K41A Checklist For A DMV Business License Company Name
K41A Checklist for a DMV Business LicenseCompany NameType of Transaction: Business License for Registration Purposes Only (Titling Services)APPLICATION PROCESS STEP 1Please note before submission of any documentsPlease email all documents to Dmv.ApplicationsCompliance@ct.gov to review before submission. K7(x) Application: (There is no application fee or renewal fee)Complete Section 1 only in name of business and have signature notarized. The signature must be consistent withthe principal/owner of the organization as indicated on the articles of organization. Anything missing will besubject to rejection. K-8X Work History: Applicant/ Members/ Users must fill out section 2C of the K8X Application. This must showany work history for the last 5 years with DMV documents, registration, and title issuance. You must fill out thisapplication completely even if a resume is being attached. The compliance unit reserves the right to deny anyapplication that fails to demonstrate valid work experience. Department of Motor Vehicles Statement Regarding Security Customer/State Documents and Marker Plates:This form must be completed with the Name of Company, Name of Principal (printed). The principal/owner mustsign the form and date it. This will only be accepted with the owner/principal on the K7X form. Agree for X license entities home state police check doc 6-15-21: These forms must be submitted to theCompliance Unit with your application. The results must be mailed to the compliance unit. They can also beemailed to dmv.applicationscompliance@ct.govMake sure that the envelope/fed ex are marked X license application background history results. Please mail to:DMVCompliance Unit Room 30560 State StWethersfield, CT 06161 Trade Name Certificate: When using a DBA from the town clerk’s office Form K26 Notarized Business License Personnel List: Must list all applicants on the K-7 and have signaturenotarized. (Attach separate word document sheet listing all users of the ORP System.) Sales Tax Permit: From the CT Dept. of Revenue Services (Must be original, can start process with temp, ifprovided) Clear Copy of Valid Driver’s License or clear copy of Gov’t issued, valid photo ID: For all applicants on the K-7X User Access Online Registration Program Requirements Document Title Service: Bottom must be completed inits entirety, and list personal email address only.
If LLC, the following are required: Certificate of Existence of good standing, as filed with secretary of state Business Inquiry Print (If CT business) Certificate of Organization Form K198 Agent for Service Operating Agreement/ User Agreement (Must be signed by all members, if more than one member)If Corporation, the following are required: Certificate of Existence of good standing, as filed with secretary of state form K198 Agent for ServiceAPPLICATION PROCESS STEP 2THESE MUST BE COMPLETED AFTER YOU GET APPLICATION PRELIMINARY APPROVALFROM COMPLIANCE UNIT State Police Record Check: This form is to be completed with all users of the Connecticut System. All ownerslisted on the K7(x) and users of either system will be required to have a background check completed at a fee of 75.00. A copy of this application and check should be sent to the DMV, but the original (along with the 75 perapplicant) should be sent to:DESPP-SPI, 111 Country Club Road Middletown, CT 06457-2389,(Please make check out to The Treasurer State of CT) K158X New 6-2021: Must be notarized with all applicable signatures per applicant)Must complete entire form in the name of business along with signatures and witnesses: 5,000 and 20,00 Suretybond for Marker Plate Issuance.
APPLICATION FOR AUTOMOBILE DEALER'SOR REPAIRER'S LICENSEK-7(X) REV. 5-2021DMV USEONLYEXAMINER INITIALSLICENSE NUMBERSTATE OF CONNECTICUTDEPARTMENT OF MOTOR VEHICLESVEHICLE AND BUSINESS REGULATIONS DIVISIONOn The Web At ct.gov/dmvINSTRUCTIONS:1. SECTION 1 must be completed by APPLICANT.2. SECTION 2 must be completed, signed, and notarized.3. Submit application and supporting documents to:DEPARTMENT OF MOTOR VEHICLES, VEHICLE AND BUSINESS REGULATIONS DIVISION, 60 STATE STREET, WETHERSFIELD, CT 06161.SECTION 1: BUSINESS INFORMATIONTYPE OF LICENSE/SERVICE REQUESTEDTITLING SERVICECHANGE OF LOCATION (Bond MUST have new location information, new Sec. of State information must be attached)OUT OF STATE DEALER (Dealer MUST maintain a valid Dealer's License in the State where they are located)NAME UNDER WHICH BUSINESS OF APPLICANT IS TO BE CONDUCTEDFULL ADDRESS OF LOCATION FOR WHICH LICENSE IS REQUESTED (Use separate application for each location)BUSINESS E-MAILMAILING ADDRESS, IF DIFFERENT FROM ABOVETYPE OF OWNERSHIPINDIVIDUALIF INCORPORATED OR LLC, UNDER LAWS OF WHICH STATEPARTNERSHIPCORPORATIONLLCTHE BUSINESS HOLDS A FACTORY FRANCHISE TO SELL THE FOLLOWING MAKE(S) OF VEHICLE(S) AT THE ABOVE LOCATIONIf applicant firm is owned by individual or partnership, enter data below for all owners. If owned by a corporation enter data for principal officers or major stockholders. If LLC, enter members and managers.TITLENAMEHOME ADDRESSDATE OF BIRTHSEXSECTION 2 - CERTIFICATION (To be signed by Owner, Partner, Managing Member, or Authorized Officer in presence of Notary)Pursuant to CGS 53a-157b, I SIGNED (Owner, partner, major stockholder or authorized officer)declare that the statements madeby me in this application or in any Xdocuments attached hereto areDATEtrue and complete to the best of Subscribed and sworntobeforeme:my knowledge and beliefTITLESIGNED (Notary Public, Justice of Peace, or Commissioner of Superior Court)X
Prepare Personnel Information - Section 2D for each Owner, Officer, Partner or MemberK-8X NEW 5-2021SECTION 2D - PERSONNEL INFORMATION - CONTINUEDINSTRUCTIONSPREPARE IN RESUME FORMAT DESCRIBING THE LAST 5 YEARS OF WORK HISTORYBeginning with PRESENT OR MOST RECENT employment or volunteer experience and working backward, each owner, officer, manager or member mustlist all positions held which are necessary for determining their eligibility as a licensee. List all positions (titles) separately, even if with the same employer.Clearly describe the work (duties) they personally performed. If additional space is required, attach an 8 1/2" x 11" sheet, using the same format. Continuethe number sequence for additional jobs listed. You must fill out this application completely even if a resume is being attached.NAME OF APPLICANT 1OFFICIAL JOB TITLE (Start with most recent job)TYPE OF BUSINESSCOMPANY NAME AND ADDRESSBUSINESS PHONE NUMBERTITLE OF IMMEDIATE SUPERVISORDEPARTMENT WHERE ASSIGNEDEMPLOYED FROM:MonthYearEMPLOYED TO:MonthTOTAL (Yrs., Mos.)YearIN DETAIL, DESCRIBE YOUR MECHANICAL, SALES, AND/OR MANAGEMENT EXPERIENCE (In Detail ) AS RELATED TO A DEALER OR REPAIRER'S LICENSE.APPLICANT NUMBER 2OFFICIAL JOB TITLE (Start with most recent job)TYPE OF BUSINESSTITLE OF IMMEDIATE SUPERVISORCOMPANY NAME AND ADDRESSBUSINESS PHONE NUMBEREMPLOYED FROM:MonthYearEMPLOYED TO:MonthTOTAL (Yrs., Mos.)YearIN DETAIL, DESCRIBE YOUR MECHANICAL, SALES, AND/OR MANAGEMENT EXPERIENCE (In Detail ) AS RELATED TO A DEALER OR REPAIRER'S LICENSE.APPLICANT NUMBER 3OFFICIAL JOB TITLE (Start with most recent job)TYPE OF BUSINESSCOMPANY NAME AND ADDRESSBUSINESS PHONE NUMBERTITLE OF IMMEDIATE SUPERVISORDEPARTMENT WHERE ASSIGNEDEMPLOYED FROM:MonthYearEMPLOYED TO:MonthTOTAL (Yrs., Mos.)YearIN DETAIL, DESCRIBE YOUR MECHANICAL, SALES, AND/OR MANAGEMENT EXPERIENCE (In Detail ) AS RELATED TO A DEALER OR REPAIRER'S LICENSE.ATTACH ADDITIONAL PAGES IF NECESSARY
STATE OF CONNECTICUTDEPARTMENT OF MOTOR VEHICLES60 State Street, Wethersfield, CT 06161http://ct.gov/dmvDepartment of Motor VehiclesStatement Regarding SecurityCustomer/State Documents and Marker PlatesName of Company:Name of Principal(Printed):I agree that all DMV/customer records/copies and files, including DMV materials, and plates:1. Will always remain under my control or an authorized company employee control.2. Will not be left unattended/unsecured.3. Will only be accessed or viewed by authorized company employees.4. All Registration and Title documents will be kept in a locked room, desk, locked safe, or file to which only Iand/or authorized company employees have access.5. I also agree that I will follow all procedures established in the online processing agreement with theAgency for registration and title processing, including security for all documents and personal customerrecords and information.The information provided to the Commissioner of Motor Vehicles herein is subscribed by me, the undersigned,under penalty of false statement in accordance with sections 14-110 and 53a-157b of the Connecticut GeneralStatutes. I understand that if I make a statement which I do not believe to be true with the intent to mislead thecommissioner, I will be subject to prosecution under the above-cited laws.Signature of Principal:XDate Signed:Seat Belts Do Save LivesAn Affirmative Action/Equal Opportunity Employer
STATE OF CONNECTICUTDEPARTMENT OF MOTOR VEHICLES60 State Street, Wethersfield, CT 06161http://ct.gov/dmvDepartment of Motor VehiclesStatement Regarding Home StatePolice Background CheckName of Company:1I agree that all officers, principals, and employees of the company will have a criminal background check in thehome state of the company as well as their state of residence, if different.2I agree that any newly hired employee or officer will have a criminal background check done in the home state ofthe company as well as their state of residence.3I agree that, upon request, all criminal check results/reports will be made available to the State of ConnecticutDepartment of Motor Vehicles for review.4I hereby swear to and certify that criminal checks agreed to above have been completed and all employees haveno convictions that will stop them from reviewing and processing documents for the sale, registration, and titlingof motor vehicles.The information provided to the Commissioner of Motor Vehicles herein is subscribed by me, the undersigned,under penalty of false statement in accordance with sections 14-110 and 53a-157b of the Connecticut GeneralStatutes. I understand that if I make a statement which I do not believe to be true with the intent to mislead thecommissioner, I will be subject to prosecution under the above-cited laws.Signature of Principal:X Date Signed:Principal’s Printed Name:Personal Email:Seat Belts Do Save LivesAn Affirmative Action/Equal Opportunity Employer
BUSINESS LICENSE PERSONNEL LISTK-26 REV. 6-2002STATE OF CONNECTICUTDEPARTMENT OF MOTOR VEHICLESDEALERS AND REPAIRERS DIVISIONOn The Web At ct.gov/dmvLICENSE NUMBERBUSINESS NAMEFEDERAL EMPLOYER IDENTIFICATION NO.(Social Security No.(s) if applicable)DOING BUSINESS ASBUSINESSANDBUSINESS ADDRESS(No. and Street)MAILING ADDRESS (If different)(No. and Street)(City or Town(State)(Zip Code)(City or Town(State)(Zip Code)MANAGER, OPERATOR, CONTACT PERSONBUSINESS TELEPHONE NUMBER(S)MANAGEMENTDEPARTMENT OF REVENUE SERVICES TAX IDENTIFICATION NUMBERINFORMATIONDEPARTMENT OF ENVIRONMENTAL PROTECTION WASTE DISPOSAL NUMBER, IF USED.(If not, specify how you dispose of your waste -oil, paint, thinner, etc. Explain on additional page.)OTHER LICENSES HELD (Leasing, Gasoline, etc. - Description and License Number of Each)FRANCHISES (New car dealers only)TYPE OF OWNERSHIPINDIVIDUALNAMEHOME ADDRESSLISTOWNERS,MEMBERS,DATE OF BIRTHMANAGERS,(City or TownHOME ADDRESSMEMBERS,DATE OF BIRTHHOME ADDRESSOFFICERSDATE OF BIRTH(No. and Street)(City or TownHOME ADDRESS(No. and Street)(City or Town(Zip Code)HOME TELEPHONE NUMBER(State)SOCIAL SECURITY NUMBER(Zip Code)HOME TELEPHONE NUMBERPOSITION WITH BUSINESS(No. and Street)(City or Town(State)SOCIAL SECURITY NUMBER(Zip Code)HOME TELEPHONE NUMBERPOSITION WITH BUSINESS(No. and Street)(City or Town(State)SOCIAL SECURITY NUMBERNAMEDATE OF BIRTH(State)POSITION WITH BUSINESSDATE OF BIRTHHOME ADDRESSHOME TELEPHONE NUMBERSOCIAL SECURITY NUMBERNAME*NOTE: A clear copyof a Connecticut/out-of-state photolicense for eachindividual listed mustbe submitted.(Zip Code)POSITION WITH BUSINESSNAMECORPORATE(State)SOCIAL SECURITY NUMBERNAMEMANAGINGOR(No. and Street)NAMEHOME ADDRESSLLCCORPORATIONPOSITION WITH BUSINESSDATE OF BIRTHPARTNERS,PARTNERSHIP(Zip Code)HOME TELEPHONE NUMBERPOSITION WITH BUSINESS(No. and Street)(City or Town(State)SOCIAL SECURITY NUMBERSIGNED (Owner, partner, major stockholder or authorizedI declare that the applicant(s) or holder(s) of this license, including any officer,member, manager, or major stockholder, have not been convicted of a violation of officer)any provision of laws pertaining to the business of a motor vehicle dealer or Xrepairer, including a motor vehicle junkyard, lease or transporter company, in thecourts of the United States or any state. I hereby certify, under penalties of false Subscribed and DATEswornstatement, that the statements made by me on this form are true and complete tothe best of knowledge and belief.to before me:(Zip Code)HOME TELEPHONE NUMBERTITLESIGNED (Notary Public, Justice of Peace, orCommissioner of Superior Court)X
STATE OF CONNECTICUTDEPARTMENT OF MOTOR VEHICLES60 State Street, Wethersfield, CT 06161http://ct.gov/dmvUSER ACCESS ONLINE REGISTRATION PROGRAM REQUIREMENTSREGISTRATION AND TITLING SERVICE ONLYAs a condition to become and remain a participating operator with the Department of Motor Vehicles’(Department’s) Online Registration Program (ORP), as a duly authorized representative of thebusiness noted below, I agree to the following terms and conditions as set forth herein. I understandthat where applicable, failure to comply with the Department’s ORP requirements may result in mybusiness’ removal from the program. This includes the automatic immediate suspension and/orrevocation of my online registration privileges, as provided by applicable law. The departmentreserves the right to immediately suspend privileges for any violations of the Online RegistrationProgram in accordance with section 14-15d-2 of the Regulations of Connecticut State Agencies.1. The company will need to submit work history of all users/ members for the last 5 years ofemployment. This must show in detail, the knowledge of DMV documents.2. The Company must be separate from any other license locations or entities doing onlineprocessing.3. The Registration and Title Company must remain in good standing with the Department at alltimes. This includes the business’ compliance with all applicable laws and Departmental policies,including, but not limited to, all requirements regarding insurance, bonding, complaints, personnel,franchises, submission of original paperwork, training, etc. in accordance with section 14-15d-2 ofthe Regulations of Connecticut State Agencies.4. The Registration and Title company shall remit, not later than ten days after the date of eachtransaction, all required documents and fees associated with such registration and title. Thedealership agrees to submit all original paperwork to the CORE Customer Operations DOL.5. The Department may conduct, as it deems necessary, an audit/investigation of any/all transactions,material(s) or information relating to the business’ online registration privileges/practices.6. The commissioner may suspend or terminate a registration and title company’s ability toelectronically file applications for certificates of registration immediately upon learning of suchcompany’s failure to comply with:a. Any provision or law regarding conduct of its business or the electronic filing of suchapplications.b. The submission of required documents or fees.c. Any procedure established by the commissioner for the use of the online system.Seat Belts Do Save LivesAn Affirmative Action/Equal Opportunity Employer
7. If the business’ online registration privileges are suspended and/or revoked, if it seeks to have itsprivileges restored, upon request, the Department’s Compliance Unit will review the business’current standing with the Department prior to making a final determination regarding suchrestoration.8. The business or title service shall not be entitled to a hearing under the provisions of chapter 54 ofthe Connecticut General Statutes to contest the suspension or termination of its ability toelectronically file such certificates, and it may continue to transact its business at a branch officeof the department.9. The title service must notify the compliance unit when a member of the company or user of thesystem leaves the business. Any new personnel will be subject to background check and mustsubmit a new user access agreement before they can process.10. The title service will be required to sign Statement Regarding Security Customer/State Documentsand Marker Plates stating that they will keep all documents in a locked safe within a locked room.This form must always be kept in the office.11. The tile service will be required to sign Statement Regarding Home State police background checkfor all employees and officers of the company. This form must always be kept in the office.The information provided to the Commissioner of Motor Vehicles herein is subscribed by me, theundersigned, under penalty of false statement in accordance with sections 14-110 and 53a-157b of theConnecticut General Statutes. I understand that if I make a statement which I do not believe to be true withthe intent to mislead the commissioner, I will be subject to prosecution under the above-cited laws.Principal SignaturePrint First NamePrint Last NameDateName of BusinessUser Personal Email Address
CERTIFICATE OF BUSINESS STATUS ANDAGENT FOR SERVICEK-198 NEW 2-2004STATE OF CONNECTICUTDEPARTMENT OF MOTOR VEHICLESBUREAU OF SAFETY AND ENFORCEMENTDEALERS AND REPAIRERS DIVISIONOn The Web At ct.gov/dmv(To Be Completed by All Licensees of the Department of Motor Vehicles, that are Domestic or ForeignCorporations, Limited Liability Companies, or Statutory Business Trusts).I, the undersigned, being duly authorized to act on behalf of(Name of Business)(Business Address)(Mailing Address)(hereinafter referred to as "the business organization") hereby certify to the Commissioner of Motor Vehicles,as to the following:1. The above listed name is the official and legal name of the business organization.2. The business organization is incorporated, chartered or organized in the State of.3. If the business organization is not incorporated, chartered or organized in the State of Connecticut, itis duly registered and authorized as a foreign corporation, limited liability company or business trustwith the Connecticut Secretary of State, provided that it transacts business in this state, inaccordance with the legal standards applicable to such a determination.4. The business organization is in good standing to conduct all of its affairs and is not subject to anycurrent legal disability including but not limited to bankruptcy, receivership or proceedings fordissolution.5. The agent for service of any process, notice or demand required or permitted by law to be served onthe business organization is as follows:PERSON OR COMPANY MUST BE IN CONNECTICUTName of Statutory Agent for Service:Business Address:Mailing Address:Business Phone:6. I acknowledge and agree on behalf of the business organization that, in addition to any other manneror method of notice authorized by law, the Commissioner of Motor Vehicles may commence anadministrative proceeding pertaining to the business organization's license status, or may order theproduction of any books, records, papers or documents in connection with any investigation as tocompliance by the business organization with the laws and regulations administered by theDepartment of Motor Vehicles, by mailing a written notice, by bulk certified mail, postage prepaid, tothe above identified agent for service at the above-stated address.7. I understand and acknowledge that the making of any false statement herein to the Commissioner ofMotor Vehicles is a violation of law, in accordance with the provisions of Sections 14-110 and53a-157b of Connecticut General Statutes, as amended:Subscribed by:(Signature)Printed Name and Title:Type of Organization:
DMV USE ONLYSURETY BOND - MOTOR VEHICLEREGISTRATION AND TITLE COMPANYK-158X NEW 6-2021LICENSE NO.:STATE OF CONNECTICUTDEPARTMENT OF MOTOR VEHICLES60 STATE STREET, WETHERSFIELD, CT 06161VEHICLE BUSINESS REGULATION DIVISIONKNOW ALL MEN BY THESE PRESENT:SURETY BOND NO.SURETY BONDINFORMATION 20,000 SURETY (MARKER PLATE ISSUANCE) 5,000 REGISTRATION ISSUANCEX LICENSE NUMBER (If currently Lic. by DMV)FULL NAME OF LICENSEE AS PRINCIPAL (Name Must Appear as in Records of DMV)LICENSEASPRINCIPALADDRESSNo. and StreetCity or TownStateZip CodeCity orTownStateZipCodeFULL NAME OF SURETY COMPANYSURETYCOMPANYADDRESSNo. and StreetSTATE UNDER WHOSE LAWS CORPORATION ORGANIZED AND EXISTINGThe above Surety, as duly authorized by law to become surety on bonds of the State of Connecticut, and the above Principal areheld and firmly bound unto the State of Connecticut in the sum as so specified above to be paid to the State of Connecticut, towhich payment the Principal and Surety do jointly and severally bind themselves, their heirs, executors, administrators,successors and assigns, and each and every one of them, firmly by these presents.THE CONDITIONS OF THIS OBLIGATION ARE SUCH THAT:WHEREAS, the Principal is an applicant or licensee under the purview of Section 14-15,14-15d-1 to 14-15d-4 ConnecticutGeneral Statutes, and WHEREAS, pursuant to the provisions of Section 14-15, 14-15d3, Connecticut General Statues, thePrincipal has been required, as a condition to his licensure, to furnish the Commissioner of Motor Vehicles a bond satisfactory tohim in the amount of 20,000 for marker plate issuance and 5,000 registration issuance conditioned upon the applicant orlicensee complying with the provisions of any State or Federal law or regulation relating to the conduct of such business andprovided as indemnity for any loss sustained by any person by reason of any acts of the licensee constituting grounds forsuspension or revocation of the license or such licensee going out of business. Such bond shall be executed in the name of theState of Connecticut for the benefit of any aggrieved party, but the penalty of the bond shall not be invoked except upon order ofthe Commissioner of Motor Vehicles after a hearing held before him in accordance with the provisions of Chapter 54 of theConnecticut General Statutes. This bond shall cover acts and omissions occurring during the period of the license granted to thePrincipal. The aggregate liability under this bond shall not exceed the penal amount.NOW THEREFORE, if the above bounded Principal shall conduct the business in full compliance with State and Federal law andregulations relating to the conduct of said business, then this obligation shall be void; otherwise to remain in full force and effect.The Signature of Principal and Surety must be witnessed by two witnesses each. A current Power of Attorney for the Surety'sattorney-in-fact must be attached to this bond.SIGNATURE OF PRINCIPALPRINTED NAME AND TITLE OF PRINCIPAL'S SIGNERXSIGNATURE OF FIRST WITNESS OF PRINCIPALPRINTED NAME OF WITNESS OF PRINCIPALXSIGNATURE OF SECOND WITNESS OF PRINCIPALPRINTED NAME OF WITNESS OF PRINCIPALXSIGNATURE OF ATTORNEY-IN-FACT OF SURETYPRINTED NAME OF ATTORNEY-IN-FACT OF SURETYXSIGNATURE OF FIRST WITNESS OF SURETYPRINTED NAME OF WITNESS OF SURETYXSIGNATURE OF SECOND WITNESS OF SURETYPRINTED NAME OF WITNESS OF SURETYXIN WITNESS WHEREOF, the Principal and Surety have signed and sealed this instrument onDAY:MONTH:YEAR:
Please note before submission of any documents Please email all documents to Dmv.ApplicationsCompliance@ct.gov to review before submission. Once approved we will follow up with the submission of original documents. APPLICATION FOR AUTOMOBILE DEALER'S OR REPAIRER'S LICENSE K-7(X) REV. 5-2021 STATE OF CONN
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DMV-349 Instructional Manual 9 The Division of Motor Vehicles (DMV) requests that: The most current version of the DMV-349 form is used. The DMV-349 form should be typewritten or, if handwritten, the officer should use black ink. The report must be legible. This is of the utmost importance for clarity, when reports are microfilmed or imaged.
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