GAVIN NEWSOM, GOVERNOR BUREAU OF AUTOMOTIVE REPAIR LICENSING UNIT PO Box 989001, West Sacramento, CA 95798 - 9001 P (855) 735 - 0462 F (855) 641 - 9982 | www.bar.ca.gov BAR - 10 1 Page 1 of 8 AUTOMOTIVE REPAIR DEALER REGISTRATION APPLICATION INSTRUCTIONS Complete this a pplication in accordance with the instructions below and include additional pages and documents as necessary. The Bureau of Automotive Repair ( BAR ) cannot consider an application for registration unless all requested information is provided. If not applica ble, indicate N/A. Submit completed application with all required information and fees to the BAR Licensing Unit at the above address. Send a separate completed application and $ 200 .00 fee to the above address for each business location. Remit fees by check or money order made payable to t he Bureau of Automotive Repair. FEES ARE NON - REFUNDABLE PURSUANT TO BUSINESS AN D PROFESSIONS CODE SECTION 158. A registration will be mailed to the address of record after your applic ation is approved and processed , provided the application does not have any deficiencies. S ECTIONS 1 14 1. NAME OF BUSINESS : Provide the exact name under which the business will be conducted. This same name should be shown on invoices and advertisements. NOTE: The motor vehicle license plate number, if provided in section 13 , item (c ), will be included as part of the registered business name. 2. NAME OF CORPORATION : Provide the name of the corporation as filed with the California Secretary of State. (This section does not apply to business es owned b y individuals or partnerships.) 3. CORPORATION NUMBER : Provide the corporation number assigned by the California Secretary of State. The corporate numbe r must be in an active status. (This section does not apply to businesses owned by individuals or partner ships.) 4. FEDERAL EMPLOYER IDENTIFICATION NUMBER: Provide the Federal Employer Identification Number (FEIN) assigned by the Internal Revenue Service. The FEIN must be in an active status. 5. BUSINESS ADDRESS: Provide the physical address where business is conducted and/or records will be maintained . PO boxes are not permitted. If your business is located at an address that has multiple shops, you must provide the unit/suite number since each business must have a unique address. All licenses are mailed to the business address. The business address must be shown on invoices and advertisements. The business address will be disclo sed on BAR website as the address of record. 6. MAILING ADDRESS: Complete only if you wish to receive correspondence at an address o ther than the business address. If you provide a mailing address, renewal notices will be sent only to this address . 7. BUSINESS AREA CODE AND TELEPHONE NUMBER: Provide the business area code and telephone number. 8. LIST ALL OWNERS , DIRECTORS , OFFICERS, PARTNER S, MEMBERS, TRUSTEES, AND RESPONSIBLE MANAGING EMPLOYEE: Pursuant to Business and Professions Code section 9884, an automotive re pair dealer shall identify the owners, directors, officers, p artners, members, trustees, responsible managing employee, and other persons who directly or indirectly control or conduct the business. Sole Proprietorship : If the business is owned by one individual, li st the full name, title (i.e., o wner), Social Security Number (SSN) or Individual Taxpayer Identification Num ber (ITIN), driver license number, area code and telephone number, and home address of the owner. Partnership : If the business is a partnership (two or more individuals), l ist the full name, title (i.e. p artner), SSN/ITIN, driver license number, area code and telephone number, and home address for each partner of the business. Corporation: If the business is a corporation, l ist the full name, title (i.e. president, secretary, t reasurer, etc.), SSN/ITIN, driver license number, area code and telephone number, and home address for each officer and director of the business. If the same person holds all corporate offices, you must state so on the application. Trust: If the business i s a trust, list the full name, title (i.e., Trustee), SSN/ITIN, driver license number, area code American LegalNet, Inc. www.FormsWorkFlow.com BAR - 101 Page 2 of 8 and telephone number, and home address for each trustee. 9. MILITARY VERIFICATION: Expedited application assistance is available for current or former United Stat es military personnel and spouses or domestic partners of active duty or reserve military personnel. A waiver of renewal requirements is available for active duty or reserve military personnel. To apply for expedited application assistance or a renewal req uirement(s) waiver, you must submit required documentation as specified at www.bar.ca.gov . (See Health and Safety Code section 44031.5(d) and Business and Professions Code sections 114.3 and 115.5.) 10. BACKGROUND : This section must be completed in its entirety. Select YES or NO for items (a) through (g ). Any relevant information not provided may result in denial of this appli cation or legal action later to revoke the registration. 11. SELLER PERMIT NUMBER, CITY/COUNTY BUSINESS LICENSE, and HAZARDOUS WASTE IDENTIFICATION NUMBER. If not applicable, indicate N/A or Exem pt. Seller Permit Number: Provide the s eller p ermit n umber as assigned by the California Board of Equalization. City/County Business License: Provide the b usiness l icense n umber as assigned by the local city or county official of that jurisdiction. If the office or jurisdiction does not require a business license , attach a detailed statement dated and signed by a person listed in section 8 of the application. Hazardous Waste Identification Number: Provide the h azardous w aste identification n umber as assigned by the United States or California Environmental Protecti on Agency. 12. TYPE OF OWNERSHIP : Select only one type of ownership: sole proprietorship, partnership, or c orporation. This appl ication is not to be used by a limited liability c orporation (LLC) . Please visit www.bar.ca.go v or call (855) 735 - 0462 to obtain the appropriate LLC application. 13. TYPE OF BUSINESS: Using the list provided, identify the primary and secondary services performed by the business and provide the corresponding number(s) in items (a) and (b). Select YES or NO for item (c). If YES, provide the license plate number for the motor vehicle used to perform mobile automotive repairs in item (e). The motor vehicle license plate number will be included as part of the registered business name that must be shown on all invoices and advertisements. (See Title 16, Section 3351.7.3 of the California Code of Regulations.) Select YES or NO for item (d). If required, provide the spray booth permit number as assigned by the local Air Quality Mana gement or Air Pollution Control District in item (e) and attach a copy of the supporting documents. 14. CERTIFICATION : The appropriate person(s) must read, sign, and date section 14 of this application. Signatures affirm that all statements are true and correc t. Any false statements made on this application may result in denial of this application or legal action later to revoke the registration. ADDITIONAL INFORMATION TYPE OF REPAIR BUSINESS REQUIRED TO REGISTER A valid registration is required for any busi ness that performs, for compensation, tests or repairs to, maintenance of, or diagnosis of malfunctions of any of the following automotive or motorcycle components: AIR CONDITIONING SYSTEM TRANSMISSION BODY AND FRAME STEERING GEAR BRAKES EMISSION CONTROL SYSTEM CLUTCH FUEL SYSTEM DRIVE TRAIN ASSEMBLY HEATER SYSTEM ELECTRICAL SYSTEM GLASS COMPONENTS ENGINE OTHER AUTOMOTIVE OR MOTORCYCLE COMPONENTS SUSPENSION (not specifically excluded) TYPE OF REPAIR BUSINESS NOT REQUIRED TO REGISTER No registration is required for the following: L A business that services only vehicles other than passenger vehicles. American LegalNet, Inc. www.FormsWorkFlow.com BAR - 101 Page 3 of 8 A fleet owner repairing only fleet vehicles. A business that performs only minor maintenance ser vices to motor vehicl es. Machine shops that meet all of the following criteria: 1. Primary business is the wholes