VillageCity
State ZIP Code
County where business located
Name:
Town
(Authorized Dealership Agent, Title) (Date)
Legal Name
Dealer License Number
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.
$
X
Wisconsin Department of Transportation
Dealer Section
PO Box 7909
Madison, WI 53707-7909
Submit in duplicate.
Area Code - Telephone Number
Trade Name(s) or DBAs
Number of
vehicles sold
in last 12
month period
Address of NONADJACENT Sales Location in SAME MUNICIPALITY
Yes
No, Attach completed service agreement
Retail
Wholesale
Do you own and operate your own service department?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 recreational vehicle dealer license ever been denied, suspended or revoked?
No Yes, When and what state? _________________________________
New
Used
SALES TAX SELLER PERMIT NUMBER (Not required for consignment sales only)
Sole Proprietorship
Partnership
Business Entity If Corporation or LLC,
Date Licensed in Wisconsin
List makes of travel trailers to be sold
Street Address or RFD
Post Oce Box Number
City
See reverse side.
Branch:
Sublot:
RECREATIONAL VEHICLE DEALER
TWO YEAR LICENSE APPLICATION
Amending Current
License Information
Issued Expires
FOR OFFICE USE ONLY
CHECK PAYABLE TO: REGISTRATION FEE TRUST
Association
Corporation
LLC
State of Incorporation or Organization
MV2187 12/2018 Ch. 218 Wis. Stats.
YES
NO
If no,
send copy
of lease.
Owner of sole proprietorship
One partner of partnership
Corporate dealership
LLC
Complete ONE of the following (whichever applicable):
Is business real estate owned by:
Dealer License (Required fee)...............................$100.00
Salesperson License............Number __________ x $8.00
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
Name and Title of Owner, Partners, Association Members, Corporation Ocers and Shareholders, LLC Managers and Members
Complete an Entity/Owner Statement (Form MV2844) for each individual listed.
Completely describe other business, if any, engaged in by your rm
Same location? License Numbers of Additional Dealerships
No Yes
Please check only ONE box that applies to your dealership.
Call 608-261-9555 if you have questions about these fees.
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.
a. All of the contracts we originate are sold or transferred
to a third party. Fee due is $100.
b. Some or all of the contracts are retained by our
dealership. Fee due is $100.
3. The total amount of installment contracts (not including 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 (not including 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.
Does your dealership write credit insurance? No Yes
CHECK PAYABLE TO: Department of Financial Institutions
Federal Employer Identication Number
