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APPLICATION FOR DEALERS LICENSE

STATE OF RHODE ISLAND ‐‐ DIVISION OF MOTOR VEHICLES Dealer Section 600 New London Avenue ,Cranston, RI 02920-3024 www.dmv.ri.gov

DATE:

PLEASE READ AND SIGN ACKNOWLEDGEMENT

I, the undersigned, acknowledged receipt of a copy of the rules and regulations regarding dealer’s, manufacturers, and rental licenses, and understand said rules and regulations.

________________________________________________________________________ CORPORATE NAME

________________________________________________________________________ d/b/a NAME

________________________________________________________________________

PRINT NAME

SIGNATURE

TITLE

DATE

_______________________________________________________________________________________

PRINT NAME

SIGNATURE

TITLE

DATE

_______________________________________________________________________________________

PRINT NAME

SIGNATURE

TITLE

DATE

_____________________________________ Administrator - DMV

DLR013 – DATED 08-25-10

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