MOTOR VEHICLE LICENSING BUREAU P. O. Box 1140 Jackson, MS 39215 Phone: (601) 923-7143 Fax: (601) 923-7134 www.dor.ms.gov
INSTRUCTIONS FOR COMPLETING APPLICATIONS FOR MOTOR VEHICLE DEALER PERMIT AND TAG(S) These procedures must be followed when applying for any type of Motor Vehicle Dealer Permit: 1. Please review the Motor Vehicle Dealer Tag Permit Law Book which includes Dealer Tag Regulations #1, #2, and #3 before completing the application forms. The Dealer Tag Permit Application must be typed or printed. Incomplete forms will be returned without processing. 2. You must have the Bond of Designated Agent executed by an insurance company in the amount of $15,000.00. This surety bond must be written by an insurance company qualified to do business in the State of Mississippi. The bond must have a seal affixed to it and a valid Power of Attorney attached. If the business is a sole ownership, the owners name as well as the business name must be shown on line 1 of the bond. If the business is a partnership, all partner’s names including the business name must be shown on line 1. The business name will be shown as a d/b/a. If the business is a corporation, the correct corporate name as registered with the Secretary of State must be on line 1. If the corporation has a trade name or dba, both names must be shown on line 1 (i.e. ABC Corp dba ABC Used Cars). The bond must be signed by the principal(s), the Attorney-in-Fact and the Mississippi resident agent where indicated on the bond. The second line of the bond must show the city in which the business will be located and operated. 3. All persons applying for a Motor Vehicle Dealer Permit are required to complete the eight (8) hour educational seminar conducted by the Mississippi Independent Auto Dealers Association (MIADA). Your application must be accompanied by the certificate of completion for the class during the twelvemonth period immediately preceding the date of the application. 4. You are required to maintain motor vehicle liability insurance providing blanket coverage on vehicles operated on the public streets and highways of this state, including vehicles in dealership inventory. Evidence of liability insurance for business and inventory vehicles shall be filed with the initial application for license and at each renewal. 5. The registration application for a sales tax number must be completed and a sales tax number assigned. A sales tax number will be required for each motor vehicle dealer location. Also, if you plan to rent vehicles, another sales tax number is required. These forms may be found at www.dor.ms.gov. 6. Wholesale only dealers must meet all the requirements outlined in the sections above. However, they are not allowed to retail vehicles to individuals, only to licensed dealers. They are not required to have a physical location, but may only maintain an inventory of two (2) vehicles and can receive one (1) wholesale dealer tag. A wholesale only dealer will be issued a sales tax wholesale account number. These permits are issued only for Mississippi Residents. 7. If you are applying for a license as a “Dismantler Only” and you sign the affidavit attesting to the fact that you will not sell any motor vehicles and/or manufactured homes, the requirement of the bond of designated agent and number will be waived and no dealer tags will be issued. 8. The completed dealer application including sales tax number assigned, bond of designated agent, notarized affidavit, certification of completion for the educational seminar, and proof of liability insurance should be forwarded to: Mississippi Department of Revenue Motor Vehicle Licensing Bureau P. O. Box 1140 Jackson, MS 39215 If you have any questions, please call the Motor Vehicle Licensing Bureau at (601) 923-7143. P. O. Box 1140
Jackson, MS 39215
AFFIDAVIT OF MOTOR VEHICLE LICENSE APPLICANT STATE OF MISSISSIPPI COUNTY OF __________________
PERSONALLY APPEARED before me, the undersigned authority in and or for the aforesaid jurisdiction, ___________________________, who after being duly sworn, did depose and say: (Name of Affiant)
My name is ________________________ and I operate a business selling motor vehicles, located at__________________________________________________ (Business Address)
I have personal knowledge of the matters set forth in this Affidavit and I am competent to testify as to these matters.
I have met the definition of “Established place of business” as provided in Section 27-19-303, Miss. Code. Ann., by having: A place owned or leased and regularly occupied by me for the primary and principal purpose of and where it is apparent that I am holding out to the general public that I am offering motor vehicles, tractors, trailers or semitrailers for sale.
By initialing the appropriate selection, I testify that I have: _______ A. An office separate from and not in conjunction with or related to any other business for the purpose of transacting the business of offering motor vehicles, tractors, trailers or semitrailers for sale. Or _______ B. A sign indicating the name of the business, the name of the owner, telephone number and that the business is a motor vehicle dealer that is clearly visible and located at the front of the lot, and a lot which is separate and apart from any other business.
5. I understand that improper testimony may result in the revocation of any subsequently issued Motor Vehicle Dealer Permit and subject me to other penalties related to false testimony. 6. I agree to return all unused titling paperwork, including but not limited to title applications and remittance advices, upon the closing of my business. ________________________________ Name of Officer/Retail Business Owner
SWORN TO AND SUBSCRIBED before me, this the ________ day of ______________, 20_____.
__________________________ Notary Public My commission expires: ___________________________________
Form 76-105-15-8-1-000 (Rev. 07/15)
Application for Motor Vehicle Dealer License
761051581000 Application for year beginning November 1,
Corporation Primary Address (Number and Street, Including Rural Route)
Sole Proprietor Number of Full Time Employees Business Name (DBA)
SSN MS Physical Address (Number and Street, Including Rural Route)
Sales Tax Number City
Fee Per Tag
Total Tag Fees
1st 12 $43.75 (ea.) over 12 $83.75 (ea.)
1 only $43.75 (ea.)
Amount Due State
Totals Total Not To Exceed $100.00.
I hereby certify that the above statements are true and correct to the best of my knowledge and make application for a permit to engage in business on the condition that I will comply in all respects with the applicable Mississippi Tax Laws and the rules and regulations hereunder.
All Permits and Tags Expire October 31
MISSISSIPPI DEPARTMENT OF REVENUE TO: MS DEPARMENT OF REVENUE POST OFFICE BOX 1140 JACKSON, MS 39215-1140
BOND OF DESIGNATED AGENT (For Motor Vehicle Dealers) BOND NUMBER________________
KNOW ALL MEN BY THESE PRESENTS That we, _________________________________________________________________________________________ of ____________________________, Mississippi, as Principal, and __________________________________________ of _______________________________________________, a corporation incorporated under the law of the State of ____________________________ as Surety are held firmly bound into the State of Mississippi, as Obligee, in the sum of Fifteen Thousand ($15,000.00) dollars, for the payment of which we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly, and severally, firmly by these present. Whereas, the Principal has been duly appointed a “Designated Agent” as provided for in Section 6, Senate Bill 1688, Laws of 1968 known as The Mississippi Motor Vehicle Title Act, and such “Designated Agent” is required to furnish this bond. THE CONDITION OF THIS OBLIGATION IS SUCH, that if the aforesaid Principal shall well and faithfully perform his duties as such “Designated Agent” then, this obligation shall be void, otherwise to remain in full force and effect. THE PARTIES HERETO mutually agree that the Surety may cancel this bond by giving thirty (30) day notice in writing to the Mississippi Department of Revenue. Such cancellation shall be effective only as to acts committed by the Principal as such “Designated Agent” after the expiration of said thirty (30) day period.
SIGNED, SEALED AND DELIVERED, this the ________ day of ___________________________ 20_______,
Insurance Company Name
Owner, Agent or Officer
____________________________________________ Phone Number
BY_____________________________________ ATTORNEY-IN-FACT AFFIX SEAL HERE:
MOTOR VEHICLE LICENSING BUREAU
P. O. Box 1140 Jackson, MS 39215 Phone: (601) 923-7143 Fax: (601) 923-7134 www.dor.ms.gov
AFFIDAVIT OF MOTOR VEHICLE DISMANTLER LICENSE
I, _____________________________________________, doing business as
_______________________________ do hereby attest that I will not sell any motor vehicles and/or manufactured homes through my business as a dismantler.
I understand that if I sell motor vehicles and/or manufactured homes, my Dismantlers License will be revoked by the Mississippi Department of Revenue.
Sworn to and subscribed before me, this______________
Day of ________________________________, 20________
P. O. Box 1140
Jackson, MS 39215
Dealer Tag Daily Log
Mail To: MS Department of Revenue Motor Vehicle Licensing Bureau P.O. Box 1140 Jackson, MS 39215-1140
Vehicle Identification Number
Dealer Tag Number
Vehicle Year Make & Model
Assigned to Employee (person)