Motor Vehicle Commission Trenton, New Jersey STATE OF NEW JERSEY PO BOX 171 Boat Section (609) 292-4517 TO PROCESS YOUR RECENT REQUEST TO OBTAIN BOAT DEALER REGISTRATIONS, WE NEED THE FOLLOWING: INITIAL APPLICATION MUST BE COMPLETED ✥ TWO PHOTOGRAPHS SHOWING YOUR BUILDING AND SIGN ✥ A NOTARIZED STATEMENT ON YOUR LETTERHEAD STATING YOU WILL NOT USE THE DEALER REGISTRATIONS FOR PLEASURE PURPOSES AND THAT YOU ARE NOT BECOMING A DEALER TO AVOID PAYMENT OF SALES TAX. THE STATEMENT MUST ALSO CONTAIN AN ESTIMATE OF HOW MANY NEW AND USED BOATS YOU EXPECT TO SELL IN A YEAR. ✥ A COPY OF A CERTIFICATE OF AUTHORITY ISSUED BY THE DIVISION OF TAXATION. TO OBTAIN THIS CERTIFICATE AND A 9-DIGIT SALES TAX NUMBER CALL, PLEASE CALL(609) 292-6400. ✥ IF YOUR BUSINESS IS A CORPORATION PLEASE SUBMIT CORPORATION PAPERS. IF YOUR BUSINESS IS A LLC PLEASE SUBMIT THE FORMATION PAPERS. ✥ CERTIFICATE OF INSURANCE WHICH REFLECTS YACHT DEALER LIABLITY COVERAGE FOR DEMOSTRATION AND TEST RIDES, COVERING ALL OWNED BOATS. ✥ THE CERTIFICATE MUST READ: MOTOR VEHICLE COMMISSION BUSINESS LICENSE SERVICES - BOATS PO BOX 171 TRENTON, NJ 08666 ✥ COLOR PHOTOGRAPHS OF OWNER, PARTNERS, OFFICERS, OR MEMBERS ✥ A BUSINESS CHECK OR MONEY ORDER MADE PAYABLE TO “NJMVC” IN THE AMOUNT OF $75.00. UPON RECEIPT OF THESE ITEMS, AN INVESTIGATION OF THE BUSINESS WILL BE SET UP. ONCE APPROVED, FOUR BOAT DEALER REGISTRATIONS AND DECALS WILL BE ISSUED AND MAILED TO YOUR BUSINESS. ENCLOSED FOR YOUR CONVENIENCE IS A RETURN ENVELOPE. Business License Compliance Unit On the Road to Excellence Visit us at www.njmvc.gov New Jersey is an Equal Opportunity Employer American LegalNet, Inc. www.FormsWorkFlow.com Business License Services PO Box 171 Trenton, New Jersey 08666-0171 Motor Vehicle Commission APPLICATION FOR LICENSE FOR OFFICE USE ONLY License No. 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. Business phone Name of Business (if corporation, corporate name) ____________________________________________________________________ Trade Name 2. Please Check [ ] Corporation Street Address [ ] Other Zip Code City County 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: Title Name 5. [ [ [ [ [ [ ] 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 Telephone Number if yes, explain: 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 7 3. Please Check appropriate Box for License: 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 6 [ ]Proprietorship [ ] Partnership Of the above Give name and address of person 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? [ ]Yes [ ]N o If yes, explain: Have the owners, partners or corporate officers, agents or employees of your organization ever used an alias or been known by any other name 9. [ ]Yes If yes, explain: [ ]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 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. Place of Incorporation/Formation Date of Incorporation/Formation 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. 13 The individual(s) signing this application certify that they have read the applicable statutes and are thoroughly familiar with the details and penalties provided. I, the undersigned, hereby certify that I _________________of the above business previously named____________________________________________ Owner, Partner, Officer, Member 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 of said corporation. Signature of Secretary/Member/Partner APPROVAL CERTIFICATE (Print Name) Clerk of the Municipality of 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 [ ] Junkyard [ ] Private Inspection Facility County of [ ] Used Motor Vehicle Dealer [ ] Fleet Inspection Facility [ ] DElC located at Complete Address _____________________________________________________ Print Name of Municipal or Zoning Board Clerk BLC-183 (R12/04) Signature of Municipal or Zoning Board Clerk 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 HOME PHONE # 3. HOW LONG HAVE YOU LIVED AT THE ABOVE ADDRESS? 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 11. SOCIAL SECURITY NUMBER 10. COLOR OF EYES 9. WEIGHT 12. DRIVER LICENSE NUMBER (STATE) 13. HAVE YOU, IN THIS OR ANY OTHER STATE OR COUNTRY EVER BEEN ARRESTED, CHARGED OR CONVICTED OF A CRIME, DISORDERLY PERSONS OFFENSE, VIOLATION OF CONSUMER PROTECTION LAWS OR REGULATIONS? YES NO IF YES, ATTACH EXPLANATION DESCRIBING NATURE OF OFFENSE, DATE, CITY AND STATE WHERE OFFENSE OCCURRED, IDENTIFY COURT OR ADMINISTRATIVE TRIBUNAL BEFORE THE CASE WAS TRIED, DATE AND SENTENCE. 14. I CERTIFY THAT THE INFORMATION PROVIDED HEREIN AND ATTACHMENTS, IF ANY, IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. SIGNATURE: DATE 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 WERE IN EACH STATE OR COUNTRY. 5 DATE OF BIRTH (MO. DAY, YEAR) 7. SEX 11. SOCIAL SECURITY NUMBER 6. PLACE OF BIRTH: (CITY. STATE OR FOREIGN COUNTRY) 8. HEIGHT 9. WEIGHT 10. COLOR OF EYES 12. DRIVER LICENSE NUMBER (STATE) 13. HAVE YOU, IN THIS OR ANY OTHER STATE OR COUNTRY EVER BEEN ARRESTED, CHARGED OR CONVICTED OF A CRIME, DISORDERLY PERSONS OFFENSE, VIOLATION OF CONSUMER PROTECTION LAWS OR REGULATIONS? YES NO IF YES, ATTACH EXPLANATION DESCRIBING NATURE OF OFFENSE, DATE, CITY AND STATE WHERE OFFENSE OCCURRED, IDENTIFY COURT OR ADMINISTRATIVE TRIBUNAL BEFORE THE CASE WAS TRIED, DATE AND SENTENCE. 14. I CERTIFY THAT THE INFORMATION PROVIDED HEREIN AND ATTACHMENTS, IF ANY, IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. SIGNATURE: BLC-205B (7/03) DATE American LegalNet, Inc. www.FormsWorkFlow.com New Jersey Motor Vehicle Commission Office of Regulatory Affairs Business License Services P.O. Box 171 Trenton, New Jersey 08666-0171 BUSINESS HOURS Name of Business___________________________________ License No. ___________________________ Address_________________________________________________________________________________ Days Open for Business Business Hours Monday From To Tuesday From To Wednesday From To Thursday From To Friday From To Saturday From To Signature of Proprietor, partner or officer_____________________________________________________ Date____________________________ MM BLC-86A (R12/03) American LegalNet, Inc. www.FormsWorkFlow.com