Ohio > Statewide > Bureau Of Motor Vehicles > Dealer Licensing
Application To Deal In Salvage Motor Vehicles BMV 4363 - Ohio
| Application To Deal In Salvage Motor Vehicles Form. This is a Ohio form and can be used in Dealer Licensing Bureau Of Motor Vehicles Statewide . |
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OHIO DEPARTMENT OF PUBLIC SAFETY BUREAU OF MOTOR VEHICLES APPLICATION TO DEAL IN SALVAGE MOTOR VEHICLES Indicate Type of License. Check One: Salvage Dealer Salvage Auction Salvage Pool 1) Please print legibly in black ink or type the following information: BUSINESS NAME DBA OR FICTITIOUS TRADE NAME, if applicable BUSINESS STREET ADDRESS CITY STATE ZIP CODE COUNTY BUSINESS TELEPHONE # ALTERNATIVE TELEPHONE # FAX # E-MAIL ADDRESS 2a) Vendor's Number 2b) Federal Tax I.D. Number 3) I, as the applicant, affirm that the business listed on this application has a net worth of at least $20,000. Yes No NO applicant shall be issued a motor vehicle salvage dealer, salvage auction, or salvage pool license, or be permitted to operate under such license, unless the business maintains a NET WORTH in the sum of not less than $20,000. 4) Are you an owner, partner, or corporate officer in any other new or used dealership, motor vehicle leasing dealership, motor vehicle distributor, motor vehicle auction, motor vehicle salvage dealership, motor vehicle salvage auction, or motor vehicle salvage pool? Yes No If yes, indicate name and permit number. NAME NAME PERMIT # PERMIT # 5) Make check payable to "Ohio Treasurer Josh Mandel". Fees are as follows: DO NOT SEND CASH Permit (Required) Master Plate (Optional) Postage (One time postage required only if plate(s) are requested) Additional Plates (Optional) FEES ARE NON-REFUNDABLE 1B 1 1 1 @ $100.00 @ $50.25 @ $4.50 = = = = + + + $100.00 $ $ $ $ You may apply for special dealer license plates to be used in conjunction with your salvage business. Ohio Revised Code Sect ion 4503.31 states in part "...placards issued pursuant to this sect ion may be used...on motor vehicles being transported by any persons regularly engaged in salvage operations or scrap metal processing from the point of acquisition to their established place of business...." 0B @ $ 10.25 each TOTAL FEES DUE 6) Indicate style of business: PROPRIETORSHIP PARTNERSHIP CORPORATION BUSINESS TRUST LIMITED LIABILITY BMV 4363 9/12 [17601163] Page 1 of 4 CRITICAL - HIGH American LegalNet, Inc. www.FormsWorkFlow.com 7) Check the appropriate box and complete the name, residence address, and Social Security Number in 7B: If making application as an LLC, Trust or Partnership, list each member, trustee, director or partner in 7B. Exception: if a member, trustee or partner is a corporation, please list the corporation's name, federal tax ID number and address in 7A and then list officers of the corporation in 7B. PART 7A Member-Use only if member is a corporation. CORPORATE BUSINESS NAME ADDRESS CITY STATE Trustee-Use only if a trustee is a corporation. Partner-Use only if a partner is a corporation. FEDERAL TAX ID# (EIN) ZIP CODE PART 7B Owner Partner President Trustee Director Member, (owning 10% or more) Partner Vice President Trustee Member, (owning 10% or more) LAST NAME HOME ADDRESS CITY STATE FIRST NAME MI BUSINESS NAME SSN ZIP CODE LAST NAME HOME ADDRESS CITY STATE FIRST NAME MI BUSINESS NAME SSN ZIP CODE LAST NAME HOME ADDRESS CITY FIRST NAME MI BUSINESS NAME SSN STATE ZIP CODE Partner Secretary Trustee Member, (owning 10% or more) Partner Treasurer Trustee Member, (owning 10% or more) LAST NAME HOME ADDRESS CITY FIRST NAME MI BUSINESS NAME SSN STATE ZIP CODE Ohio residents who are owners, all partners, president, all members, owning 10% or more, and all trustees MUST be electronically fingerprinted and must request the results to be sent electronically to direct copy "BMV Dealer Licensing" at the web check locations in order for them to be forwarded to the BMV dealer licensing section. For a complete list of electronic fingerprinting locations in Ohio visit www.OhioAttorneyGeneral.gov for background check locations in Ohio. BMV 4363 9/12 [17601163] Page 2 of 4 CRITICAL - HIGH American LegalNet, Inc. www.FormsWorkFlow.com NOTE: Only Out-of-State applicants may submit a fingerprint card, exemption form and processing fee in lieu of having their prints electronically scanned. Please contact the Dealer Licensing Section at (614) 752-7636 to obtain a fingerprint card and an exemption form. 8) Answer each of the following questions truthfully to the best of your knowledge: HAS THE APPLICANT, OR ANY OF THE APPLICANT'S, OWNERS, PARTNERS, OFFICERS, OR DIRECTORS, INDIVIDUALLY, OR AS OWNER, PARTNER, OFFICER, OR DIRECTOR OF A BUSINESS ENTITY: Previously applied for license to deal in motor vehicles? Yes No If yes, give business name, type of license, date and result of such application. NAME APPLIED IN TYPE OF LICENSE DATE RESULT OF APPLICATION A. B. NAME Ever been refused a motor vehicle salvage dealer's license, motor vehicle salvage auction license, or motor vehicle salvage pool license, or been the holder of a license which was revoked or suspended? Yes No If yes, give business name, type of license, date and permit number. TYPE OF LICENSE DATE PERMIT NUMBER C. Ever been convicted of a felony? Yes No If yes, give particulars on a separate sheet and attach to this application. Ever been convicted of a fraudulent act in connection with dealing in salvage motor vehicles? If yes, give particulars on a separate sheet and attach to this application. Yes No NOTE: Any felony conviction or any misdemeanor conviction related to dealing in salvage motor vehicles is reason for the Bureau of Motor Vehicles to DENY the application. 9) Are you or do you intend on sharing the proposed business location with another licensed dealer? Yes No If yes, indicate the business name and, if available, the permit number of the other dealer. (See note below) NAME PERMIT NUMBER NOTE: A certificate of compliance form, BMV 4347, must be submitted with this application, if you answered YES to the above question. 10) Was the proposed business location previously occupied by another licensed dealer? If yes, give the business name, if available. BUSINESS NAME Yes No YOU WILL LOSE YOUR DRIVER LICENSE IF YOU DRIVE WITHOUT INSURANCE OR OTHER ACCEPTABLE FINANCIAL RESPONSIBILITY COVERAGE In Ohio, it is illegal to drive any motor vehicle without insurance or other financial responsibility (FR) coverage. It is also illegal for any motor vehicle owner to allow anyone else to drive the owner's vehicle without FR coverage. PROOF OF COVERAGE IS REQUIRED: Whenever a police officer issues a traffic ticket At all vehicle inspection stops Upon traffic court appearances and Upon random checks by the Registrar of Motor Vehicles. ANY DRIVER OR OWNER WH
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