Fillable APPLICATION FOR BUSINESS LICENSE AND GARAGE REGISTRATION (Department of Motor Vehicles )

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APPLICATION FOR BUSINESS LICENSE AND GARAGE REGISTRATION (Department of Motor Vehicles )

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  • 41 other fields

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Occupational and Business Licensing
555 Wright Way
Carson City, Nevada 89711
(775) 684-4690
www.dmvnv.com
OBL237 (11/2016)
Page 1 of 2
APPLICATION FOR BUSINESS LICENSE AND GARAGE REGISTRATION
State Business License Number
DMV License Number
(If new applicant, please leave blank)
Individual/Corporate Name
DBA Name
Mailing Address
Street
City
State
Zip Code
Physical Address
Street
City
State
Zip Code
Business Phone Number
Business Fax Number
E-Mail Address
FEIN:
Reason for Submittal
Business Type
Dealer
(Business Activity)
Schools
(Business Activity)
☐
New Application
☐
Rebuilder
☐
Dealer
☐
Drive School
☐ Principal Location
☐
Manufacturer
☐ New Motor Vehicle
☐ Behind-the-Wheel
☐ Branch Location
☐
Distributor
☐ Used Motor Vehicle
☐ Classroom
☐
Change
☐
Transporter
☐ New Trailer
☐ Correspondence
Mark type of change(s)
☐
Broker
☐ Used Trailer
☐ Internet
☐ Add Activity
☐
Wrecker
☐ New Motorcycle
☐ Minors
☐ Remove Activity
☐ Electronic Notification
☐ Used Motorcycle
☐ Change of Principal(s)
☐
Salvage Pool
☐ Moped
☐
Traffic Safety School
☐ Adding ☐ Deleting
☐ Consignment Auction
☐ Long Term Lessor
☐ Classroom
☐ Change of Business Structure
☐ Live ☐ Internet
☐ Short Term Lessor
☐ Correspondence
☐ Change of Business Address
☐
Body Shop
☐ Short Term Tlr Lessor
☐ Internet
☐ Mailing ☐ Physical
☐ Class A Certificate
☐ Consignment Auction
☐
DUI School
☐ Change of Curriculum
☐ Live ☐ Internet
☐ Classroom
☐ Change of Class Schedule
☐
OHV Dealer
☐ Correspondence
☐ Change of Email Address
Garage Registration
☐ New OHV
☐ Internet
☐ Change of Business Name
☐
Garage
☐ Used OHV
Number of Technicians
☐ Long Term OHV Lessor
Emission Control
(Business Activity)
☐ Short Term OHV Lessor
Requested Name
☐
OHV Manufacturer
Type of Repairs
☐
Emission Station
☐ Gas
☐
Previous Name
☐ Diesel
☐
Duplicate License
☐ Test Only
☐ Test & Repair
☐ Fleet, Test Only
☐ Fleet, Test &
Repair
Dealers selling new vehicles must list vehicle makes franchised to sell:
☐
Individual
☐
Partnership
☐
LLP
☐
LLC
☐
Corporation
Incorporated in State of
File Date
Occupational and Business Licensing
555 Wright Way
Carson City, Nevada 89711
(775) 684-4690
www.dmvnv.com
OBL237 (11/2016)
Page 2 of 2
OWNERSHIP: List name and title of each individual, each partner, whether general or limited, or each principal officer,
director or stockholder participating in the direction, control or management of the policy of the business. Use separate page if
necessary. Ownership change requires notification to the Department.
Name (Last, First, Middle)
Title
Registered Agent’s Information:
For Garage Registration Only: Additional Location(s)
Name of Business
Address
Phone Number and
Managers Name
# of
Technicians
Nevada Revised Statute and Nevada Administrative Code Chapters:
NRS/NAC Chapters 445B &
482
NRS/NAC Chapters 482 &
490
NRS/NAC Chapter 483
NRS/NAC Chapters 487 &
597 (Body Shop & Garage
only)
Station and Inspector
licensing.
Broker, Dealer, Distributor,
Long Term Lessor,
Manufacturer, Rebuilder,
Salesman, Short Term Lessor
and Transporter licensing,
including Off-Highway Vehicle
Industry Licensing.
Instructor and School
licensing.
Body Shop, Garage, Salvage
Pool and Wrecker licensing or
registration.
I understand providing false information or the omission of the requested information in this application is grounds to deny,
suspend, or revoke my business license or registration and constitutes a gross misdemeanor under Chapter 482, 483, 487,
445B and 490 of the Nevada Revised Statutes. Furthermore, I understand it is my responsibility to review the aforementioned
Nevada Revised Statute and Nevada Administrative Code Chapters with respect to the license or registration I am applying for
and agree to comply with the requirements stated therein. I declare under penalty of perjury that the foregoing is true and correct.
NOTE: TO BE SIGNED BY SOLE OWNER, PARTNER, OR OFFICER OF THE CORPORATION ONLY.
Signatures must be original. Photocopies are not acceptable.
Applicant’s Signature
Title
Date
State of Nevada
County of
Subscribed and sworn to before me this
day of
20
by
Signature of Notary Public or Authorized Nevada DMV Representative
Notary Seal
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APPLICATION FOR BUSINESS LICENSE AND GARAGE REGISTRATION (Department of Motor Vehicles )

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Completed 24 December 2020

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