Dpsmv 1968 Form PDF Details

In the State of Louisiana, the Department of Public Safety and Corrections Office of Motor Vehicles mandates the use of the DPSMV 1968 form for Auto Title Company Application processes. This detailed document is pivotal for businesses seeking authorization to operate within this sector, requiring meticulous completion for either new applications or renewals. Each location and co-owner necessitates a separate submission, underlining the state's rigorous standards towards transparency and legal compliance. Furthermore, the form demands precise match of business names across bonds and contracts, alongside the disclosure of physical and mailing addresses, contact information, and, if applicable, previous license details. It delves into the applicants’ legal history, querying on matters such as prior license denials, revocations, or any criminal convictions, emphasizing the importance of integrity within the industry. Additionally, the inclusion of three references, with at least one from a customer, showcases the emphasis on reputable service provision. The signing of this form before a notary, accompanied by a stipulated fee, underscores the formal commitment by applicants to adhere to Louisiana’s legal and regulatory frameworks governing auto title companies. As such, the DPSMV 1968 form stands as a critical tool in ensuring only qualified, responsible entities engage in auto title transactions, safeguarding consumer interests and promoting a dependable automotive business environment in Louisiana.

QuestionAnswer
Form NameDpsmv 1968 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other nameslouisiana dpsmv title application pdf, louisiana dpsmv title application, louisiana dpsmv1968 department public safety auto form, la title company application pdf

Form Preview Example

State of Louisiana

Department of Public Safety and Corrections

Office of Motor Vehicles

 

 

 

 

P. O. Box 64886

 

 

 

 

 

Baton Rouge, Louisiana 70896-4886

 

□NEW □RENEWAL

Auto Title Company Application

 

 

 

 

 

 

 

A SEPARATE APPLICATION MUST BE SUBMITTED FOR EACH LOCATION AND EACH CO-OWNER

 

 

 

PLEASE TYPE OR PRINT

 

 

 

Business Name (must read exactly the same on both the bond and on the contract)

 

 

 

 

 

 

 

 

 

 

 

Physical Address of Business

 

 

 

 

Parish

 

 

 

 

 

 

 

 

 

 

City

 

 

 

State

 

Zip Code

 

 

 

 

 

 

 

 

 

Mailing Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

State

 

Zip Code

 

 

 

 

 

 

 

 

 

 

Phone No.

 

 

 

Fax No.

 

 

(

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(

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Email Address: (Mandatory)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Previous License No. /Authorization No. (if applicable)

 

 

Bond No.

 

 

 

 

 

 

 

 

 

 

 

Name of Surety Company

 

 

 

 

Surety’s Phone No.

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

State

 

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.Has any license ever been denied, revoked or suspended by this Department to you or any of the principals of the partnership or corporation? Yes _____ No _____ if yes, give details below.

2.Have you ever been on probation or sentenced to jail/prison as a result of a felony conviction or guilty plea to a felony charge? Yes ____ No ____ If yes, give the law enforcement authority (city police, sheriff, FBI, etc.) the offense, date of the offense, place and disposition of case. Use back of this document if additional space is needed.

3.You are required to submit three (3) references, at least one of which must be from a current/former customer.

4.PLEASE READ THIS APPLICATION, ALL ATTACHMENTS AND THIS CERTIFICATION PRIOR TO

SIGNING THIS APPLICATION BEFORE A NOTARY PUBLIC

I HEREBY CERTIFY THAT THE STATEMENTS MADE HEREIN ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF AND THAT I AM FAMILIAR AND WILL ABIDE WITH THE PROVISIONS OF ALL THE LAWS, RULES AND REGULATIONS UNDER WHICH THIS REQUEST IS MADE.

OWNER’S SIGNATURE ________________________________________________________________DRIVER’S LICENSE #____________________

OWNER’S PRINTED NAME _____________________________________________________________

SWORN TO AND SUBSCRIBED BEFORE ME THIS ________________________________ DAY OF _____________________________, 20 _______

NOTARY PUBLIC SIGNATURE __________________________________________________________________________________________________

NOTARY PUBLIC PRINTED NAME & NUMBER _________________________________________________________ /____________________________

FEE: A check/money order in the amount of $200.00 must accompany request. If auto title companyhas more than one location, a separate request and a fee of $50.00 must be submitted for each additional location.

$

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MVCA Officer

Dollar Amount Received

Date Processed

DPSMV 1968 (R 02/2012)

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louisiana dpsmv title application pdf completion process shown (stage 1)

2. The next part is usually to complete all of the following fields: Previous License No Authorization, Address City, Suretys Phone No, State, Zip Code, Has any license ever been denied, partnership or corporation Yes No, Have you ever been on probation, You are required to submit three, PLEASE READ THIS APPLICATION ALL, SIGNING THIS APPLICATION BEFORE A, and I HEREBY CERTIFY THAT THE.

How one can complete louisiana dpsmv title application pdf portion 2

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How you can fill out louisiana dpsmv title application pdf stage 3

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