MOTOR VEHICLE DEALER
TWO YEAR LICENSE APPLICATION
MV2186 12/2019 Ch. 218 Wis. Stats.
Submit in Duplicate
Wisconsin Department of Transportation
Dealer and Agent Section
PO Box 7909, Madison, WI 53707-7909
Check this box if This is a Buyout Application
Amending Current License Information
(Area Code) Telephone Number
County (Business Location)
City Village Township
Name:
State of Incorporation or Organization
If Corporation or LLC, Date Licensed in Wisconsin
Business Entity: Sole Proprietorship LLC
Corporation Partnership Association
Types of Vehicles to be Sold (check all that apply)
Autos Trucks Motorcycles Other (specify):
List Makes of New Vehicles to be Sold
Address of Non-Adjacent Sales Location in Same Municipality
Branch:
Name and Title of Owners, Partners, Association Members, Corporate Officers or Shareholders, LLC Members or Managers
(Complete form MV2844 Entity / Owners Statement for each individual)
Completely Describe Other Business, Engaged in by Your Firm
Dealer License Numbers of Additional Dealerships
Was there a licensed dealer at this same location previously this year?
Yes No If Yes, Dealer Name:
Do you own and operate your own service department?
Yes No – Attach Completed Service Agreement
Have you, as an individual and your above named firm, been licensed as a dealer before?
Yes No If Yes, Same Location: Yes No
Complete ONE of the Following (whichever applicable)
Is Business Real Estate Owned by:
Yes No – Owner of Sole Proprietorship
Yes No – One Partner of Partnership
Yes No – Corporate Dealership
Yes No – LLC
If No, Send Copy of Lease
Has your motor vehicle dealer license ever been denied, suspended or revoked?
Yes No If Yes, When and what state:
Are you licensed as a motor vehicle salvage dealer at the same location?
Yes No If Yes, List License Number:
NUMBER OF VEHICLES SOLD IN LAST 12 MONTH PERIOD
Sales Tax
Seller Permit Number
Check Only ONE Box (applicable to your dealership)
1. During the next two years our dealership will sell ALL
vehicles on a Cash Only basis. Fee due is $20.
2. Our dealership originates retail installment sales contracts
and/or consumer leases:
a. All of the contracts or leases we originate are sold or
transferred to a third party. Fee due is $100.
b. Some or all of the contracts or leases are retained by
our dealership. Fee due is $100.
3. The total amount of installment contracts and/or consumer
leases originated and retained in the last 12 months was
$ , which is $100,000 or less. Fee due is $100.
4. The total amount of installment contracts and/or consumer
leases originated and retained in the last 12 months was
$ , which is greater than $100,000.
Do not submit a fee. You will receive a separate bill.
Dealer License – Required Fee ($40) ....................... ........... $ 40
Branch License ($40) ................................................ ..... $
Sublot License ($2) .................................................... ..... $
Salesperson License(s) ($8)
(if test required, pay examiner) ............ # x $8 ..... $
WI Buyer License(s) ($12) ................. # x $12 ..... $
Buyer ID Card(s) ($12) ...................... # x $12 ..... $
Dealer License Plates – Required (first 2 plates) ...... ......... $ 150
Number of Additional Plates ($10) ..... # x $10 ..... $
List letters of All Missing Plates:
Replacement License Plates for Lost, Damaged,
or Illegible Plates ($4 each) ...................................... ..... $
Yes No Does your dealership write credit insurance?
In the event of plate increase or decrease, recalculate fees.
Check Payable To:
Department of Financial Institutions .................. Total $
Check Payable To:
Registration Fee Trust .......................................... Total $
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.
(Signature of Authorized Dealership Agent)
