New Jersey > Statewide > Motor Vehicle Commission
Motorcycle Inspection License Application - New Jersey
| Motorcycle Inspection License Application Form. This is a New Jersey form and can be used in Motor Vehicle Commission Statewide . |
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New Jersey Motor Vehicle Commission STATE OF NEW JERSEY Business License Services (888) 486-3339 ext.5014 toll-free in NJ (609) 292-6500 ext.5014 Trenton, New Jersey 08666 Enclosed are the applications necessary for the issuance of a MOTORCYCLE INSPECTION LICENSE. Please ensure that all of the items below are returned for the processing of a license. A copy of your driver license Corpcode number Initial Application Supplementary Application Child Support Certification Sticker Identification card License fee $25.00 License Certification Form Copy of corporate papers (if applicable) Original Certificate of Insurance in the amounts of $300,000 bodily injury and $50,000 property damage. The certificate holder should read: Motor Vehicle Commission - PIF Section P.O. Box 170 Trenton, NJ 08666 Color photo of each officer, owner, partner or corporate officer Fingerprint (See attached instruction letter) Business hours Copy of Certificates listed below: A. NJ Sales Tax Identification B. NJ Unemployment Registration C. Federal Employer Identification If you have any questions, please contact us at the phone number listed above. BLC-60 (R 01/08) American LegalNet, Inc. www.FormsWorkFlow.com Motor Vehicle Commission APPLICATION FOR LICENSE FOR OFFICE USE ONLY License No. Business Licensing Services Bureau PO Box 171 Trenton, New Jersey 08666-0171 Date Reg. No. Approved by Email The undersigned hereby applies for the license(s) checked in Part 3 and submits the following certified statement: Corp Code 1. Name of Business (if corporation, corporate name) ____________________________________________________________________ Trade Name Street Address City Zip Code County 2. Please Check Business phone [ ] Corporation [ ] Other [ ]Partnership [ ]Proprietorship 3. Please Check appropriate Box for License: [ ] Leasing Company [ ] Driving School [ ] Moped Dealer [ ] Junkyard [$] Private Inspection Facility [ ] Fleet Fleet Inspection Facility [ ] Other Home Address [ [ [ [ [ ] New & Used Motor Vehicle Dealer ] Auto Body Repair Facility ] Used Motor Vehicle Dealer ] Fleet DEIC ] DElC All applicants please provide the following information and attach copies of proof thereof: A. NJ Sales Tax Identification Number B. NJ Unemployment Registration Number C. Federal Employer Identification Number 4. Complete the following for proprietor, partners, or corporate officers: Name Title Telephone Number 5. Have the owners, partners, or officers ever been arrested, charged or convicted of a criminal or disorderly persons offense in this or any other state? [ ]Yes [ ]N o if yes, explain: 6 Do you knowingly intend to employ a person who has been convlcted of the above, or any other crime or who was previously licensed as any in this or any other state and was subject to license suspension or revocation? [ ]Yes [ ]No Give name and address of person Of the above 7 Have the owners, partners or corporate officers ever held any of the above licenses? [ ] Yes [ ]N o If yes, please explain the type of license and license numbers American LegalNet, Inc. www.FormsWorkFlow.com 8. Was the license ever suspended or revoked? If yes, explain: [ ]Yes [ ]N o 9. Have the owners, partners or corporate officers, agents or employees of your organization ever used an alias or been known by any other name If yes, explain: [ ]Yes [ ]N o 10. Does any stockholder own more than 10% of the corporation's stock? If yes, give name, address and holding [ ] Yes [ ]N o 11 Place of Incorporation/Formation Date of Incorporation/Formation Attach copy of the Certificate of Incorporation/Formation which has been filed with the N.J. Secretary of State. Foreign Corporations must submit a copy of their Authorization to do business in New Jersey as a Foreign Corporation in addition to a copy of their corporate/formation papers. Date of authorization to do business in New Jersey 12 The applicant certifies all information contained herein is true and agrees any untruthful representation and any violation of the applicable statutes and regulations promulgated by the Commission shall be reasonable and proper grounds for license suspension or revocation. He further agrees to notify the Commission immediately of any change in the status of the business or of any other information which would change the answers and statements in this application or supplement thereto. The individual(s) signing this application certify that they have read the applicable statutes and are thoroughly familiar with the details and penalties provided. Owner, Partner, Officer, Member 13 I, the undersigned, hereby certify that I _________________of the above business previously named____________________________________________ and that the information I have submitted is true to the best of my knowledge. _______________________________________________________________ Print Name of Applicant Signature and Title of Applicant the undersigned, hereby certify that I am Secretary/Member/Partner of the above Corporation and have witnessed the signature of__________________________ who is President, Vice-President or Member Signatureof Secretary/Member/Partner of said corporation. APPROVAL CERTIFICATE Clerk of the Municipality of (Print Name) State of New Jersey, hereby certify that the Municipal Governing Body or Zoning Commission has approved the location. establishment and maintenance of the business checked below: [ ] Leasing Company [ ] Fleet DElC [ ] Driving School [ ] New & Used Motor Vehicle Dealer [ ] Moped Dealer [ ] Auto Body Repair Facility [ ] Other Motorcycle [ ] Junkyard [ ] Private Inspection Facility located at Complete Address _____________________________________________________ Print Name of Municipal or Zoning Board Clerk County of [ ] Used Motor Vehicle Dealer [ ] Fleet Inspection Facility [ ] DElC Signature of Municipal or Zoning Board Clerk BLC-183 (R12/04) Date American LegalNet, Inc. www.FormsWorkFlow.com BUSINESS LICENSE SERVICES SUPPLEMENTARY APPLICATION BUSINESS NAME BUSINESS PHONE # 1. FULL NAME INCLUDING MIDDLE NAME AND SUFFIX, IF ANY 2. STREET ADDRESS CITY STATE 3. HOW LONG HAVE YOU LIVED AT THE ABOVE ADDRESS? HOME PHONE # 4. LIST THE CITIES, STATES OR FOREIGN COUNTRIES WHERE YOU LIVED BEFORE AND HOW LONG YOU W E R E IN EACH STATE OR COUNTRY. 5. DATE OF BIRTH (MO. DAY, YEAR) 7. SEX 6. PLACE OF BIRTH: (CITY, STATE OR FOREIGN COUNTRY) 8. HEIGHT 9. WEIGHT 10. COLOR OF EYES 11. SOCIAL SECURITY NUMBER 12. DRIVER LICENSE NUMBER (STATE) 13. HAVE YOU, IN THIS OR ANY OT
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