Dmv Form Dsd 7 – Fill Out and Use This PDF

ARE YOU CURRENTLY LICENSED BY THE MOTOR VEHICLE DEALER BOARD? YES

NO

IF YES, PLEASE INDICATE DEALER NUMBER _________________________

1. FIRST

M.

LAST

3. ANSWER THESE QUESTIONS

YES

NO

A. HAVE YOU EVER BEEN REFUSED A MOTOR

HOME ADDRESS

(P.O. BOX NOT ACCEPTABLE)

VEHICLE DEALER'S OR SALESPERSON'S

LICENSE OR HAD SUCH LICENSE SUSPENDED

OR REVOKED?

CITY

STATE

ZIP CODE

B. HAVE YOU EVER BEEN CONVICTED OF A

FELONY?

C. HAVE YOU EVER BEEN CONVICTED OF ANY

SEX

WEIGHT

HEIGHT

EYE

HAIR

DATE OF BIRTH

SOCIAL SECURITY NO.

FRAUDULENT OR CRIMINAL ACT INVOLVING

THE BUSINESS OF SELLING MOTOR VEHICLES?

2. NAME OF EMPLOYER

D. HAVE YOU EVER BEEN CONVICTED OF

ODOMETER TAMPERING, LARCENY OF A

VEHICLE OR RECEIPT OR SALE OF A STOLEN

TRADING AS

VEHICLE?

E. IF THE ANSWER TO B, C, OR D OF THE ABOVE

QUESTIONS IS YES, ATTACH A COPY OF

STREET ADDRESS

DEALER CERT. NO.

CONVICTION RECORD(S), NAME OF

PROBATION OFFICER, DATE(S), AND COURT

JURISDICTION(S).

CITY

STATE

ZIP CODE

LICENSE YEAR ENDING

4. Check all boxes that apply.

6. I certify that the applicant named herein is employed

Qualification for salesperson

Original Salesperson License

by the firm as a salesperson or representative and is

Qualification for dealer operator

Transfer salesperson license

not an independent contractor.

(must attach existing license)

Independent

If application is for a salesperson's license, I certify

Franchised

Renewal of salesperson license

the applicant is not employed by another dealer

Upgrade from salesperson to dealer

Factory or distributor representative

unless the dealerships are owned by the same

person, partnership or corporation. All information

operator

contained herein is true and correct.

*NOTE: A salesperson license must be obtained in addition to your qualification if you sell

motor vehicles.

DEALERSHIP AUTHORIZED SIGNATURE

5. I certify that I am not employed by another dealer unless the dealerships are owned by the same

operator.

DATE (mm/dd/yyyy)

APPLICANT SIGNATURE

DATE (mm/dd/yyyy)

I certify and affirm under penalty of perjury that the information contained in this application is true and correct to the

best of my knowledge. I understand that it is unlawful to knowingly make a false statement and any violation may be

prosecuted as a Class 5 felony or a Class 2 misdemeanor. In addition, I have completed and signed the attached

consent form to authorize DMV to conduct a criminal history inquiry solely for the purpose of evaluating this

application.

PRIVACY STATEMENT

In accordance with Sections 2.1-196.1, 2.1-731 and 2.1-734 et al of the Virginia Code, the State

Comptroller

requires that this information, including your social security number, be collected for debt set off collection purposes.

* Re-issues that do not extend their current month of expiration will be issued at no fee.

Re-issues that extend the month of expiration will be issued as originals at full fee.