Fillable All Initial Business License Applicants Announcement The New (The State of New Jersey)

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All Initial Business License Applicants Announcement The New (The State of New Jersey)

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Visit us at www.NJMVC.gov
New Jersey is an Equal Opportunity Employer
(R11/19)
Business Licensing Services Bureau
P.O. Box 170
Trenton, NJ 08666-0170
609-292-6500 ext. 5014
609-292-4400
Announcement
All Initial Business License Applicants
The New Jersey Motor Vehicle Commission, Business Lice
nsing Services Bureau (BLS) does not
accept up-front license and registration payments (excluding application fees) with the submission
of an initial business license application for the following license privileges:
New and Used Car Dealers
Special Category Registration and Plates
Auto Body Shops
Driving Schools
Inspection and Emission Repair Facilities
A notification requesting payment of the license and registration fees along with proof of insurance
and bond requirements will be sent after preliminary approval of all licensing requirements and a
site inspection, where applicable. The wall license and license plates, if applicable, will be mailed
to the licensed location once your payment is processed.
Your compliance with this policy is greatly appreciated. For further information on the
initial licensing process, call 609-292-6500 x5014.
Note: Applicants for Auto Body and Private Inspection Facilities licenses must submit a $20.00
application fee with their initial license application.
STATE OF NEW JERSEY
Enclosed is copy of the applicable law, application and supplemental forms
necessary to apply for Transporter plates and registrations.
Each applicant for Transporter plates and registrations must establish and maintain
a permanent place of business in New Jersey. Said business must display an
exterior sign, which reflects the business name and the facility must conform with all
municipal requirements.
$ certificate of insurance must be submitted which reflects liability insurance
coverage in the minimum amounts of $100,000/$250,000 bodily injury and $25,000
property damage and the total number of plates that the policy will cover. The
certificate holder must read as follows:
NJ Motor Vehicle Commission
Business Licensing Services Bureau
P.O. Box 171
Trenton, NJ 08666-0171
Sincerely,
Business Licensing Services Bureau
(Rev. 1/1)
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If you have any questions, please call (609) 292-6500 ext.5014.
Business Licensing Services Bureau
P.O. Box 171
Trenton, NJ 08666-0171
609-292-6500 ext. 5014
Visit us at www.NJMVC.gov
New Jersey is an Equal Opportunity Employer
Visit us at www.NJMVC.gov
New Jersey is an Equal Opportunity Employer
(R11/19)
Business Licensing Services Bureau
P.O. Box 170
Trenton, NJ 08666-0170
609-292-6500 ext. 5014
609-292-4400
FOR OFFICE USE ONLY
License No.
Reg. No.
EIN #
Approved by
Date
Email
The undersigned hereby applies for the license(s) checked in Part 3 and submits the following certified statement:
1.
Name of Business (if corporation, corporate name)
Business Phone
2. Please Check
Trade Name
Corporation
Partnership
Proprietorship
Business Address Other __________________________________________
City Zip Code County
All applicants please provide the following information and attach copies
of proof thereof:
A. NJ Sales Tax Identification Number _______________________________
B.
NJ Unemployment Registration Number
_____________________________
C.
Federal Employer Identification Number
_____________________________
4.
Complete the following for proprietor, partners or corporate officers:
Name Title Home Address Telephone Number
5.
Have the owners, partners or officers ever been arrested, charged or convicted of a criminal or disorderly person offense in this or any other state?
Yes If yes, explain: ___________________________________________________________________________________________________________________
No ______________________________________________________________________________________________________________________________
6.
Has any current or prospective partner, officer, director, other controlling person, or employee of the applicant previously held a license issued under the
authority of the Commission or any other state, which license was suspended or revoked and never reinstated?
Yes
Give name and address of person
No
APPLICATION F O R B U S I N E S S LICENSE
3. Please check appropriate box for applicable license:
տ Leasing Company տ Driving School տ Private Inspection Facility
տ Fleet Inspection Facility տ New & Used Motor Veh. Dealer
տ Used Motor Veh. Dealer
տ Auto Body (Full)
տ Auto Body (Limited) տ Auto Body (Sublet)
Special Category Registration (Select one from options below)
տ
Auction տ Boat Dealer տ Converter տ Finance տ Insurer
տ Leasing
տ Manufacturer տ Non-Conventional տ Transporter
Visit us at www.NJMVC.gov
New Jersey is an Equal Opportunity Employer
(R11/19)
7. Do the owners,
principals, partners or officers now hold, or have they ever held, any of the licenses listed in #3 or in any other jurisdiction?
Yes If yes, please provide the type of license(s), license number(s) and jurisdiction(s) and dates of licensure: ____________________________
No ________________________________________________________________________________________________________________________________
8.
Have the license(s) provided above ever been suspended or revoked in New Jersey or any other jurisdiction?
Yes If yes, explain: ______________________________________________________________________________________________________________________
No _________________________________________________________________________________________________________________________________
9. Does this business have a subsidiary company or a parent company?
Yes If yes, explain: _____________________________________________________________________________________________________________________
No _________________________________________________________________________________________________________________________________
10.
Have the owners, partners or officers, agents or employees of your organization ever used an alias or been known by any other name?
Yes If yes, explain: _____________________________________________________________________________________________________________________
No _________________________________________________________________________________________________________________________________
11. Does any stockholder own more than 10% of the corporation's stock?
Yes If yes, give name, address and holding: ______________________________________________________________________________________________
No _________________________________________________________________________________________________________________________________
12.
Place of Incorporation / Formation
Date of Incorporation/Formation
Date of authorization to do business in New Jersey
Attach copy of the Certificate of Incorporation/Formation
which has been filed with the N.J. Secretary of State.
Foreign Corporations must submit a copy of their
Authorization to do business in New Jersey as a Foreign
Corporation in addition to a copy of their corporate or
formation papers.
13. Does the location for which you seek a license, or seek to renew a license, comply with all State and local laws, ordinances and regulations
concerning the activities permitted by this license?
Yes
No
14. The applicant certifies all information contained herein is true and agrees that any untruthful representation and any violation of the applicable
statutes and regulations promulgated by the Commission shall be reasonable and proper grounds for license suspension or revocation and
may subject the applicant to administrative, civil or criminal penalty. He/She further agrees to notify the Commission immediately of any change
in the status of the business or of any other information which would change the answers and statements in this application or supplement
thereto.
15. I am, and will continue to be, in compliance with all State and local laws, regulations and ordinances regarding the operation of this business.
16.
The individual(s) signing this application certifies that they have read the applicable statutes and are thoroughly familiar with the details
provided and potential penalties.
I, the undersigned, hereby certify that I am the __________
of the above business named ____________________________________________________
President, Owner, Officer, Member
and that the information I have submitted is true. I am aware that if any of the statements are willfully false, I am subject to penalty.
______________________________________________________________________ ______________________________________________________________________________
Print Name of Applicant Signature and Title of Applicant
I, the undersigned, hereby certify that I am Secretary/Member/Partner of the above Corporation and have witnessed the signature of ______________________________________________________
who is _________________________________________of said corporation.
P
resident, Owner, Officer, Member
_________________________________________________________________________________
Signature of Secretary/Member/Partner
Visit us at www.NJMVC.gov
New Jersey is an Equal Opportunity Employer
BLC-205B (R11/19)
Business Licensing Services Bureau
P.O. Box 170
Trenton, NJ 08666-0170
609-292-6500 ext. 5014
609-292-4400
APPLICANT’S INFORMATION
PLEASE PRINT
BUSINESS NAME
BUSINESS PHONE NUMBER
1. APPLICANT FULL NAME (Including Middle and Suffix, if any)
2. STREET ADDRESS
3. CITY 4. STATE 5. ZIP CODE 6. COUNTY
7. HOW LONG HAVE YOU LIVED AT THE ABOVE ADDRESS? 8. HOME PHONE NUMBER
9. LIST ALL THE CITIES, STATES AND FOREIGN COUNTRIES WHERE YOU HAVE LIVED, OVER THE LAST 20 YEARS AND HOW LONG YOU LIVED IN EACH.
10. DATE OF BIRTH (MONTH, DAY, YEAR) 11. PLACE OF BIRTH (CITY, STATE OR FOREIGN COUNTRY)
12.
SEX
13. HEIGHT 14. WEIGHT 15. COLOR OF EYES 16. DRIVER LICENSE NUMBER
17.
SOCIAL SECURITY NUMBER* __________________________________________________
*You must disclose your Social Security number to the NJMVC. Failure to do so may result in denial/non-renewal of licensure.
Pursuant to N.J.S.A. 54:50-25 et seq. of the New Jersey taxation law and N.J.S.A. 2A:17-56.7 et seq. of the New Jersey Child Support Program
Improvement Act, the licensing agency to which this form is submitted is required to obtain your Social Security number. Pursuant to these authorities,
the licensing agency is also obligated to provide your Social Security number to:
a. the Director of Taxation to assist in the administration and enforcement of any tax law, including for the purpose of reviewing compliance with
State tax law, updating, and correcting tax records; and
b. the Probation Division or any other agency responsible for child support enforcement, upon request
18. HAVE YOU EVER BEEN CONVICTED OF A CRIME ARISING OUT OF FRAUD OR MISREPRESENTATION?
Ƒ NO Ƒ YES IF YES, ATTACH EXPLANATION DESCRIBING NATURE OF OFFENSE, DATE, CITY AND STATE WHERE OFFENSE OCCURRED, IDENTIFY
COURT OR ADMINISTRATIVE TRIBUNAL BEFORE THE CASE TRIED, DATE AND SENTENCE
I CERTIFY THAT THE INFORMATION PROVIDED HEREIN AND ATTACHMENTS, IF ANY, ARE TRUE. I AM AWARE THAT IF ANY
OF THE STATEMENTS ARE WILLFULLY FALSE, I AM SUBJECT TO ADMINISTRATIVE, CIVIL AND/OR CRIMINAL PENALTY.
SIGNATURE: _____________________________________________ DATE: ___________________________
Visit us at www.NJMVC.gov
New Jersey is an Equal Opportunity Employer
BLS-43 (R11/19)
Business Licensing Services Bureau
P.O. Box 170
Trenton, NJ 08666-0170
609-292-6500 ext. 5014
609-292-4400
CHILD SUPPORT CERTIFICATION FORM
_
_____________________________________________________________________________________________
Business Name
____________________________________________ ________________________________
Applicant’s Name (Print) Date of Birth
____________________________________________
Social Security Number
*You must disclose your social security number to the NJMVC. Failure to do so may result in denial/non-
renewal of licensure.
Pursuant to N.J.S.A. 54:50-25 et seq. of the New Jersey taxation law and N.J.S.A. 2A:17-56.7a et seq. of
the New Jersey Child Support Program Improvement Act, the licensing agency to which this form is submitted
is required to obtain your Social Security number. Pursuant to these authorities, the licensing agency is also
obligated to provide your Social Security number to:
a. The Director of Taxation to assist in the administration and enforcement of any tax law, including
for the purpose of reviewing compliance with State tax law, updating, and correcting tax records;
and
b. The Probation Division or any other agency responsible for child support enforcement, upon
request.
Under the provisions of N.J.S.A. 2A:17-56.7a et seq., responses to the questions listed below are required.
Intentional misstatements may result in administrative action including, but not limited to, denial of licensure,
immediate suspension or revocation of the license, or criminal prosecution.
1. Do you have a child support obligation?
2. If yes, does the amounts in arrears equal or exceed the amount of child support
payable for six months?
3. Are you subject to a child-support warrant?
I certify that the foregoing responses made by me are true and I am aware that if any of the foregoing
statements are willfully false, I am subject to penalty.
___________________________________________________ _________________________
Signature Date
Yes
No
Yes
No
Yes
No
BUSINESS HOURS
Days Open for Business Business Hours
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 
Business Licensing Services Bureau
P.O. Box 171
Trenton, NJ 08666-0171
Visit us at www.NJMVC.gov
New Jersey is an Equal Opportunity Employer
Special Category Registration Certification – Allowable Use of Business Location
I understand that, in accordance with N.J.A.C. 13:21-15.2 (h), a special category business location
must comply with all zoning, planning use and environmental laws and ordinances and that all
activities permitted by the license will be permitted therein.
I hereby certify that the location(s) for which I seek a license complies with all State and local laws,
ordinances and regulations concerning the activities permitted by the dealer license.
I certify that the foregoing statements made by me are true. I am aware that if any of the foregoing
statements are willfully false, I am subject to penalty.
Name of Business: ______________________________________________________________
___________________________ ________________________ ___________
Dealer Owner/ Principal Name Signature Date
STATE OF NEW JERSEY
Business Licensing Services Bureau
P.O. Box 170
Trenton, NJ 08666-0170
(609) 292-6500 #5014
%/65
Visit us at www.NJMVC.gov
New Jersey is an Equal Opportunity Employer
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All Initial Business License Applicants Announcement The New (The State of New Jersey)

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Completed 10 October 2021

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