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15. SIGNATURES AND CERTIFICATIONS (Each applicant listed for Item 8 must sign)
CAUTION: ANY MISLEADING, INCOMPLETE, OR FALSE STATEMENT MAY BE GROUNDS FOR DENIAL OF THIS APPLICATION OR SUSPENSION
OR REVOCATION OF ANY LICENSE ISSUED.
I/we hereby certify that the persons named in this application have read: Chapter 2 of the Michigan Vehicle Code, other applicable
laws that pertain to my/our dealer license and the department’s Dealer Manual (available at Michigan.gov/sos) and understand the
requirements of the license type that I/we are applying for.
I/we hereby certify that within the 6 months period preceding the date of the application, the applicant, the partners of the applicant, or
the principal officers of the applicant, as applicable, completed the prelicensure dealer training program as required by MCL 257.248l(2).
I/we hereby certify that each retail sales location will have a designated employee that has completed the dealer training program
required under section MCL 257.248l(3) or (5) as applicable within 90 days of the license issuance. A single individual may not be the
designated individual for more than 3 locations.
I/we hereby certify that the business named in this application maintains, and will maintain once a license is issued, an established
place of business as required by MCL 257.14.
I/we hereby certify that the business named in this application will maintain records only at the established place of business and will
provide the records for inspection upon request by an agent of the Secretary of State or law enforcement.
I/we hereby certify that the business named in this application maintains, and will maintain once a license is issued, records as
required by law and/or prescribed by the Secretary of State, which may include a police book, temporary registration log, vehicle parts
purchase and sales records.
I/we hereby certify that the persons named in this application, if maintaining an electronic police book, will ensure that a paper copy is
available upon request by an agent of the Secretary of State or law enforcement.
I/we hereby certify that the persons named in this application will take the necessary precautions to ensure the protection of the
required records from fire, water damage or malfeasance.
I/we understand that the Secretary of State is not responsible for the validity of documents that I/we complete and file with the
Secretary of State. I/we further understand that I/we are responsible for any false information, errors or omissions in regards to documents
presented to the Secretary of State for processing.
I/we hereby certify that the persons named in this application are not acting as the alter ego, in the place of, or on behalf of, any other
person or persons in seeking this license.
If granted a license I/we hereby certify that the persons named in this application will not sublet the dealer license to other persons
and/or allow unlicensed individuals to use the license to conduct their own business/transactions. I/we understand that I/we are fully
responsible for all transactions conducted with my/our dealer license number. I/we will take the necessary measures to prevent the
unauthorized use of my/our dealer license number including properly completing all paperwork, forms, police book entries, temporary
registration log entries, inspection of auction sales and inventory control records.
I/we hereby grant the licensing authority in any state or jurisdiction listed in this application authority to release information concerning
any previous license applications, licensing history, and disciplinary actions or sanctions to the Secretary of State or his/her agents.
I/we hereby grant any employers named in this application authority to release information concerning my/our employment history to
the Secretary of State or his/her agents.
I/we authorize the Secretary of State to receive and review the criminal history of the individuals listed in item 8 from the Michigan
State Police and the FBI via Livescan.
I/we stipulate and agree that any legal process affecting this business served on the Secretary of State or his/her agents shall have
the same effect as if personally served on me/us. I/we agree that this appointment shall remain in force as long as any liability of this business
remains outstanding within the State of Michigan.
If granted a Class A or Class B or Class W vehicle dealer license, I/we certify that I/we have and will maintain security for payment of
benefits under personal protection insurance, property protection insurance, and residual liability insurance as required by Public Act 294 of
1972 (no-fault insurance) for as long as this license is in effect.
If granted a Cl
ass A, Class B, or Class D vehicle dealer license, I/we certify that I/we have and shall maintain a surety bond in the
amount of $25,000 (twenty-five thousand dollars) for as long as this license is in effect.
I/we, the applicants named herein, hereby certify that the statements contained in this application are true to the best of my/our
knowledge and belief. Signatures are required below.
Printed Name Signature Title Date
Printed Name Signature Title Date
Printed Name Signature Title Date
Printed Name Signature Title Date