Utah Form Tc 301 – Fill Out and Use This PDF

• Make check or money order payable to Utah State Tax Commission.Federal ID number:

Organizational Structure Must check one.

Individual	Government	Business	Trust
 Sole Proprietor	 Federal	 Corporation	 Trust
	 State	 General Partnership
	 Tribal	 Limited Partnership
	 Political Subdivision	 Limited Liability Partnership
  	 	 Limited Liability Company
Organization Date	Enter the date of qualification or incorporation in Utah: ___________________
	(Contact the Dept. of Commerce at 801-530-4849)

Department of Commerce Entity Number Enter number issued by the Dept. of Commerce.

License Type You must submit a separate application for each license type.
  New motor vehicle dealer	$127	 New motorcycle, off-highway				 Distributor branch/distributor/				 Transporter	$51
			vehicle and/or small trailer dealer		$51	factory branch		$61
  Used motor vehicle dealer	$127	 Used motorcycle, off-highway				 Manufacturer		$102		 Dismantler	$102
			vehicle and/or small trailer dealer		$51
  Special equipment dealer $127		 Body shop $112				 Remanufacturer $102				 Crusher $102
  Salvage Acquisition $0
Business Information
Business entity name - PRINT							Business phone number
Business street address (PO Box not acceptable)				Cell phone number					Fax number
City				County					State	ZIP Code
Business mailing address				Business email address
City				County					State	ZIP Code

DBA/Business Name (the business or trade name you operate under)

Only complete this section if different than business entity.

DBA name (must be the name listed on your sign)		Business phone number
Business street address - PO Box not acceptable	Cell phone number		Fax number
City	County		State	ZIP Code
Business mailing address	Business email address

Page 1 of 4

TC-301, page 2 of 4

Owner(s), partner(s) or corporate officers information Attach additional sheet(s) if necessary.

You must apply in person at MVED (210 N 1950 W, Salt Lake City, Utah) if:

1.you are applying for dealer license as any entity type and any of the owners are not U.S. citizens; or

2.you are a sole proprietor who is not a U.S. citizen and you are applying for any of the following licenses: body shop, crusher, distributor, dismantler, manufacturer, factory branch, distributor branch, remanufacturer or transporter.

Bring proof that you and/or any of the owners who are not U.S. citizens are in the United States lawfully under 8 USC 1641. Also bring your/their employment authorization card(s) and documentation showing the I-94 (arrival/departure) number(s) and Alien Registration Number(s) issued by the U.S. Citizenship and Immigration Service.

Owner #1 name			Title		Home phone
Home address			Social Security Number		Driver’s license number and state
City		State		ZIP Code	Date of birth
Hair color	Eye color	Height		Weight	Gender
					 Male	 Female
Place of birth		Citizenship			Race

Under state and federal law we cannot issue a license to any person who does not provide the following information.

Check one (Providing false information subjects the signer to the penalties of perjury.):

 I am a U.S. citizen.	SSN: _______________________
 I qualify under 8 U.S.C. 1641 and I am present in the U.S. lawfully.						I-94#*: _______________________
Alien #*: _______________________			Employment authorization card #*: _______________________
Owner #2 name				Title			Home phone
Home address				Social Security Number			Driver’s license number and state
City		State			ZIP Code		Date of birth
Hair color	Eye color	Height			Weight		Gender
							 Male	 Female
Place of birth		Citizenship					Race

Under state and federal law we cannot issue a license to any person who does not provide the following information.

Check one (Providing false information subjects the signer to the penalties of perjury.):

 I am a U.S. citizen.	SSN: _______________________
 I qualify under 8 U.S.C. 1641 and I am present in the U.S. lawfully.						I-94#*: _______________________
Alien #*: _______________________			Employment authorization card #*: _______________________
Owner #3 name				Title			Home phone
Home address				Social Security Number			Driver’s license number and state
City		State			ZIP Code		Date of birth
Hair color	Eye color	Height			Weight		Gender
							 Male	 Female
Place of birth		Citizenship					Race

Under state and federal law we cannot issue a license to any person who does not provide the following information.

Check one (Providing false information subjects the signer to the penalties of perjury.):
 I am a U.S. citizen. SSN: _______________________
 I qualify under 8 U.S.C. 1641 and I am present in the U.S. lawfully.	I-94#*: _______________________

Alien #*: _______________________ Employment authorization card #*: _______________________

* The Alien Registration Number (A#), I-94 (arrival/departure) number and employment authorization card are issued by the U.S. Citizenship and Immigration Service.

TC-301, page 3 of 4

1.List at least five years of employment history, including dates, for each owner. Also include any motor vehicle salesperson, dealer, dismantler or auction license you have held and if the license has ever been denied, suspended or revoked. Attach additional pages if needed.

Owner #1	Owner #2		Owner #3

2.During the past 10 years, have you been charged with, found in violation of, or convicted of any misdemeanors or felonies in Utah or in any other state? This includes any charges to which a “plea in abeyance,” or a guilty plea, are entered. You are not required to disclose simple traffic infractions.

Yes	 No	Failure to disclose any of the requested information may result in suspension or revocation of this license. A charge,
		violation of, or criminal conviction for a motor vehicle or drug-related crime, fraud or registered sex offense can be
		grounds for denial, suspension or revocation of your application or license, even if the plea is held in abeyance. Attach
		additional pages if needed.

If yes, list each, including dates: (A copy of your criminal history, provided by BCI, may be attched.)

Owner #1	Owner #2		Owner #3

Yes  No If yes, state what type and from which event from your criminal history:

__________________________________________________________

Franchise Dealers

If you are a franchise dealer of new vehicles, RVs, motorcycles and/or trailers, report the information below and attach your franchise agreement to this application

						TC-301, page 4 of 4
Special Plates & Decals
 Manufacturer		 Transporter	 Dealer	 Dismantler
______	Dealer plates* ($12.00 each)		. . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . .	. . .$		__________
______	Motorcycle plates* ($12.00 each) . .		. . . . . . . . . . . . . . . . . . . .	. . . . . . . . . . . . .	. . .$		__________
______	Dismantler, manufacturer or transporter plates* ($10.00 each)				. . .$		__________
*Handling fee ($2.50 for 1-2 plates, $3.50 for 3 or more plates)				. . . . . . . . . . . . .	. . .$		__________
						Total $	__________
Additional instructions: __________________________________________
Decal number (office use only): ______________________________________
Insurance company: _______________________________					Policy number: _______________
Address: ____________________________________					Telephone number: _____________

Note: You must submit a current copy of your plate insurance declaration every time you order or renew plates. Insurance must be issued in the name of the licensed business.

Signatures – All owners must sign

Owner #1

I am familiar with the motor vehicle dealer licensing laws and other laws of Utah governing the conduct of persons in the motor vehicle industry and will cooperate with the Utah State Tax Commission to eliminate abuse and unfair trade practices.

I certify under penalty of perjury that the above information is correct and complete. I further certify that my business, as reported on this application, is in compliance with the Motor Vehicle Business Act of the Utah Code.

____________________________________ _______________

Signature*Date

____________________________________

Signer’s printed name

Owner #2

I am familiar with the motor vehicle dealer licensing laws and other laws of Utah governing the conduct of persons in the motor vehicle industry and will cooperate with the Utah State Tax Commission to eliminate abuse and unfair trade practices.

I certify under penalty of perjury that the above information is correct and complete. I further certify that my business, as reported on this application, is in compliance with the Motor Vehicle Business Act of the Utah Code.

____________________________________ _______________

Signature*Date

____________________________________

Signer’s printed name

Owner #3

I am familiar with the motor vehicle dealer licensing laws and other laws of Utah governing the conduct of persons in the motor vehicle industry and will cooperate with the Utah State Tax Commission to eliminate abuse and unfair trade practices.

I certify under penalty of perjury that the above information is correct and complete. I further certify that my business, as reported on this application, is in compliance with the Motor Vehicle Business Act of the Utah Code.

____________________________________ _______________

Signature*Date

____________________________________

Signer’s printed name

* The signer(s) must be owner, partner or corporate officer, or have POA. Submit copy of POA if applicable.