Fillable Printable Form 5308 - Missouri Department Of Revenue

Form 5308 - Missouri Department Of Revenue

I hereby certify the following:

1.Iamanauthorizedofceremployedbythefranchisoridentiedonthisapplication;

2.Pursuanttomynormaldutiesasanemployeeofthefranchisoridentiedonthisapplication,Iamauthorizedtocompletethisapplication;

3.Thefranchisor’splaceofbusinessidentiedaboveisoccupiedandisused,inpart,tofacilitatethefranchisingofmotorvehicledealerswho

 operatewithinthestateofMissouri;

4.ThefranchisormaintainsregularbusinesshoursduringwhichtheDepartmentofRevenueisabletocontactthefranchisor;and

5. ThefranchisorwillnotifytheDepartmentnotlessthanten(10)dayspriortomovingtheirplaceofbusinessorchangingtheirtelephonenumber.

Form

5308

MissouriDepartmentofRevenue

Application For Motor Vehicle Franchisor

or Manufacturer License

Names You Are

Doing Business As

SignatureofAuthorizedOfcerTitle

PrintedNameofAuthorizedOfcerDate(MM/DD/YYYY)

____/____/________

FranchisorNameTelephoneNumberattheStreetAddressProvided

StreetAddress(NoPostOfceBoxes)Country

CityState/ProvinceZipCode

(______)______-________

Useseparatesheetifneeded

Principal Corporate Ofcers

And Their Position Titles

Vehicle Brands That You Provide

Sales And Service Agreements For

Name of

Mediators

Mail to:MotorVehicleBureauPhone: (573)526-3669

P.O.Box43Fax: (573)751-4789

JeffersonCity,MOE-mail:[email protected]

65105-0043

Visit

//dor.mo.gov/forms/Dealer_Operating_Manual.pdf

for additional information.

Form5308(Revised05-2014)

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Instructions

Completetheapplicationandsubmitwiththeappropriatefees.Allillegible,incorrect,orincompleteapplications

will be rejected.

•ChecklistforRequirements

•Completeeachareaontheapplication

•Completethebusinessnameandaddress.Thecompletebusinessnamemustbeshown.Apostofce

boxnumberwithoutastreetaddresswillnotbeacceptedasanactualbusinessaddress.

•Completethevehiclebrandsthatyouprovidesalesandserviceagreementsfor.

•Applicationsignedbyanauthorizedofcer.

•AlistofmediatorsasprescribedinSection 407.822, RSMo.Forpurposeofcomplyingwiththis

requirement,amediationpanelisalistofuninterestedthirdpartieswhomayfaciliatethenegotiationof

asatisfactorysolutiontoadisputebetweenthefranchisorandfranchisee,pursuantto407.810 to

407.835 RSMo.

•Onecheckormoneyorderforlicensurefeeof$150madepayabletotheMissouriDepartmentof

Revenue.

Note:TheMissouriDepartmentofRevenuemayelectronicallyresubmitchecksreturnedforinsufcientor

uncollectedfees.

Form5308(Revised05-2014)