Vehicle Services Bureau
Application for Name
Change for Dealers
Please submit the following items with this application:
• A $2.06 fee (fee includes 3% administration fee per MCA 61-3-111)
• An Application for Dealer License (MV25)
• An Inspection Form (MV105)
• A rider for your bond showing the Bonding Company has changed their records. This must
be signed by a Bonding Agent.
• A certificate of liability insurance showing the new business name.
• If a Corporation: Also submit a certified copy of the corporate resolution authorizing the
name change.
• If dealer is a franchised dealer, a letter from the franchisor approving the name change.
Other form instructions:
• All dealers using the electronic TRP service are required to update their Montana Interactive
account if their dealer name changes. Therefore, please complete the three forms required
to update your registered user account and submit them to Montana Interactive. If the
required forms are not submitted, access to the TRP service will be suspended until your
account is updated. Visit the website at https://app.mt.gov/registered/
to obtain the
required forms.
Registered Dealer ________________________________________________________________
Name under which presently registered
Location ________________________________________________________________________
Street or box number and city or town
Montana county and state authorities reserve the right to reject any form that has been altered.
MV28 (11/19) Upon request, this form can be made available in an alternate format.
P.O. Box 201431, 302 N Roberts, Helena, MT 59620-1431
Phone (406) 444-3661 Fax (406) 444-0116 dojdealerinfo@mt.gov
Email ___________________________________________ Phone _________________________
Dealer License Number ____________________________________________________________
New Name ______________________________________________________________________
I ____________________________hereby certify under penalty of law (MCA 45-7-203 Unsworn Falsification to
Authorities) that on this date___________________________:
• I am the person named on this form
• The statements made and information contained on this form are true and correct to the best of my
knowledge, information and belief
• If signing for a business entity or trust, I have full authority to do so
• I authorize the insurance company to release all general liability insurance policy information to the state
of Montana, Vehicle Services Bureau
• My name, as it appears above, is intended for the purposes of this document to be my genuine signature
and acknowledgment of this form.
• Applicant agrees to comply with the provisions of the Mont. Code Ann., and rules and regulations
promulgated thereunder applicable to motor vehicle dealers, distributors and manufacturers in effect on
the date of this Application.
• Electronically sign here to submit via email.........................
• Or sign below if scanning, faxing, or mailing form.
_________________________________________________________________________________________________________________________
Signature of owner/corporate officer (If corporate officer, give title) (This is my legal signature) Date
Electronic signature of owner/corporate officer
Certification:
click to sign
signature
click to edit
![]()
