Fillable INSTRUCTIONS FOR COMPLETING A DEALER LICENSE APPLICATION 1) (State of New Hampshire)

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INSTRUCTIONS FOR COMPLETING A DEALER LICENSE APPLICATION 1) (State of New Hampshire)

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Page 1 of 2 01/2016
INSTRUCTIONS FOR COMPLETING A DEALER LICENSE APPLICATION
1) If you are an existing Dealer renewing or making changes, please print dealer letter and number in upper right
corner.
2) Indicate reason for application in upper right corner.
3) Check off Dealer Type if applicable. Select the type of dealer based on the majority of your sales or type of
license you are applying for: In the case of a Retail Dealer License, you would select Auto if 51% or more of your
business is autos, select Moto if 51% or more is motorcycles. Selecting wholesale means you only sell to other
dealers.
4) Select type of business that you are registered and operating as.
5) State whether or not you have ever been licensed as a dealer in NH previously
6) Enter Corporate Name if applicable. This must exactly match the way the name is registered with Secretary of
State. No abbreviations. All business names must be registered with the Secretary of State per RSA 349:1. A copy
of the Good Standing from Secretary of State must be attached. Please visit the Secretary of State’s web site at
https://www.sos.nh.gov/corporate/soskb/csearch.asp
7) Enter Trade Name. If there is no trade name of record and only a corporate name then reprint corporate name or
print SAME. All business names must be registered with the Secretary of State per RSA 349:1. A copy of the
Good Standing from Secretary of State indicating that the trade name is “Active” must be attached. Please
visit the Secretary of State’s web site at https://www.sos.nh.gov/corporate/soskb/csearch.asp
This is the name required on the signage.
8) Enter Business Mailing Address. This can be a P O Box and can be updated at renewal time without prior
approval.
9) Enter Business Legal Address: This is the single, physical location approved by the DMV where the business is
conducted. This cannot be changed without prior notification and approval per Saf-C 2003.03.
10) Include the business phone number and e-mail address.
11) Business hours of operation: List the hours of operation per day. The total hours of operation each week must
comply with the Saf-C 2001.15
12) List the Owners/Partners/Members of the business that are responsible for business in New Hampshire. The
Full legal name, gender, date of birth, driver’s license number, complete physical home address, home phone
number, signature of each owner and the percentage of ownership in the business must be completed. Use an
additional sheet of paper if necessary. A criminal record for each owner is required from the state of New
Hampshire and the state that person resides in as well for all new applicants. The criminal record must accompany
the new applications. Please don’t request that they be sent directly to the Dealer desk.
Owner updates require notification in writing 30 days prior to the effective date with the signature of all owners
per Saf-C 2009.05. Do not wait until renewal time to update the owners of record. Departing owners will need to
sign letters stating they are no longer owners of the business. Dealer licenses are non-transferable.
Page 2 of 2 01/2016
13) You must answer all of the questions asked. If they are left blank or signatures are missing, the application
will be returned.
14) If selling, provide an original (not a copy) Surety Bond pursuant to RSA 261:98 in the amount of $25,000.00
with a raised seal on the bond and original signatures in the exact name and physical address of the dealer as it is
registered with the Secretary of State and named on the application. A surety bond must be maintained at all times
during the license. If the bond is cancelled or rescinded, the dealer license must be surrendered.
15) Provide all copies of supporting documentation required per application i.e. criminal records, a current copy of
the lease and or a statement that the lease is in good standing with the landlord if you are a tenant at will. And a
current Service Agreement with a currently licensed inspection station with original signatures.
16) List all persons, other than owners, authorized to purchase dealer supplies on behalf of the business if
applicable. Owners are already authorized.
17) If renewing; provide a current inventory of the dealer plate(s), listed alphabetically.
18) All business personnel should read and understand the Agreement. One owner must sign and date the
application.
Note: All applications are subject to approval by the town or city where the dealer is applying. The DMV will be
contacting the town to verify their approval. Prior to submitting the completed application to the DMV, the
applicant may want to make contact with their appropriate town office or board to see if there are any requirements
that must be met or restrictions regarding their proposed business before the town will approve usage of the
property for the dealer. All dealers must be in compliance with their town or city at all times.
For more complete information regarding dealer types and associated rules and laws please visit
http://www.nh.gov/safety/divisions/dmv/registration/dealers/index.htm Interactive application forms can also be
found at this website. Complete the forms on line and print them out, sign and mail them in with all supporting
documentation to the Division of Motor Vehicles, Dealer Desk, 23 Hazen Drive, Concord NH 03305 You may
want to send the packet “signature required” so that you have confirmation that it was received.
Applications must be received completely filled out and signed with all required attachments included to be
considered complete. Incomplete application will be returned and that will slow down the process.
Robert L. Quinn
Commissioner of
Safety
Elizabeth A.
Bielecki
Director of Motor
Vehicles
STATE OF NEW HAMPSHIRE
NH DEPARTMENT OF SAFETY
Division Of Motor Vehicles
23 Hazen Drive, Concord, NH 03305
603- 227-4120
NEW
RENEWAL
LOCATION CHANGE
NAME CHANGE
DEALER #:
APPLICATION FOR AUTOMOTIVE RECYCLING DEALER REGISTRATION
RSA 261:123
BUSINESS IS: CORPORATION PARTNERSHIP SOLE SS/FED ID
Have you ever had another dealer license? YES NO If yes, what name and type?
CORPORATE NAME:
TRADE NAME:
All businesses must be registered with the NH Secretary of State per RSA 349:1. Please attach a copy of good standing.
BUSINESS MAILING
ADDRESS:
Street/P.O. Box
Town/City
Zip Code
BUSINESS LOCATION:
Street
Town/City
Zip Code
BUSINESS TELEPHONE
NUMBER:
FAX NO:
BUSINESS EMAIL (optional):
BUSINESS HOURS (indicate days and hours pursuant to RSA 261:103 and SAF-C 2001:15):
MONDAY:
TUESDAY:
WEDNESDAY:
THURSDAY:
FRIDAY:
SATURDAY:
SUNDAY:
OWNERS/PARTNERS/AND IF A CORPORATION, OFFICERS/MEMBERS WHO WILL BE THE RESPONSIBLE PARTY FOR THE NH
BUSINESS: (PLEASE ATTACH ADDITIONAL SHEETS IF NEEDED)
Full Legal Name: Gender: Date of Birth: Driver License #: % of Ownership:
Complete Physical Home Address:
Home Phone:
Signature:
Full Legal Name:
Gender:
Date of Birth:
Driver License #:
% of Ownership:
Complete Physical Home Address:
Home Phone:
Signature:
1. All business names must be registered with the NH Secretary of State. Please attach a proof of “Good Standing” for the
corporate name and verification of an “Active” trade name.
2. Are you principally engaged in the motor vehicle business? YES NO
3. Does the location and operation of this business meet all local zoning and other regulatory requirements? YES NO
4. Do you intend to be engaged in the business of buying secondhand motor vehicles for the purpose of remodeling, taking apart
or rebuilding same, or the buying or selling of parts of secondhand motor vehicles, or tires or the assembling of secondhand
motor vehicle parts to the general public? YES NO
5. Is this business operated from an enclosed, commercial building? YES NO
6. Do you own or lease the premises? OWN LEASE If leased, a copy of the current lease must be provided.
7. Is the required Dealer Bond on file with the Division of Motor Vehicles? YES NO
If YES, name of Insurance
THIS APPLICATION MUST BE ENDORSED BY A CITY / TOWN OFFICIAL:
I hereby certify that
doing business as
has obtained a license to operate a Junk Yard business at the above location and has
obtained a Certificate of Approval for the location of the Junk Yard as required by RSA 236:115.
Expiration Date of Certificate of Approval:
SIGNATURE OF CITY / TOWN
OFFICIAL
POSITION
DATE
FOR RENEWAL ONLY:
A. Has there been any change in ownership or location of this business which has not been previously reported in writing to the
Director? YES NO
B. Please conduct a physical inventory of all plates issued to your business and list them by letter and location/assignment,
in alphabetical order (attached additional sheet if necessary):
Plate #
Weight
Plate #
Weight
Plate #
Weight
Plate #
Weight
Plate #
Weight
Plate #
Weight
Plate #
Weight
Plate #
Weight
Plate #
Weight
C. List any lost/stolen plate(s) not previously reported to the Director of Motor Vehicles and submit a Lost Plate form RDMV 125A
for each plate:
RENEWAL PLATE FEES:
7,000 lbs.:
$60.00
$
OR
OR
7,001 lbs. and up:
$1.48 per hundred lbs.
$
LICENSE FEE:
$250.00
Due Annually
$ 250.00
TOTAL AMOUNT ATTACHED:
$
Fees are based on a two year application and reflect even year renewals. Odd year renewals may be prorated when applicable.
AGREEMENT
In consideration of our application for a Recycling Dealer Registration, this business does hereby agree to be familiar with, and abide by all applicable statutes
and rules, to be principally engaged in the motor vehicle business. And also certify that the location and operation of the business does not violate any existing
local ordinance or regulations, and agree to notify the Director of the Division of Motor Vehicles in writing of any change of address or business status,
including ownership, 30 days prior to the effective date of such change.
I further understand that a violation of any of the rules and regulations issued by the
Director, Division of Motor Vehicles, will be deemed sufficient cause for an administrative hearing and penalties may be imposed.
OWNER’S NAME:
TITLE:
OWNER’S SIGNATURE:
DATE:
This application is signed and any additional information is offered under the penalty of unsworn falsification pursuant to RSA 641:3.
RDMV 710 (Rev. 05/2021)
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INSTRUCTIONS FOR COMPLETING A DEALER LICENSE APPLICATION 1) (State of New Hampshire)

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Completed 15 January 2022

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