />I, the undersigned, certify under penalty of s.345.17 Wisconsin Statutes, that (1) a lease agreement covering at least the licensing year has been <br />executed, if premises are not owned by applicant, and (2) the answers and statements on this application are true and correct to the best of my <br />knowledge. <br />See reverse side. x <br />(Authorized Dealership Agent, Title) (Date) <br />