Business Licensing Services Bureau P.O. Box 168 Trenton, New Jersey 08666-0168 (609) 292-6500 ext.5094 New Jersey Motor Vehicle Commission CHECKLIST FOR ITEMS FOR A INITIAL DRIVING SCHOOL Enclosed are applications necessary for the issuance of a New Jersey licensed Driving School. Please ensure that all of the items are returned for the processing of a license: { } Initial application (must be signed and sealed by the Zoning officer or clerk of the municipality where the business is located) { } List of driving instructors and Signature record list { } Specific Qualified supervising instructor as defined in N.J.A.C 13:23-1.1 – Need a letter from current school owner for proof of 500 hours { } Sample of contract and sample of service record { } Statement of whether classroom instruction is offered { } Proposed yellow page (phone directory) advertisements { } Other proposed advertisements { } Photocopy of money receipts { } Hours of operation form { } Proof of Worker’s Compensation coverage for all employees { } Original Certificate of Insurance in the amounts of $250,000 bodily injury and $50,000 property damage. The certificate holder should read: Motor Vehicle Commission – Driving School Section P.O. Box 168 Trenton, NJ 08666-0168 { } Copy of corporate papers (if incorporated) { } $10,000 Surety Bond (form enclosed) { } Summary application (all owners, officers, or partners) { } Child support form (all owners, officers, or partners) { } Fingerprint receipt from Sagem Morpho, Inc. (if not on file) { } Copy of Federal Tax Identification Number { } License fee(s) made payable to: NJMVC $250.00 School license $75.00 each Initial Instructor $25.00 each Authorized Agent $3.00 each Instructor transfer The following items must be “on-location” at the time of scheduled site investigation: � � � � Landline telephone Telephone answering machine Locked file cabinet/safe Dual controlled vehicle(s) owned/leased and registered in the Driving School or lessor I certify that the above items are being submitted for the processing of a Driving School license. My failure to submit the required documents will be cause for the application package being returned and the site inspection voided. ___________________________________ APPLICANT PRINT NAME ___________________________________ APPLICANT’S SIGNATURE and DATE On the Road to Excellence www.njmvc.gov New Jersey is an Equal Opportunity Employer American LegalNet, Inc. www.FormsWorkFlow.com Business Licensing Services Bureau PO Box 168 Trenton, New Jersey 08666-0168 Motor Vehicle Commission APPLICATION FOR LICENSE FOR OFFICE USE ONLY License No. Date Reg. No. Email Approved by The undersigned hereby applies for the license(s) checked in Part 3 and submits the following certified statement: Corp Code 1. Business phone Name of Business (if corporation, corporate name) ____________________________________________________________________ Trade Name 2. Please Check [ ] Corporation Street Address [ ] Other Zip Code City County All applicants please provide the following information and attach copies of proof thereof: A. NJ Sales Tax Identification Number B. NJ Unemployment Registration Number C. Federal Employer Identification Number 4. Complete the following for proprietor, partners, or corporate officers: Name 5. Title 3. Please Check appropriate Box for License: [ ] Leasing Company [$ ] 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 Telephone Number 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 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? Of the above [ ]Yes [ ]No 7 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 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. 11 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 of said corporation. President, Vice-President or Member Signatureof Secretary/Member/Partner APPROVAL CERTIFICATE Clerk of the Municipality of County 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 [ ] Junkyard [ ] Private Inspection Facility [ ] Used Motor Vehicle Dealer [ ] Fleet Inspection Facility [ ] DElC located at Complete Address _____________________________________________________ Print Name of Municipal or Zoning Board Clerk BLC-183 (R 9/08) Signature of Municipal or Zoning Board Clerk Date American LegalNet, Inc. www.FormsWorkFlow.com BUSINESS LICENSING SERVICES BUREAU 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 EXPLANATIONDESCRIBING 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 (R 9/08) DATE American LegalNet, Inc. www.FormsWorkFlow.com Business Licensing Services Bureau P.O. Box 171 Trenton, New Jersey 08666-0171 (609) 292-6500 #5014 _______________________________________________________________________________________ CHILD SUPPORT CERTIFICATION FORM _________________________________________ Business Name _________________________________________ Applicant’s Name (Print) __________________ Date of Birth _________________________________________ Social Security Number Under the provisions of N.J.S.A. 2A:17-56.7 et seq., responses to the questions listed below are required. Misstatements will be just cause to take administrative action including, but not limited to, denial of licensure, immediate suspension or revocation of the license. 1. Do you have a child support obligation? Yes No 2. If yes, do the arrearage amounts equal or exceed the amount of child support payable for six months? No Yes 3. Are you subject to a child-support warrant? Yes No I certify that the foregoing responses made by me are true and I am aware that the making of false statements may subject me to contempt of court. ______________________________________________ __________________ Signature Date BLS-43 (R 9/09) On the Road to Excellence www.njmvc.gov New Jersey is an Equal Opportunity Employer American LegalNet, Inc. www.FormsWorkFlow.com Motor Vehicle Commission Trenton, New Jersey STATE OF NEW JERSEY BUSINESS LICENSING SERVICES BUREAU TO ALL DRIVING SCHOOL OWNERS The New Jersey Motor Vehicle Commission has now established a live fingerprint scan process to streamline criminal background checks required as a condition of licensure. As part of the Business License application process, it is required that all applicants, authorized agents or driving school instructors, proprietors, partners and corporate officers, schedule an appointment with the States private fingerprint scan vendor MorphoTrak (formerly Sagem Morpho, Inc.) All you need do is call this toll free number 1-877-503-5981 (English or Spanish Operators) or TTY-1­ 800-673-0353 (HEARING IMPAIRED Modem Required) to arrange an appointment to be scanned at an established site. When scheduling your appointment, you will be asked to provide certain personal information including your driver’s license and social security number. Please make sure you have this information available when scheduling your appointment. In addition, you will be asked to provide the following Motor Vehicle Commission identification numbers: ORIGINATING AGENCY REFERRAL NUMBER (ORI) AGENCY CASE NUMBER CATEGORY DOCUMENT TYPE STATUTE 39:12-2 and 3 NJ920530Z (Your Driver License Number) MVK RB 1 COMMERCIAL DRIVING SCHOOL LICENSE Please complete the applicant information form contained on the back of this letter. Though certain information is already filled in, you will need to supply certain personal information in blocks 9 through 26 as well as your driver’s license number in block 7 which will be used as your agency case number. Please have this form filled in and present it when you appear for your appointment along with the proper photo identification as noted on the back of this letter. After supplying this information you will be scheduled for an appointment at one of the electronic scan sites. You will be required to pay a one-time fee in the amount of $70.25 incorporating all required background checks. Payment must be made at the time of scheduling your appointment. AT THE TIME OF SCANNING YOU WILL RECEIVE A RECEIPT FROM THE STATE’S VENDOR. PLEASE SUBMIT THIS RECEIPT OR A COPY THEREOF AS PART OF YOUR BUSINESS LICENSE APPLICATION PACKAGE. If you have any questions concerning this procedure, please contact the following area: NEW JERSEY MOTOR VEHICLE COMMISSION BUSINESS LICENSING SERVICES BUREAU DRIVING SCHOOL LICENSING SECTION (609) 292-6500 ext.5094 PLEASE BRING THIS LETTER AND PHOTO IDENTIFICATION WITH YOU WHEN YOU APPEAR TO BE FINGERPRINTED REV 9/09 American LegalNet, Inc. www.FormsWorkFlow.com . www.bioapplicant.com/nj Formerly Sagem Morpho Inc (1) Originating Agency Number (ORI #) (2) Category (3) Statute Number MVK NJ920530Z 39:12-2, 3 (4) Reason for Fingerprinting (5) Document Type COMMERCIAL DRIVING SCHOOL LICENSE RB1 (7) Contributor’s Case # (Unique Identifier) (6) Payment Information $70.25 (8) Miscellaneous DL# (9) First Name (10) MI (12)Daytime Phone Number ( ) (13) Social Security Number (11) Last Name (14) Date of Birth (15) Height (16) Weight - (17) Maiden Name (if married female) (18) Place of Birth (U.S. State –for US Citizen; Country for all others) (19) Country of Citizenship (20) Home Address Address (21) Gender (Select one) (22) Hair Color (Indicate most predominant color, one only) Male ( ) Female ( ) Both ( ) (25) Occupation City (23) Eye Color State Zip (24) Race (Select One) A Asian/ Pacific Islander ( includes Asian Indian) B Black W White ( Includes Hispanic/ Spanish Origin) U Unknown I American Indian / Alaska Native (26) Employer (Name) Employer Address City State Zip APPLICANT INFORMATION – READ THIS FORM CAREFULLY AND FOLLOW ALL INSTRUCTIONS TO COMPLETE THE FINGERPRINT PROCESS. You MUST present this completed form at your appointment to be FINGERPRINTED. NO EXCEPTIONS ALLOWED. Applicants without forms or with incomplete forms will not be printed. IDENTIFICATION IS REQUIRED- ACCEPTABLE ID REQUIREMENTS –ID MUST include Photo, Name, Address (Home/ Employer) and Date of Birth. Acceptable ID MUST be issued by a Federal, State, County or Municipal entity for Identification purposes. Examples of acceptable ID are: 1) Valid Photo Drivers License or Valid Photo ID issued by any State DMV or NJ MVC, 2) Passport. Acceptable ID MUST meet all of the underlined requirements above and MUST be present on one (1) ID. Combinations of documents are NOT acceptable. If acceptable ID is not presented you will not be fingerprinted. For applicants who are required to pay for their own fingerprinting fees, payment is required at the time of scheduling. Payment may be made with a credit card or electronic debit from a checking account. Remember your account will automatically be debited. An $11 fee is charged to cover the cost of a scheduled appointment for applicants who do not cancel/reschedule by noon on the business day prior to your scheduled appointment (Saturday noon for Monday appointments). All appointments can be canceled/rescheduled via the web without penalty if cancellation requirements are met. The $11 fee will also apply for applicants who are turned away from the printing sites due to the inability to present proper ID, who fail to present this completed Universal Fingerprint Form provided to you by your requesting agency or employer, or who are turned away because information on this form does not match the information provided during the scheduling process. You will be refunded State and Federal search fees only. Appointment scheduling is available via the web at www.bioapplicant.com/nj, 24 hours per day, 7 days per week. For applicants who do not have web access, appointments can be made by contacting us toll free at (877) 503-5981 on a first call, first served basis Monday through Friday, 8:00 AM to 5:00 PM EST and Saturday, 8:00 AM to 12 noon EST. English and Spanish speaking operators are available. Hearing impaired scheduling is available at (800) 673-0353. ONLY applicants who schedule through the call center can make payment by money order at the fingerprint site. No other form of payment is accepted at the fingerprint site. Your APPLICANT ID, Site, Date, Time of your appointment, and payment authorization will be confirmed by the call center agent or web confirmation when scheduling is complete. You must record this information in the appropriate blocks below while speaking with the operator. If you appear for fingerprinting at a site where you are not scheduled or on a different date and time, you will be turned away and not fingerprinted. If applicable, you may incur the $11 appointment fee. Your PCN number will be recorded when your fingerprinting has been completed. You MUST retain a copy of the form and a copy of the receipt provided to you by the Fingerprint Technician for your records. NO RECEIPTS WILL BE PROVIDED AFTER THE DATE OF PRINTING. Applicant ID No. Scheduled Site/ Date/ Time Agency Information #1 PYMT Authorization PCN Agency Information #2 APPLICANTS MUST NOT ALTER, SHARE, OR REUSE THIS FORM FORM NO. NJAPS2, Version 4.0 September 1, 2009 American LegalNet, Inc. www.FormsWorkFlow.com Motor Vehicle Commission Trenton, New Jersey STATE OF NEW JERSEY BUSINESS LICENSING SERVICES BUREAU TO ALL AUTHORIZED AGENTS AND INSTRUCTORS The New Jersey Motor Vehicle Commission has now established a live fingerprint scan process to streamline criminal background checks required as a condition of licensure. As part of the Business License application process, it is required that all applicants, authorized agents or driving school instructors, proprietors, partners and corporate officers, schedule an appointment with the States private fingerprint scan vendor MorphoTrak (formerly Sagem Morpho, Inc.). All you need do is call this toll free number 1-877-503-5981 (English or Spanish Operators) or TTY-1­ 800-673-0353 (HEARING IMPAIRED Modem Required) to arrange an appointment to be scanned at an established site. When scheduling your appointment, you will be asked to provide certain personal information including your driver’s license and social security number. Please make sure you have this information available when scheduling your appointment. In addition, you will be asked to provide the following Motor Vehicle Commission identification numbers: ORIGINATING AGENCY REFERRAL NUMBER (ORI) AGENCY CASE NUMBER CATEGORY DOCUMENT TYPE STATUTE 39:12-5 and 6 NJ920530Z (Your Driver License Number) MVK RB 1 COMMERCIAL DRIVING SCHOOL LICENSE Please complete the applicant information form contained on the back of this letter. Though certain information is already filled in, you will need to supply certain personal information in blocks 9 through 26 as well as your driver’s license number in block 7 which will be used as your agency case number. Please have this form filled in and present it when you appear for your appointment along with the proper photo identification as noted on the back of this letter. After supplying this information you will be scheduled for an appointment at one of the electronic scan sites. You will be required to pay a one-time fee in the amount of $70.25 incorporating all required background checks. Payment must be made at the time of scheduling your appointment. AT THE TIME OF SCANNING YOU WILL RECEIVE A RECEIPT FROM THE STATE’S VENDOR. PLEASE SUBMIT THIS RECEIPT OR A COPY THEREOF AS PART OF YOUR BUSINESS LICENSE APPLICATION PACKAGE. If you have any questions concerning this procedure, please contact the following area: NEW JERSEY MOTOR VEHICLE COMMISSION BUSINESS LICENSING SERVICES BUREAU DRIVING SCHOOL LICENSING SECTION 609-292-6500 ext.5094 PLEASE BRING THIS LETTER AND PHOTO IDENTIFICATION WITH YOU WHEN YOU APPEAR TO BE FINGERPRINTED REV 9/09 American LegalNet, Inc. www.FormsWorkFlow.com . www.bioapplicant.com/nj Formerly Sagem Morpho Inc (1) Originating Agency Number (ORI #) (2) Category NJ920530Z (3) Statute Number MVK 39:12-5, 6 (4) Reason for Fingerprinting (5) Document Type RB1 COMMERCIAL DRIVING SCHOOL LICENSE (7) Contributor’s Case # (Unique Identifier) INSTRUCTORS LICENSE (9) First Name (10) MI (12)Daytime Phone Number ) $70.25 (8) Miscellaneous DL# ( (6) Payment Information (13) Social Security Number (11) Last Name (14) Date of Birth (15) Height (16) Weight - (17) Maiden Name (if married female) (18) Place of Birth (U.S. State –for US Citizen; Country for all others) (19) Country of Citizenship (20) Home Address Address (21) Gender (Select one) (22) Hair Color (Indicate most predominant color, one only) Male ( ) Female ( ) Both ( ) (25) Occupation City (23) Eye Color State Zip (24) Race (Select One) A Asian/ Pacific Islander ( includes Asian Indian) B Black W White ( Includes Hispanic/ Spanish Origin) U Unknown I American Indian / Alaska Native (26) Employer (Name) Employer Address City State Zip APPLICANT INFORMATION – READ THIS FORM CAREFULLY AND FOLLOW ALL INSTRUCTIONS TO COMPLETE THE FINGERPRINT PROCESS. You MUST present this completed form at your appointment to be FINGERPRINTED. NO EXCEPTIONS ALLOWED. Applicants without forms or with incomplete forms will not be printed. IDENTIFICATION IS REQUIRED- ACCEPTABLE ID REQUIREMENTS –ID MUST include Photo, Name, Address (Home/ Employer) and Date of Birth. Acceptable ID MUST be issued by a Federal, State, County or Municipal entity for Identification purposes. Examples of acceptable ID are: 1) Valid Photo Drivers License or Valid Photo ID issued by any State DMV or NJ MVC, 2) Passport. Acceptable ID MUST meet all of the underlined requirements above and MUST be present on one (1) ID. Combinations of documents are NOT acceptable. If acceptable ID is not presented you will not be fingerprinted. For applicants who are required to pay for their own fingerprinting fees, payment is required at the time of scheduling. Payment may be made with a credit card or electronic debit from a checking account. Remember your account will automatically be debited. An $11 fee is charged to cover the cost of a scheduled appointment for applicants who do not cancel/reschedule by noon on the business day prior to your scheduled appointment (Saturday noon for Monday appointments). All appointments can be canceled/rescheduled via the web without penalty if cancellation requirements are met. The $11 fee will also apply for applicants who are turned away from the printing sites due to the inability to present proper ID, who fail to present this completed Universal Fingerprint Form provided to you by your requesting agency or employer, or who are turned away because information on this form does not match the information provided during the scheduling process. You will be refunded State and Federal search fees only. Appointment scheduling is available via the web at www.bioapplicant.com/nj, 24 hours per day, 7 days per week. For applicants who do not have web access, appointments can be made by contacting us toll free at (877) 503-5981 on a first call, first served basis Monday through Friday, 8:00 AM to 5:00 PM EST and Saturday, 8:00 AM to 12 noon EST. English and Spanish speaking operators are available. Hearing impaired scheduling is available at (800) 673-0353. ONLY applicants who schedule through the call center can make payment by money order at the fingerprint site. No other form of payment is accepted at the fingerprint site. Your APPLICANT ID, Site, Date, Time of your appointment, and payment authorization will be confirmed by the call center agent or web confirmation when scheduling is complete. You must record this information in the appropriate blocks below while speaking with the operator. If you appear for fingerprinting at a site where you are not scheduled or on a different date and time, you will be turned away and not fingerprinted. If applicable, you may incur the $11 appointment fee. Your PCN number will be recorded when your fingerprinting has been completed. You MUST retain a copy of the form and a copy of the receipt provided to you by the Fingerprint Technician for your records. NO RECEIPTS WILL BE PROVIDED AFTER THE DATE OF PRINTING. Applicant ID No. Scheduled Site/ Date/ Time Agency Information #1 PYMT Authorization PCN Agency Information #2 APPLICANTS MUST NOT ALTER, SHARE, OR REUSE THIS FORM FORM NO. NJAPS2, Version 4.0 September 1, 2009 American LegalNet, Inc. www.FormsWorkFlow.com STATE OF NEW JERSEY Motor Vehicle Commission SURETY BOND OF DRIVING SCHOOL Bond No. Effective Date Expiration Date KNOW ALL MEN BY THESE PRESENTS: That we, (Business Name) , a Surety Company qualified and as Principal, and duly licensed to do business in the State of New Jersey, as Surety, are held and firmly bound unto the PEOPLE OF THE STATE OF NEW JERSEY, in the penal sum of TEN THOUSAND AND NO/100DOLLARS ($10,000.00), lawful money of the United States of America, for the payment of which, well and truly made, the undersigned Principal and Surety bind themselves, their respective heirs, administrators, successors, and assigns, jointly and severally, firmly by these presents. The CONDITION of the foregoing obligation is such, that whereas Principal has made, or is about to make, application to the State of New Jersey for a DRIVING SCHOOL LICENSE. NOW THERFORE, if the Principal in its business of operating a Driving School shall not practice any fraud and shall not make any fraudulent representations which cause monetary loss to a person taking instruction from the school, then this obligation will be null and void, otherwise to remain in full force and effect. This bond shall be effective on day of ,20 , and shall run concurrently with the period of the license granted to the Principal, and shall remain in the full force and effect for any renewals thereof, provided, however, that the penalty of said bond shall not be cumulative from year to year, and the total liability of Surety herein shall not exceed the sum of $10,000.00, regardless of the number of license periods for which said bond is in force. It shall be the responsibility of the surety to notify the New Jersey Motor Vehicle Commission immediately upon the payment of any funds which decrease the liability of the surety under this bond, and immediately upon acquiring knowledge of a final judgement for which the surety is liable under the bond. American LegalNet, Inc. www.FormsWorkFlow.com This bond may be canceled by the Surety upon the Surety serving written notice upon the Motor Vehicle Commission of its desire to cancel, and the cancellation date shall be thirty (30) days from the date said notice of cancellation is received. IN WITNESS WHEREOF the said Principal and Surety have hereunto signed these presents this day of 20 CORPORATE SEAL Principal (Licensee) Signature & Title (Licensee) Surety (Firm’s Name) Sworn to and subscribed before Me this day of 20 Signature Notary Public of New Jersey . Address of Surety Attorney-in-Fact for Surety County BLC-91 (R7/03) American LegalNet, Inc. www.FormsWorkFlow.com New Jersey Motor Vehicle Commission Business Licensing Services Bureau P.O. Box 168 Trenton, New Jersey 08666-0168 Phone: (609) 292-6500 ext.5094 DRIVING SCHOOL BUSINESS HOURS Name of School___________________________________ 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____________________________ BLC-86 (R 9/08) MM American LegalNet, Inc. www.FormsWorkFlow.com Motor Vehicle Commission Business Licensing Services Bureau P.O. Box 168 Trenton, New Jersey 08666-0168 Phone: (609) 292-6500 ext.5094 EXPIRATION NAME OF SCHOOL AND NUMBER DATE The owner is to enter below a list of all instructors. This includes school owners, partners and employees intending to act in the capacity of instructors, full or part time. Instructor’s Signature Instructor’s Number Supervising Instructor's Name Initial or renewal applications must be prepared by each instructor and submitted with this form. No person may give instruction without securing and having in their possession a valid driver license. This form must be submitted to NJMVC, Business License Services, P.O. Box 168, Trenton, New Jersey 08666-0168 at the time of applying for an additional instructor license. Should an instructor leave the employ of the above school, the owner shall notify the Chief Administrator of Motor Vehicle Commission immediately, in writing. BLC-87 (R 9/08) American LegalNet, Inc. www.FormsWorkFlow.com Motor Vehicle Commission Business Licensing Services Bureau P.O. Box168 Trenton,New Jersey 08666-0168 (609) 292- 6500 x5094 EXPIRATION NOTE: The following are the only person authorized and empowered to sign service agreements for the school. EFFECTIVE DATE The undersigned owner of the named Driving School hereby authorizes the person(s) whose signatures appear below to execute and sign service agreements in the owner’s behalf. Signature Name of Driving School Print Name School No. Owner’s Signature Signature of record must be filed for all persons authorized to sign service agreements. If you authorize any other person to sign service agreements, or if you revoke the authority of any person to sign such service agreements, you shall notify this Commission immediately. Please send any revisions to the NJMVC, Business License Services, Driving School Section, P.O. Box 168, Trenton, New Jersey 08666-0168 This form may be duplicated BLC-88 (R 9/08) American LegalNet, Inc. www.FormsWorkFlow.com Motor Vehicle Commission Business Licensing Services Bureau PO Box 168 Trenton, NJ 08666-0168 Phone: (609) 292-6500 ext.5094 DRIVING SCHOOL SUBJECT: Approved behind-the-wheel course for Commercial Driving Schools Special learner permits. It is mandatory that the following listed instructions be included in all courses given by a commercial driver school t o students utilizing a special learner's permit. The course must be a minimum of six hours actual behind-the-wheel instruction. Starting: Adjusting of seat, mirrors Seat belts Check parking brake Gear shift in proper position Ignition switch on Starting of engine Signaling: Check traffic Putting vehicle in motion Stopping: Checking traffic Signaling Proper position Stopping vehicle smoothly and safely Gear shift in proper position Setting parking brake Shutting engine off Steering: Proper hand positions on wheel Proper grip on wheel Center of lane Aim high in steering Turning: Signaling Vehicle Position Right turns Left turns Right turn on red Highway Driving: Lane Positioning Signaling Changing lanes Speed control Merging Intersections: Signaling Lane positioning Right of way Passing Three Point Turn: Signaling Vehicle positioning Checking of traffic Turning Parking: Signaling Checking of traffic Vehicle positioning Hand position Turning of wheel Speed control Proper gear position Set brakes Ignition off RemoveKey Backing: Checking traffic Hand position Straight Iine Speed control ST-116 (R 9/08) American LegalNet, Inc. www.FormsWorkFlow.com Motor Vehicle Commission P. O. Box 168 Trenton, New Jersey 08666 STATE OF NEW JERSEY BUSINESS LICENSING SERVICES BUREAU (609) 292-6500 ext.5094 TO: DRIVING SCHOOL OWNERS 1. The initial instructor application, a $75.00 check or money order made payable to NJMVC, Child support certification form and a copy of receipt for fingerprint scanning must be mailed to Business Licensing Services Bureau, Driving School Section, POB 168 Trenton, NJ 08666, after the applicant(s) has appeared for the tests. 2. Written and vision test will be administered when applicant appears at the Driver Testing Center. All applicants who wish to obtain an Initial Driving School Instructor’s license may do so on a walk in basis between the hours of 8:00 a.m. and 11:00 a.m. a the following Driver Testing Centers and Inspection Stations: Cherry Hill Driver Testing Executive Campus Ste 110 Bldg # 1 Cherry Hill NJ 08002 WRITTEN TEST ONLY Cherry Hill Inspection 617 Hampton Rd. Cherry Hill NJ 08002 ROAD TEST ONLY Eatontown Driver Testing 109 Rt. 36 Eatontown NJ 07724 WRITTEN & ROAD TEST Miller Air Park Driver Testing Rt. 530 & Mule Rd. Berkeley Twp NJ 08721 Tuesday,Wednesday, Thursday WRITTEN & ROAD TEST Rahway Driver Testing 1140 Woodbridge Rd. & Hazelwood Ave. Rahway NJ 07065 WRITTEN & ROAD TEST Trenton Driver Testing (Bakers Basin) 3200 Brunswick Pike ( Rt. 1) Lawrenceville NJ 08648 WRITTEN & ROAD TEST Wayne Driver Testing 481 Rt. 46 West Wayne NJ 07470 WRITTEN & ROAD TEST West Deptford Driver Testing 215 Crown Point Road Thorofare NJ 08086 WRITTEN TEST ONLY 3. Scheduling the road test will be made by the Driver Testing Center after the vision and written testing phase has been successfully completed. The road test may be scheduled the same day if time and staffing allows. If the road test is full, the test will be scheduled on the next available day. 4. The license will not be issued until we receive the results of the instructor test and the fingerprint check. American LegalNet, Inc. www.FormsWorkFlow.com Motor Vehicle Commission Business Licensing Services Bureau P.O. Box 168 Trenton, New Jersey 08666-0168 P:609-292-6500 x5094 DRIVING SCHOOL - INITIAL INSTRUCTORS LICENSE APPLICATION FEE: $75.00 Instructor License Number D.L.Check Expires To be submitted to Motor Vehicle Services for the purpose of securing approval to engage in motor vehicle driving instructions by an owner, officer or employee (full or part-time) in connection with a driving school license pursuant to the provisions of 39:12 R.S. ALL APPLICANTS ARE REQUIRED TO PASS A KNOWLEDGE TEST, VISION TEST, DRIVING INSTRUCTION TEST AND JUDGMENT OF DRIVING ABILITY TEST GIVEN BY MOTOR VEHICLE SERVICES, AND ARE REQUIRED TO SUBMIT TO FINGERPRINTING. The Instructor applicant will complete both sides of this application. Date Print Name Telephone No. Resident Address (Street) (City) (State) (Zip Code) PERSONAL DESCRIPTION: Height Weight Date of Birth Any Permanent physical marks? Yes No- Do you possess a current N.J. Driver’s License? Color Eyes If so, describe Yes No ­ Expiration Date N.J. Driver License No. Have you held a N.J. Driver License for the last four consecutive years? Yes No If no, give residence address in state where you were previously licensed NOTE: You must submit a certified abstract of your driving record if the state of licensure is other than New Jersey, and a copy of your Drivers License. Has your driver license privilege ever been suspended or revoked in this or any other state? Yes No If yes, give particulars Name of Driving School Address of Driving School (Street) State your position with driving school. Owner (State) (City) Partner Officer Employee BLC-84 (R 9/08) American LegalNet, Inc. www.FormsWorkFlow.com Have you ever applied for a Driving School Instructor License, or Driving School License in this or any other state? Yes No Have you ever been denied a driver’s license, a driving instructor license or a driving school license in this or any other state? Yes- No- If yes, give particulars Have you ever been convicted of inducing another to resort to fraud or fraudulent practices in relation to securing a license to drive a motor vehicle or motorcycle? Yes- No If yes, give particulars Have you ever been arrested for, charged with, indicted for or convicted of any of the offenses enumerated in 13:23-2.12? Yes No If yes, give particulars CIVIL AND FEDERAL OFFENSE HISTORY (INCLUDING COURT MARTIAL) (RECORD ALL ARRESTS AND CONVICTIONS) Date Offense Court Disposition Penalty I, THE UNDERSIGNED, DECLARE THAT I AM THE APPLICANT NAMED HEREIN, KNOW THE CONTENTS OF THIS APPLICATION, AND CERTIFY THE CONTENTS HEREIN TO BE TRUE. (Signature of Applicant) (Date) SCHOOL OWNER’S STATEMENT OF CONSENT I am the owner, or partner or officer of the Driving School listed herein, and believing the information given herein is true, hereby endorse consent in the issuing of an instructor license to the applicant. (Signature) (Title) (Date) Initial instructor applicants are required to submit to tests prescribed by the Chief Administrator to determine that they possess the minimum qualifications for licensing. American LegalNet, Inc. www.FormsWorkFlow.com Business Licensing Services Bureau P.O. Box 168 Trenton, New Jersey 08666-0168 609-292-6500 ext.5094 Commission "AUTHORIZED AGENT" APPLICATION - DRIVING SCHOOL DL Check Initial Renewal Phone No. Name (Print) Address City, State, Zip Code Age Date of Birth Height Weight Color of Hair Color of Eyes Driver’s License No. Expires State of Licensure Driving School by whom you are to be employed Answer the following questions: 1. Have you ever been arrested for, charged with, indicted for or convicted of any of the offenses If “yes” explain. enumerated in 13:23-2.12? 2. Have you ever had your driving privileges suspended or revoked in this or any other state? If “yes” explain. 3. Have you ever been refused a drivers license in this or any other state? SIGNATURE OF APPLICANT If “yes” explain. DATE BLC-82 (R 9/08) American LegalNet, Inc. www.FormsWorkFlow.com The following is to be completed by Driving School Owner. I hereby certify that the applicant here named is applying with my authorization, for approval to act as an “Authorized Agent” for the Driving School. It is understood that the “Authorized Agent” shall be permitted to transport the school’s students to a Driver Testing Center to take the driving test portion of the driver’s examination or to purchase a permit. SIGNATURE OF SCHOOL OWNER, PARTNER OR OFFICER DATE: INSTRUCTIONS TO APPLICANT This application must be accompanied by: 1. A certified abstract of your driving record from the Driver’s Licensing State if other than New Jersey (initial and renewal), and a copy your Drivers License. 2. FEE. $25.00 (one year period). Check or money order made payable to NJ Motor Vehicle Commission or NJMVC Business License Compliance. This application is to be submitted to Motor Vehicle Commission, Business License Services, P.O. Box 168, Trenton, New Jersey 08666-0168. American LegalNet, Inc. www.FormsWorkFlow.com