FOR OFFICE USE ONLY
Street Address or RFD City State ZIP Code
County where business located
Legal Name
Dealer License NumberArea Code - Telephone Number
Trade Name(s) or DBAs
Post Oce Box Number
MOTOR VEHICLE WHOLESALER
TWO YEAR LICENSE APPLICATION
Issued Expires
Amending Current
License Information
Wisconsin Department of Transportation
Dealer Section
PO Box 7909
Madison, WI 53707-7909
MV2860 10/2019 Ch. 218 Wis. Stats.
VillageCity
Type of Vehicles to be Sold
Autos
Trucks
Motorcycles
Name:
Township
Sole Proprietorship
Partnership
Association
Corporation
LLC
State of Incorporation or Organization
If Corporation or LLC,
Date Licensed in Wisconsin
Business Entity
Name and Title of Owner, Partners, Association Members, Corporation Ocers and Shareholders, LLC Managers and Members
Complete an Entity/Owner Statement (Form MV2844) for each individual listed.
Was there a licensed dealer at this same location previously this year?
No Yes, Name dealer ________________________________________
Have you, as an individual and your above-named rm, been licensed as a dealer before?
No Yes, Same location? No Yes
Has your motor vehicle dealer license ever been denied, suspended or revoked?
No Yes, When and what state? _________________________________
Are you licensed as a motor vehicle salvage dealer at same location?
No Yes, Give license number __________________________________
YES
NO
Owner of sole proprietorship
One partner of partnership
Corporate dealership
LLC
Complete ONE of the following (whichever applicable):
Is business real estate owned by:
If no,
send copy
of lease.
No
Will your wholesaler license be used to operate a motor vehicle
salvage pool in accordance with s.218.50 Wis. Stats.?
Yes
Dealer License (Required fee).................................$40.00
Wisconsin Buyer's License(s)....Number _______ x $12.00
Buyer ID Card(s)................ Number __________ x $12.00
Dealer License Plates Required.....First 2 plates = $150.00
Number of additional plates ________________ @ $10.00
List letters of all missing plates
Replacement License Plates for lost, damaged,
or illegible plates........................................each plate $4.00
$CHECK PAYABLE TO: REGISTRATION FEE TRUST
(Authorized Dealership Agent, Title) (Date)
XSee reverse side.
I, the undersigned, certify under penalty of s.345.17 Wisconsin Statutes, that: (1) A lease agreement covering at least the licensing year has been executed,
if premises are not owned by applicant, and; (2) The answers and statements on this application are true and correct to the best of my knowledge.
AUTOS
TRUCKS
MOTORCYCLES OTHERS (specify)
Number of vehicles sold wholesale in last 12 month period
License Numbers of Additional Dealerships
Completely describe other business, if any, engaged in by your rm - Same location?
No
Yes
Federal Employer Identication Number
Clear Form
0.00
0.00
0.00
0.00
2. Check one box and sign below:
If business address on reverse side does not include a specic street number, furnish directions to your business location,
including highway numbers or letters and distances.
Section B
Following Applies To First-time Dealer Applicant Or Application For Amended License
Because of Business Relocation or Ownership Change
Proper local ocials must sign below, BEFORE submitting this application. All applicants complete section A.
If business is located in a township, complete both sections A and B.
Attention Zoning Authorities: The requirements for a motor vehicle wholesaler/distributor are as follows:
1. A permanent building, not a tent or temporary stand.
2. An oce within the building.
3. An outdoor vehicle display lot for at least one vehicle adjacent to the building or all vehicles kept indoors.
4. An exterior sign with business name as it will appear on the license certicate and any other name used to do
business under. The lettering of the sign must be a minimum of 4 inches high, unless smaller dimensions are
required by local zoning or sign ordinance.
5. A sign posted on or adjacent to the entrance door describing business hours. The sign must also include a
notice that sales are restricted to dealers only.
X
A local permit or license is required and has been issued.
A local permit or license is not required.
X
X
(Municipality)
(Signature)(Print Name)
(Ocial Title)
1. Operation of this dealer business at the location(s) stated above is in accordance with local
zoning regulation.
Section A
(Municipality)
(Signature)(Print Name)
(Ocial Title)
(County)
(Signature)(Print Name)
(Ocial Title)
County Zoning Approval - required only if business is located in a township.
Operation of this dealer business at the location(s) stated above is in accordance with local zoning regulation.
Business Name / Location
Business Name / Location
Clear Form
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