State ZIP Code
County where business located
Motor Vehicle Manufacturer or Manufacturer Branch License ................................................................................ $40.00
Motor Vehicle Distributor, Distributor Branch ........................................................................................................... $40.00
Manufacturer or Distributor Representative's License ........................................................Number __________ x $8.00
Resident Manufacturer or Distributor License Plates - Available if unloaded vehicles operated on Wisconsin highways
while in transit or for trial tests .......................................................................................................First 2 plates = $150.00
Number of additional plates ________________________________________________________________ @ $10.00
List letters of all missing plates _____________________________________________________________________
Replacement License Plates .................................................................................................................... each plate $4.00
(Authorized Dealership Agent, Title) (Date)
Legal Name
Area Code - Telephone Number If Previously Licensed, Give Year & License Number
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X__________________________________________________
Trade Name(s) or DBAs
City
Wisconsin Department of Transportation
Dealer and Agent Section
4822 Madison Yards Way
P.O. Box 7909
Madison, WI 53707-7909
FOR OFFICE USE ONLY
Issued
Expires
$CHECK PAYABLE TO: REGISTRATION FEE TRUST
Loaded tractors, trucks or trailers weighing over 8,000 pounds gross, which are owned by the manufacturer or distributor, shall display special
demonstration license plates for trial purposes. Such demonstration plate application form shall be sent upon request.
Complete a Representative License Application (form MV2184) and include the $8.00 fee for EACH representative you employ, including any members
of your rm who contact dealers in Wisconsin in the capacity of a manufacturer or distributor representative.
Type of Business Business Entity
Distributor
Distributor Branch
Manufacturer
Manufacturer Branch
Name:
City Village
Town
Sole Proprietorship
Partnership
Association
Corporation
LLC
Post Oce Box NumberBusiness Address
MV2034 10/2019 Ch. 218 Wis. Stats.
Motor Vehicle Manufacturer, Manufacturer
Branch, Distributor or Distributor Branch
Two Year License Application
If Corporation or LLC, Give Date & State
Name, Title, and Residence Address of Owner, Partners, Association Members, Corporation Ocers, LLC Managers and LLC Members
YES NO
Are you also licensed to sell motor vehicles at retail in Wisconsin? If yes, give license number: _________________________________
Does your rm manufacture or install on previously assembled truck chassis, special bodies or equipment which constitutes a major
manufacturing alteration, or does your rm distribute such vehicles?
If yes, does your rm own the vehicle, including chassis and special body or equipment mounted thereon and does the complete unit bear a
trade name designated by you, thereby qualifying your rm as a motor vehicle manufacturer or distributor?
Have you, your ocers, directors, partners, or companies aliated with you, any nancial or management interest in a sales nance company
operating in Wisconsin? If yes, to what extent?
Are you or companies aliated with you a party to any contract or understanding with any motor vehicle dealer or distributor either directly or
indirectly, whereby such dealer or distributor is obligated to sell, assign, or transfer any retail sales contracts, in this state, to a specied sales
nance company, or class of such companies or other specied person, which is contrary to section 218.01 of the Wisconsin Statutes, relating
to coercion and subsidy?
Do you or companies aliated with you recommend a nance plan to your dealers? If yes, to what extent?
Does your business or aliates' vehicle advertising recommend the use of any sales nance company's nance plan?
Do you or your aliates have a written agreement with any sales nance companies whereby your products will be nanced at wholesale or retail?
List makes of new vehicles manufactured or distributed
If secondary manufacturer, describe type of equipment installed on preassembled
motor vehicle chassis and designated use of nished vehicle.
Federal Employer Identication Number
By signing this License, Manufacturer or Distributor agrees to adhere to the Jurisdiction of the State of Wisconsin, all current laws and the licensing and
regulatory authority of the State of Wisconsin and the Wisconsin Department of Transportation, Division of Motor Vehicles. I, the undersigned, certify under
penalty of s.946.32 or s.345.17 Wisconsin Statutes, that the answers and statements on this application are true and correct to the best of my knowledge.
No Fee if also Licensed
WI Motor Vehicle Dealer
click to sign
signature
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