Business Licensing Services Bureau P.O. Box 171 Trenton, NJ 08666-0171 STATE OF NEW JERSEY P.O. Box 171 Dealer Unit Enclosed is copy of the applicable law, application and supplemental forms necessary to apply for Leasing plates and registrations. Each applicant for Leasing plates and registrations must establish and maintain a permanent place of business in New Jersey. Said business must display an exterior sign, which reflects the business name and the facility must conform with all municipal requirements. The fee for issuance of the registrations and plates is $257.50 for one (1) set and is to be paid by certified check or money order. In addition, a certificate of insurance must be submitted which reflects liability insurance coverage in the minimum amounts of $100,000/$250,000 bodily injury and $25,000 property damage and the total number of plates that the policy will cover. The certificate holder must read as follows: NJ Motor Vehicle Commission Business Licensing Services Bureau P.O. Box 171 Trenton, NJ 08666-0171 If you have any questions, please call (609) 292-6500 ext.5014. Sincerely, Business Licensing Services Bureau On the Road to Excellence Visit us atwww.njrnvc.gov New Jersey is an Equal Opportunity Employer American LegalNet, Inc. www.FormsWorkFlow.com Motor Vehicle Commission Business Licensing Services Bureau PO Box 171 Trenton, New Jersey 08666-0171 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. [ [ [ [ [ [ ] 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 Leasing 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 Title 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 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 Of 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 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 [ ]N o 10. If yes, explain: If yes, explain: 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 I, 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 1, (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 Leasing [ ] Junkyard [ ] Private Inspection Facility located at [ ] Used Motor Vehicle Dealer [ ] Fleet Inspection Facility [ ] DElC Complete Address _____________________________________________________ Print Name of Municipal or Zoning Board Clerk BLC-183 (R12/04) County of 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 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 Business Licensing Services Bureau P.O. Box 170 Trenton, New Jersey 08666-0170 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, Officer or Member _______________________________________________ Date____________________________ MM BLC-86A (R 4/11) American LegalNet, Inc. www.FormsWorkFlow.com 39:3-18. General registration; "D" or temporary plates; fees A manufacturer of motor vehicles, motor-drawn vehicles, motor vehicle bodies, motorized bicycles, or motorcycles doing business in this State may, with regard to motor or motor-drawn vehicles, motorized bicycles, or motorcycles owned or controlled by him, obtain general registration and registration plates therefor of the style and kind provided for in this subtitle, with the letter “D” stated thereon. Such plates can be placed on any vehicle or cycle owned or controlled by such manufacturer, but only if it is operated only for shop, demonstration or delivery purposes. A bona fide converter of commercial motor vehicles, motor-drawn vehicles or motor vehicle chassis doing business in this State may, with regard to motor or motor-drawn vehicles owned or controlled by him, obtain general registration and registration plates therefor of the style and kind provided for in this subtitle, with the letter “D” stated thereon. Such plates can be placed on any vehicles owned or controlled by such converter, but only if such vehicles are operated for shop, demonstration or delivery purposes. A bona fide dealer in motor vehicles, motor-drawn vehicles or motorcycles doing business in this State and having a license to do business as such issued by the director may, with regard to motor or motor-drawn vehicles or cycles owned by him, obtain general registration and registration plates therefor of the style and kind provided for in this subtitle, with the letter “D” stated thereon. Such plates shall only be placed on any vehicle or cycle owned by such dealer; and provided, such vehicle is not used for hire. Any person who shall be convicted of a violation of this paragraph shall be subject to a fine not, exceeding $100.00. A bona fide dealer in motorized bicycles, as defined in R.S. 39:1-1, who has an established place of business in this State, may, with regard; to motorized bicycles owned by him, obtain general registration and registration plates therefor of the style and kind provided for in this subtitle, with the letter “D” stated thereon. The plates can be placed on a motorized bicycle by the dealer, but only if the motorized bicycle is operated only for shop, demonstration, or delivery purposes. Any person engaged in the business of financing the purchase of motor or motor-drawn vehicles or motorized bicycles or lending money thereon may, with regard to motor or motor-drawn vehicles or motorized bicycles owned or controlled by him, obtain general registration and registration plates therefor of the style and kind provided for in this subtitle, with the word “temporary” stated thereon. Such plates can be placed on any such vehicle only when it is being transported from the place where it has been kept by the purchaser or borrower to the place where it is to be kept by the repossess or, when the repossessor desires to operate it for the purpose of demonstration for sale. Any corporation engaged in the business of insuring motor vehicles, motorized bicycles, or motor-drawn vehicles against theft may, with regard to vehicles owned or controlled by it, obtain general registration and registration plates therefor of the style and kind provided for in this subtitle, with the word “temporary” stated thereon. Such plates can be placed on any such vehicle, if ownership or control thereof has been obtained by virtue of the terms of an insurance against theft contract made by such corporation, and only "when the vehicle is to be transported for delivery to the owner thereof from the place where it has been abandoned by or seized from a thief. Any person, partnership or corporation engaged in the business of transporting motor or motordrawn vehicles or motorized bicycles from the place of manufacture for delivery to dealers may, with regard to such vehicles, obtain general registration and registration plates therefor of the kind and style provided for in this subtitle, with the word “temporary” stated thereon, but only if the director is satisfied as to the financial responsibility of such person, partnership or corporation to meet any claim for damages arising out of any automobile accident and satisfactory evidence of such responsibility ;has been filed with him. American LegalNet, Inc. www.FormsWorkFlow.com Any person engaged in the business of renting or leasing motor vehicles, motorized bicycles, or motor-drawn vehicles may, with regard to said motor vehicles, motorized bicycles, or motordrawn vehicles owned by him, obtain general registration and registration plates therefor, provided for in this subtitle, with the word “temporary” stated thereon. Said registration plates may be placed on any motor vehicle, motorized bicycle, or motor-drawn vehicle owned by such person while said vehicle is not individually registered and not in use as a rented or leased vehicle. A bona fide dealer in “nonconventional” type motor vehicles, as defined in R.S. 39:10-2, who has an established place of business in this State, may, with regard to “nonconventional” type motor vehicles owned by him, obtain general registration and registration plates therefor of the style and kind provided for in this subtitle, with the letter “D” stated thereon. Such plates can be placed on any “nonconventional” type motor vehicle by such dealer, but only if such "nonconventional" type motor vehicle is operated only for shop, demonstration or delivery purposes. Any person, partnership or corporation engaged in the business of conducting a wholesale automobile auction block in this State for duly licensed dealers only, at least once each week, may, with regard to vehicles controlled by it, obtain general registration and registration plates therefor of the style and kind provided for in this subtitle, with the word "temporary" stated thereon. Such plates can be placed on any vehicle controlled by the auction block, which is to be transported from the place where stored by the owner to the auction block. Such plates may not be displayed on a vehicle sold at the auction block for delivery to the purchaser. Application for such plates shall be approved only if the director is satisfied as to the financial responsibility of such person, partnership or corporation to American LegalNet, Inc. www.FormsWorkFlow.com