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DMV
INSTRUCTIONS FOR COMPLETING AN
ORIGINAL APPLICATION FOR THREE YEAR VEHICLE DEALER
CERTIFICATE AS A DEALER OR REBUILDER OF VEHICLES
DEPARTMENT OF TRANSPORTATION
DRIVER AND MOTOR VEHICLE SERVICES
1905 LANA AVE NE, SALEM OREGON 97314
OFFICE HOURS for Business Licensing Unit, in the Salem DMV Headquarters office, business hours are
8:00 a.m. – 4:30 p.m., Monday through Friday except Thursdays 9 a.m. –
4:30 p.m., (closed holidays).
READ ALL PARTS of the application before completing it. Your application
will be returned to you if any
part is incomplete or missing.
SUBMIT THESE ITEMS TOGETHER:
MAIL TO:
DMV BUSINESS LICENSING UNIT
1905 LANA AVE NE
SALEM OR 97314
Phone: (503) 945-5052
Website: www.oregondmv.com
YOUR COMPLETED APPLICATION (Be sure you provide copies of ALL
owners, partners, LLC members or corporate officers official photo ID's)
PLATE BILLING LIST (Renewal applications only)
SURETY BOND (Must show original/wet signature of owner/partner/member)
LIABILITY
INSURANCE CERTIFICATE
EDUCATION CERTIFICATE from a DMV approved provider or a
CERTIFICATION OF EXEMPTION (Form 735-370C)
FEES (Fees are itemized on the front of the application: use the plate billing
list to renew)
LEGAL NAME If your business is a sole proprietorship, list your full name as the legal name. If your business
is a partnership, list the full names of each partner or the partnership name. If your business is an LLC, list the
name of the limited liability company (includes "LLC") registered with the Oregon Secretary of State's Business
Registry. If your business is a corporation, list the name of the corporation (includes Inc, Corp, etc.) as shown in
the Business Registry (name search).
BUSINESS NAME If using an assumed business name or trade name, list the business name registered
with the Oregon Secretary of State's Corporation Division. If you do not know your Oregon Business Registry
number(s), locate it in the Business Registry database, or contact Corporation Division at (503) 986-2200.
Similar names NOT permitted. DMV will NOT issue or renew a certificate where the business name is identical or
indistinguishable from an existing dealer name. See OAR 735-150-0027(6).
FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN) Provide your FEIN, not your SSN. For more information
go to www.IRS.gov.
MAIN BUSINESS LOCATION Write the address of your primary business location on Line 3.
Your vehicles must be sold and displayed for sale at this location. Selling or displaying vehicles at a
different location is a violation of ORS 822.040(2) and (3). If you change your business location, you must submit a
correction application (Form 735-371) to DMV before you sell or display vehicles for sale at the new location.
MAILING ADDRESS All mail will go to the address on Line 4, except items which need a UPS-type delivery,
such as trip permit and temporary permit books, as well as dealer plates, which will go to the business address on Line 3.
SUPPLEMENTAL LOCATION USING THE SAME BUSINESS NAME A separate supplemental
application (Form 735-372) must be completed for each additional location where you operate your dealer
business. You must conduct business at each supplemental location under the same name as the primary location.
TYPE OF OPERATION – Complete all information on Lines 5 through 8.
CITY/COUNTY LOCATION APPROVAL Take your dealer application to the applicable city or county zoning, planning,
or community development office to obtain their approval on Lines 9 through 11. Some cities and
counties charge a fee for signing the application. Pursuant to ORS 822.025(6) you must get location approval on
your original application.
DMV DEALER LOCATION EXEMPTIONS Each business location established by a dealer must: (1) have
sufficient space to display one or more vehicles of the type the dealer has been issued a certificate to sell;
(2) provide a means for the public to contact the dealer or an employee of the dealer at all times during
the dealer’s normal business hours; (3) display an exterior sign affixed to the land or building that identifies
the dealership by the name; and (4) display, in a publicly conspicuous manner, the vehicle dealer certificate.
Any dealer wanting an exemption from the requirements in (1) through (3) must complete a request for
location requirement exemption Form 735-7178 (separate from city/county approval). There is no exemption permitted
from (4) above.
OWNERSHIP / APPLICANT’S CERTIFICATION SIGNATURE Provide name, residence
address, mailing address and signature of owners, partners, LLC members or corporate officers on Page 3,
do not list CEOs, Chairs of the Board, General Managers, Directors. Every owner listed on the application
must provide a certifying signature. Attach copies of ALL owners, partners, LLC members or
corporate officers valid government-issued photo ID's to the application.
735-370A (1-24)
(Continued on back...)
PRINCIPAL’S DEALER HISTORY – Complete all information in this section.
SURETY BOND The bond form provided by DMV must be completed, signed and sealed by your bonding company.
You must sign the bond, too. The owner name(s), legal and business name and business location must match the
dealer application exactly.
LIABILITY INSURANCE CERTIFICATION The liability insurance certification form provided by DMV must be
completed, signed and stamped by your insurance company. DMV will also accept an insurance company form furnished
by the insurance company as long as it duplicates the DMV form. DMV does not accept “ACORD” forms or binders. The
owner name(s), legal and business name and business location on the insurance certificate must match
the dealer application exactly.
DEALER EDUCATION –
Must submit education certificate from an approved provider or submit DMV Certificate of Exemption (Form 735-370C).
Original Applicant needs 8 hours of education (check www.oregondmv.com Dealers & Businesses page for
providers).
Renewal applicant needs 4 hours of education per year in a licensing period (12 hours continuing education for 3-
year certificate).
Must be completed by one of the applicants listed on page 3.
OTHER INFORMATION
CHANGING YOUR BUSINESS NAME You must file a correction application (
Form 735-371) with DMV before you
conduct dealer business using a new name. The correction application must be signed by an owner and include:
a rider from your bonding company, and
a new certificate of insurance from your liability insurance company.
See correction application (Form 735-371) for fee.
CHANGING YOUR BUSINESS LOCATION If you move your dealership, you must file a correction application (Form
735-371) with DMV before you sell or display at a new location. The correction application must be signed by an owner
and include:
location approval from the applicable city or county,
a rider from your bonding company, and
a new certificate of insurance from your liability insurance company.
See correction application (Form 735-371) for fee.
CHANGING YOUR BUSINESS NAME and LOCATION You must file a correction application (Form 735-371) with
DMV if you change your business name and location. The correction application must be signed by an owner and include:
a rider from your bonding company, and
a new certificate of insurance from your liability insurance company.
OTHER CHANGES You must file a correction application (Form 735-371) with DMV if you add or remove a partner,
LLC member or corporate officer or change your ownership structure (e.g., individual to partners, partners to corporation,
LLC to corporation). The correction application must be signed by an owner (including all new owners being added or
removed) and include:
See correction application (Form 735-371) for fee.
SUPPLEMENTAL CERTIFICATE You need a supplemental business certificate for each additional location
where you conduct dealer business. The supplemental location must use the same business name as the primary
location. A supplemental application must be filed with DMV before you conduct dealer business at the additional
location. The supplemental application (Form 735-372) must be signed by an owner and include:
location approval from the city or county, and
See application for fees.
DEALER PLATES Dealer plates may only be used on vehicles owned or in sales inventory by the dealer, and in actual
use by the dealer, members of the dealer’s firm, any salesperson thereof or any person authorized by the dealer.
Dealer plates may not be used on vehicles operated for commercial purposes.
To report a missing plate, submit information to: DMV Business Licensing Unit at 1905 Lana Ave NE, Salem OR
97314, or email [email protected]. Specify the alpha numeric character of the missing plate (e.g.,
DA123A).
To purchase additional plate(s), submit Form 735-6938 and fee to: DMV Business Licensing Unit, 1905 Lana
Ave NE, Salem OR 97314.
If you have any questions please contact Business Licensing Unit at (503) 945-5052
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Page 1
EFFECTIVE DATECUSTOMER NUMBER EXPIRATION DATE DEALER NUMBER
ORIGINAL
RENEWAL
If this is a renewal, do not complete the fee information. Use the
attached billing list to calculate your fees. The billing list MUST be submitted
with your renewal application.
O
F
F
I
C
E
U
S
E
CERTIFICATE FEE
LATE FEE
SUPPLEMENTALS
RENEWAL PLATES
ADDITIONAL PLATES
TEMPORARY PLATES
TOTAL
$
$ 1,188.00
$ ________
$ ________
Original Certificate (Includes one plate).................................
Additional Locations __________ @$350.00 .....................
TOTAL =
$
BUSINESS NAME AND ADDRESS
Any alteration of Line 3 voids location approval.
735-370 (5-24)
DEPARTMENT OF TRANSPORTATION
DRIVER AND MOTOR VEHICLE SERVICES
1905 LANA AVE NE, SALEM OREGON 97314
DMV
APPLICATION FOR
THREE YEAR VEHICLE DEALER CERTIFICATE
AS A DEALER OR REBUILDER OF VEHICLES
I / we primarily sell: New Vehicles Used Vehicles
TYPE OF OPERATION
CHECK ORGANIZATION TYPE: Corporation:PartnershipIndividual LLC
ZIP CODE
BUSINESS TELEPHONE
MAIN BUSINESS LOCATION (STREET AND NUMBER) CITY COUNTY
BUSINESS NAME (IF ASSUMED BUSINESS NAME, FILL IN REGISTRY NO.) OREGON REGISTRY NO.
______________________________
LEGAL NAME OF APPLICANT (OWNER, PARTNERSHIP, LLC OR CORPORATION NAME)
FEDERAL ID NUMBER (FEIN)
OREGON REGISTRY # (IF LLC OR CORPORATION)
If corporation, list the state under
which business is incorporated:
MAILING ADDRESS CITY STATE ZIP CODE
Certification of local zoning. ORS 822.005 requires a vehicle dealer certificate, unless exempt under ORS 822.015, for any person
who:
(If renewal, required only if dealer is changing business location)
IF “YES,” SERVICE FACILITY LOCATION (STREET AND NUMBER) CITY ZIP CODE
(a)
LOCATION APPROVAL
EMAIL
Buys, sells, brokers, trades or exchanges vehicles either outright or by means of any conditional sale, bailment, lease,
security interest, consignment or otherwise; OR
Displays a new or used vehicle, trailer, or semitrailer for sale; OR
Acts as any type of agent for the owner of a vehicle to sell the vehicle or acts as any type of agent for a person interested
in buying a vehicle to buy a vehicle.
(c)
(b)
THE CERTIFICATION BELOW IS TO BE COMPLETED BY THE LOCAL ZONING OFFICIAL. The approval below should be based
upon whether the applicant can do ANY of the activities listed in (a) through (c) above under applicable ordinances, at the location
of the business given on Line 3. Pursuant to ORS 822.025, applicant shall meet requirements below.
I / we are a franchise dealer:
I / we sell NEW RECREATIONAL VEHICLES:
No
Yes
If “Yes,” name the makes
Yes No
Place stamp or seal here
As the zoning official for the jurisdiction where this business is located, I verify by my signature that the location of this business as stated on this application
complies with any land use ordinances of the jurisdiction pursuant to ORS 822.025.
PRINT NAME TITLE
SIGNATURE DATE
X
CITY OF: COUNTY OF:
( )
TELEPHONE NUMBER
(Supplemental Application Form 735-372 required for each
location)
Additional plates 12" x 6"
_____
or 7" x 4"
_____
@$550...
(4WO SIZES, STANDARD AND SMALL, AVAILABLE
Check box if restrictions on the location
approval are in an attached letter from
the zoning authority.
Print
Clear Form
0.00
0.00
1,188.00
&
PRINCIPAL’S DEALER HISTORY
Information on the principals of this business is requested under Oregon Revised Statutes (ORS) 822.035 and Oregon
Administrative Rule (OAR) 735-150-0024.
OAR 735-150-0010(28) defines the principal of a dealership as ³an owner, partner, corporate officer or other person who
controls or manages the business organization or employees or agents of the business organization.´ “Principal”
includes all owners, partners, members, corporate officers, or directors.
Please provide the following information about all owners listed on this application and other principal(s) of the
business:
Has any principal of this dealership been financially or operationally involved in any jurisdiction, including Oregon,
with a vehicle dealership whose certificate or right to apply for a certificate was revoked or is currently suspended?
NO
YES, revoked or is currently suspended. If “YES,” complete Section 19.
NAME OF DEALERSHIP PRINCIPAL’S NAME(S)
19
DEALER CERTIFICATE NUMBER STATE WHERE SUSPENDED / REVOKED DATE OF SUSPENSION / REVOCATION EXPIRATION OF SUSPENSION
Has any applicant ever been an owner or principal on a vehicle dealer certificate in Oregon (excluding current application)?
NO YES: If “YES,” complete Section 21.
NAME OF DEALERSHIP PRINCIPAL’S NAME(S)
21
DEALER CERTIFICATE NUMBER
OWNER INFORMATION AND CERTIFICATION
False certification is a Class B misdemeanor under ORS 162.085 and is punishable by six months in jail, a fine of up to
$2,500 or both. In addition, civil penalties and DMV sanctions against
you or your dealer certificate may be imposed.
With this in mind . . .
I CERTIFY . . .
I am an owner, a partner, limited liability company member or corporate officer of this dealership and my name is
listed on this application.
ALL information on this application is accurate and complete.
I deal in vehicles and conduct business at the location given on Line 3 of this application.
The dealership will comply with all applicable laws and administrative rules.
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 certificate.
Page 2
BUSINESS LOCATION INFORMATION:
LEASED / RENTED: LEASE OR RENTAL PERIOD: _______________
Property is (check one):
OWNED
If property is “Leased / Rented” complete the following:
PROPERTY OWNER’S FULL NAME (As shown on County Property Records)
TELEPHONE NUMBER
( )
PROPERTY OWNER’S MAILING ADDRESS
CITY STATE ZIP CODE
(Be sure to attach a separate sheet to show additional owners.)
List the primary owner, partners, LLC members or corporate officers.
If a member of a limited liability company (LLC) is a corporation, the president must provide information below.
If a partner of a partnership is a corporation, the president must provide information below.
If corporation or LLC, the Oregon registered agent name and addresses are required below.
OREGON REGISTERED AGENT NAME
TELEPHONE NUMBER
15
( )
OREGON REGISTERED AGENT MAILING ADDRESS CITY STATE ZIP CODE
16
OREGON REGISTERED AGENT STREET ADDRESS CITY STATE ZIP CODE
17
12
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735-370 (5-24)
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20
OWNERSHIP INFORMATION
PRINT NAME OF OWNER, PARTNER, LLC MEMBER OR CORPORATE OFFICER TITLE TELEPHONE NUMBER
22
( )
DATE OF BIRTH DRIVER LICENSE NUMBER STATE OF ISSUANCE
EMAIL
23
RESIDENCE ADDRESS CITY STATE ZIP CODE
24
MAILING ADDRESS (IF DIFFERENT) CITY STATE ZIP CODE
25
DATE
26
CERTIFYING SIGNATURE OF OWNER SHOWN ON LINE 22 ABOVE
X
PRINT NAME OF OWNER, PARTNER, LLC MEMBER OR CORPORATE OFFICER
27
DATE OF BIRTH DRIVER LICENSE NUMBER
28
RESIDENCE ADDRESS
29
MAILING ADDRESS (IF DIFFERENT)
30
31
CERTIFYING SIGNATURE OF OWNER SHOWN ON LINE 27 ABOVE
X
TITLE TELEPHONE NUMBER
( )
STATE OF ISSUANCE
EMAIL
CITY STATE ZIP CODE
CITY STATE ZIP CODE
DATE
PRINT NAME OF OWNER, PARTNER, LLC MEMBER OR CORPORATE OFFICER T
ITLE TELEPHONE NUMBER
32
( )
DATE OF BIRTH DRIVER LICENSE NUMBER
STATE OF ISSUANCE
EMAIL
33
RESIDENCE ADDRESS
CITY STATE ZIP CODE
34
MAILING ADDRESS (IF DIFFERENT)
CITY STATE ZIP CODE
35
DATE
36
CERTIFYING SIGNATURE OF OWNER SHOWN ON LINE 32 ABOVE
X
PRINT NAME OF OWNER, PARTNER, LLC MEMBER OR CORPORATE OFFICER TITLE TELEPHONE NUMBER
37
( )
DATE OF BIRTH DRIVER LICENSE NUMBER
STATE OF ISSUANCE
EMAIL
38
RESIDENCE ADDRESS
CITY STATE ZIP CODE
39
MAILING ADDRESS (IF DIFFERENT)
CITY STATE ZIP CODE
40
CERTIFYING SIGNATURE OF OWNER SHOWN ON LINE 37 ABOVE
DATE
41
X
Page 3
(Over for Photo ID...)
DMV AGENT AGREEMENT
The dealer is granted the following options as a DMV agent and must comply with all applicable
laws and administrative rules. The dealer is not obligated to perform any of these options except
as required by law. *Snowmobile dealers must act as DMV agents for Oregon residents.
*Accept applications and fees for titles and registrations of vehicles they sell, and only charge fee
amounts set by Oregon Revised Statutes (ORS) and Oregon Administrative Rules (OAR).
Perform vehicle identification number inspections on vehicles they sell, except a dealer may not
perform an inspection under those situations described in OAR 735-022-0070(6)(A-G).
Issue temporary registration permits for unregistered vehicles they sell.
Agent status can be placed on probation, suspension or revoked as allowed in OAR 735-150-0120
for non-compliance of any ORS of the Oregon Vehicle Code.
By signing this application on Page 3, the dealer becomes an agent of DMV and agrees to comply
with all administrative rules and all dealer related statutes in the Oregon Vehicle Code.
735-370 (5-24)
42
Please attach copies of ALL owners, partners, LLC members or corporate officers valid
government photo ID’s. If the residence address on the photo ID is different than the
residence address listed on Page 3, submit a statement explaining why the addresses do
not match.
Copy must be legible.
Submit fees and these items to DMV together:
Application (Form 735-370)
Bond (Form 735-370B)
Certification of Liability Insurance (Form 735-370B) or Certification of Exemption (Form
735-7024)
Billing List (renewals only)
Supplemental Application (if more than one location) (Form 735-372)
Certificate of education completion or Certification of Exemption from Dealer Education
Requirements (Form 735-370C).
Request for DMV location requirement exemption if applicable.
Copies of ALL owners, partners, LLC members or corporate officers valid government-
issued photo ID’s.
To: DMV Business Licensing Unit
1905 Lana Ave NE
Salem OR 97314
Phone: (503) 945-5052
Business office hours are: 8:00 a.m. – 4:30 p.m. Monday –
Friday, except for Thursdays 9 a.m. – 4:30 p.m., (closed
holidays).
Page 4
735-370 (5-24)
SURETY BOND
DM V
BOND NUMBER
NOTE: TO BE COMPLETED BY BONDING COMPANY. FAILURE TO
DEPARTMENT OF TRANSPORTATION
DRIVER AND MOTOR VEHICLE SERVICES
ACCURATELY COMPLETE THIS FORM WILL CAUSE DELAY.
1905 LANA AVE NE, SALEM OREGON 97314
PLEASE TYPE OR PRINT LEGIBLY WITH INK.
LET IT BE KNOWN:
THAT
(INDIVIDUAL NAME OF OWNER, ALL PARTNERS OR MEMBERS, OR NAME OF CORPORATION)
DOING BUSINESS AS
(BUSINESS NAME AS GIVEN ON THE CERTIFICATE APPLICATION)
HAVING ITS PRINCIPAL PLACE OF BUSINESS AT
(STREET ADDRESS, CITY, STATE, ZIP CODE)
WITH ADDITIONAL PLACES OF BUSINESS AT
(STREET ADDRESS, CITY, STATE, ZIP CODE)
(STREET ADDRESS, CITY, STATE, ZIP CODE)
AS PRINCIPAL(S), AND
(SURETY NAME)
( )
(ADDRESS, CITY, STATE, ZIP CODE) (TELEPHONE NUMBER)
A CORPORATION ORGANIZED AND EXISTING UNDER AND BY VIRTUE OF THE LAWS OF THE STATE OF _________________,
AND AUTHORIZED TO TRANSACT A SURETY BUSINESS IN THE STATE OF OREGON, AS SURETY, ARE HELD AND FIRMLY
BOUND TO THE STATE OF OREGON IN THE PENAL SUM OF $50,000 FOR EACH YEAR THE CERTIFICATE IS VALID, FOR THE
PAYMENT OF WHICH THE PRINCIPAL(S) AND SURETY JOINTLY AND SEVERALLY BIND THEMSELVES, THEIR RESPECTIVE
SUCCESSORS, AND ASSIGNS. THE MAXIMUM AMOUNT PAYABLE UNDER THE BOND FOR PAYMENT OF CLAIMS BY PERSONS
OTHER THAN RETAIL CUSTOMERS OF THE VEHICLE IS $10,000.
WHEREAS, THE PRINCIPAL(S) IS APPLYING FOR A VEHICLE DEALER CERTIFICATE ISSUED BY THE OREGON DEPARTMENT OF
TRANSPORTATION;
THE CONDITION OF THIS OBLIGATION IS SUCH THAT WHEN THE ABOVE NAMED PRINCIPAL(S) IS ISSUED A VEHICLE DEALER
CERTIFICATE TO CONDUCT, IN THIS STATE, A BUSINESS AS A DEALER OR REBUILDER OF VEHICLES, SAID PRINCIPAL(S)
SHALL CONDUCT SUCH BUSINESS WITHOUT FRAUD OR FRAUDULENT REPRESENTATION, AND WITHOUT VIOLATION OF ANY
OF THE PROVISIONS OF THE OREGON VEHICLE CODE SPECIFIED IN ORS 822.030(2), THEN AND IN THAT EVENT THIS
OBLIGATION TO BE VOID, OTHERWISE TO REMAIN IN FULL FORCE AND EFFECT UNLESS CANCELLED PURSUANT TO ORS
822.030(1)(a).
THIS BOND SHALL BECOME EFFECTIVE AS OF THE DATE THE PRINCIPAL(S) IS ISSUED A VEHICLE DEALER CERTIFICATE BY
THE OREGON DEPARTMENT OF TRANSPORTATION. THIS BOND SHALL BE DEEMED CONTINUOUS IN FORM AND REMAIN IN
EFFECT FOR THE ENTIRE PERIOD FOR WHICH CERTIFICATION IS GRANTED AND FOR EACH SUCCEEDING CERTIFICATION
PERIOD UPON RENEWAL OF THE VEHICLE DEALER CERTIFICATE, UNTIL DEPLETED BY CLAIMS PAID, UNLESS THE SURETY
SOONER CANCELS THE BOND. THIS BOND MAY BE CANCELED BY THE SURETY GIVING WRITTEN NOTICE OF SUCH
CANCELLATION TO THE DRIVER AND MOTOR VEHICLE SERVICES DIVISION OF THE OREGON DEPARTMENT OF
TRANSPORTATION.
THIS BOND SHALL BE ONE CONTINUING OBLIGATION AND THE LIABILITY OF THE SURETY SHALL BE LIMITED TO THE
AMOUNT OF THE PENALTY OF THIS BOND REGARDLESS OF WHETHER THIS BOND IS RENEWED OR OTHERWISE CONTINUED
IN EFFECT BEYOND THE ORIGINAL CERTIFICATION PERIOD, IRRESPECTIVE OF THE NUMBER OF YEARS IT IS IN EFFECT.
THIS BOND IS EFFECTIVE ___________________________
(MONTH, DAY, YEAR)
-- ANY ALTERATION VOIDS THIS BOND --
IN WITNESS WHEREOF, THE SAID PRINCIPAL(S) AND SAID SURETY HAVE EACH EXECUTED THIS BOND BY ITS AUTHORIZED
REPRESENTATIVE(S) AND HAVE AFFIXED THE SURETY CORPORATE SEAL HEREUNTO
THIS ________________ DAY OF ___________________________________ , ___________ .
(DAY) (MONTH) (YEAR)
SIGNATURE (OWNER/PARTNER/MEMBER OR CORPORATE OFFICER)
TITLE
X
SIGNATURE OF SURETY (AUTHORIZED REPRESENTATIVE)
TITLE
X
SURETY'S AGENT OR REPRESENTATIVE MUST COMPLETE THIS SECTION: PLACE SURETY SEAL BELOW
IN THE EVENT A PROBLEM ARISES CONCERNING THIS BOND, CONTACT:
NAME
TELEPHONE NUMBER
( )
ADDRESS
CITY, STATE, ZIP CODE
735-370B (4-24)
APPROVED BY ATTORNEY GENERAL’S OFFICE
AGENT NAME AND ADDRESS CITY, STATE, ZIP CODE
THIS POLICY IS ISSUED TO (REGISTERED BUSINESS NAME OF DEALER, PARTNERS, OR CORPORATION NAME) BUSINESS NAME OF DEALERSHIP (DBA)
CERTIFICATE OF INSURANCE
TO BE COMPLETED BY INSURANCE COMPANY LICENSED TO DO BUSINESS IN OREGON
INSURANCE POLICY NUMBER (BINDER NOT ACCEPTABLE) EFFECTIVE DATE
EXPIRATION DATE
INSURANCE COMPANY NAME AND ADDRESS (NOT AGENT)
INSURANCE COMPANY PHONE NUMBER
( )
AGENT NAME AND ADDRESS CITY, STATE, ZIP CODE
THIS POLICY IS ISSUED TO (REGISTERED BUSINESS NAME OF DEALER, PARTNERS, OR CORPORATION NAME) BUSINESS NAME OF DEALERSHIP (DBA)
DEALERSHIP ADDRESS DEALER NUMBER
I CERTIFY THAT THE FOLLOWING IS TRUE AND CORRECT. The above described policy has been issued
and provides liability limits of coverage required under ORS 806.070; provides for payment of judgments of the
type described in ORS 806.040; covers all motor vehicles manufactured, owned, operated, used or maintained
by, or under the control of the named insured; covers all persons who, with the consent of the named insured,
use or operate motor vehicles manufactured, owned or maintained by, or under the control of, the named insured;
the insurer shall give written notice of any cancellation of the policy to DMV Business Licensing Unit; the
insurer shall continue to be liable under the policy until DMV receives the notice of cancellation or until the
cancellation date specified in the notice, whichever is later.
It is a crime under ORS 162.085 to certify the truth of a statement when you know it is not true. Such a crime is a
Class B misdemeanor and is punishable by a jail sentence of up to six months, a fine of up to $2,500 or both.
SUPPLEMENTAL DEALERSHIP ADDRESS
SUPPLEMENTAL DEALERSHIP ADDRESS
CITY, STATE, ZIP CODE
CITY, STATE, ZIP CODE
PRINT NAME OF INSURER’S AUTHORIZED REPRESENTATIVE TELEPHONE NUMBER DATE
SIGNATURE OF INSURER’S AUTHORIZED REPRESENTATIVE INSURER’S ADDRESS STAMP OR SEAL (If no stamp attach a business card)
X
DEALER LIABILITY INSURANCE
General Information
WHAT IS NEEDED: ORS 822.033 requires a dealer to carry vehicle liability insurance coverage for their
dealership. A Certificate of Insurance must be filed with the Business Licensing Unit each time a dealer applies for
a new or renewal business certificate, or when the certificate on file is expired in order to provide continuous coverage.
AMOUNTS OF COVERAGE: ORS 806.070 requires the policy to provide coverage in specific amounts and
ORS 806.040 requires the policy to provide for the payment of judgments.
ADDITIONAL STIPULATIONS: ORS 822.033 requires that the coverage provide each of the following:
The policy must cover ALL MOTOR VEHICLES manufactured, owned, operated, used or maintained by,
orunder the control of the named insured.
The policy must cover ALL PERSONS who, with the consent of the named insured, use or operate motor
vehicles manufactured, owned or maintained by, or under the control of, the named insured.
The insurer must give written notice of ANY CANCELLATION of the policy to the Business Licensing Unit.
The insurer shall CONTINUE TO BE LIABLE under the policy until the Business Licensing Unit receives
the notice of cancellation or until the cancellation date specified in the notice, whichever is later.
(Note: This means that even if the policy expires and is not renewed, the insurer continues to be liable
until the Business Licensing Unit receives a notice of cancellation.)
TERM OF COVERAGE: The dealer must maintain coverage throughout the license period covered by
their business certificate. If the policy lapses for any reason, the dealer must file a new Certificate of
Insurance providing continuous coverage with the Business Licensing Unit.
EXEMPTION: ORS 822.033(3) states a dealer is exempt from the requirement to file a Certificate of Insurance if
they deal exclusively in certain types of vehicles. To get the exemption, a dealer must file a Certificate of
Exemption, Form 735-7024. To request a Form 735-7024, call DMV Business Licensing Unit at (503) 945-5052.
All Certificates of Exemption are subject to approval upon review by the Business Licensing Unit.
735-370B (4-24)
DMV
EDUCATION REQUIREMENTS
DEPARTMENT OF TRANSPORTATION
DRIVER AND MOTOR VEHICLE SERVICES
CERTIFICATION OF EXEMPTION
1905 LANA AVE NE, SALEM OREGON 97314
DEALER NUMBER EXPIRATION DATE
INSTRUCTIONS:
Renewal applications may qualify for an exemption from dealer education. All certificates of exemption
are reviewed by DMV for acceptability.
This form must be submitted with an Application for a Dealer Business Certificate.
This form must be completed by an owner, partner, LLC member or corporate officer of the dealership.
Mark the box below to show the type of exemption sought.
Read and sign the certification statement at the bottom of this form.
Submit this exemption along with your application for a dealer certificate to:
Business Licensing Unit, 1905 Lana Avenue NE, Salem OR 97314. Telephone: (503) 945-5052.
BUSINESS NAME OF DEALERSHIP
MAIN BUSINESS LOCATION CITY ZIP CODE
The education requirements do not apply to an applicant for a vehicle dealer certificate under ORS
822.020 or 822.040 if the applicant is one of the dealers listed below and have a current or is renewing a
dealer certificate. I understand that if I sell or otherwise act as a vehicle dealer regarding any type of
vehicle other than those listed below, I must file the appropriate certificate of education* with the
DMV Business Licensing Unit:
*
Note:
All original applications (including franchises) require a preliminary 8 hour dealer education certificate unless
an applicant has a certificate with a currently certified Oregon dealer.
A franchised dealer in Oregon for nationally advertised new vehicles.
A franchised dealer in Oregon for nationally advertised new recreational vehicles.
A vehicle rental company with a nationally advertised franchise under the ownership of a
corporation that operates nationwide.
A national auction company that holds dealer and dismantler certifications and sells totaled vehicles.
Applicant IRURULJLQDOFHUWLILFDWHKROGVD SUHFHUWLILFDWLRQeducation certificate fromD current, certified
Oregon dealer.
List affiliated dealer name and number: ______________________________________________.
CERTIFICATION
False statement is a Class B misdemeanorunderORS162.085andispunishablebysixmonthsin
jail, a fine of up to $,00, or both. In addition, civil penaltLHV of up to $00 and DMV sanctions
againstyouoryourdealercertificate may be imposed.
With these penalties in mind, I CERTIFY I am an owner, partner, LLC member or corporate officer
ofthis dealership and all information on this Certificate of Exemption is true and correct.
PRINT NAME OF CERTIFYING OWNER / PARTNER / CORPORATE OFFICER / LLC MEMBER
TITLE
SIGNATURE OF CERTIFYING OWNER / PARTNER / CORPORATE OFFICER / LLC MEMBER
DATE
X
735-370C (1-24)
DM V
DEPARTMENT OF TRANSPORTATION
DRIVER AND MOTOR VEHICLE SERVICES
1905 LANA AVE NE, SALEM OREGON 97314
LIABILITY INSURANCE
CERTIFICATION OF EXEMPTION
DEALER NUMBER EXPIRATION DATE
INSTRUCTIONS:
You may qualify for an exemption from liability insurance if you deal exclusively in certain types of
vehicles. All certificates of exemption are reviewed by DMV for acceptability.
This form must be submitted with
an Application for a Dealer Business Certificate.
This form must be completed by an owner, partner, LLC member or corporate officer of the dealership.
Mark the box to show the type of vehicle you sell exclusively. Dealer plates will not be issued to you
if you sell antique vehicles.
Read and sign the certification statement at the bottom of this form.
Submit this exemption along with your application for a dealer certificate to:
Business Licensing Unit, 1905 Lana Avenue NE, Salem OR 97314. Telephone: (503) 945-5052.
BUSINESS NAME OF DEALERSHIP
MAIN BUSINESS LOCATION CITY ZIP CODE
This business deals exclusively in the vehicle types which I have marked below. I understand that if I
sell or otherwise act as a vehicle dealer regarding any type of vehicle other than those listed below, I
must file a Certificate of Insurance with the Business Licensing Unit.
Antique motor vehicles which have been issued permanent registration under ORS 805.010
Class I or Class III all terrain vehicles (ATVs)
Snowmobiles
Trailers (utility, horse
, boat)
Campers and Travel Trailers
CERTIFICATION
False certificate of exemption from liability insurance is a Class B misdemeanor under ORS 162.085
and is punishable by six months in jail, a fine of up to $2,500, or both. In addition, a civil penalty of up to
$1,000 and DMV sanctions against you or your dealer certificate may be imposed.
With these penalties in mind, I CERTIFY I am an owner, partner, LLC member or corporate officer of
this dealership and all information on this Certificate of Exemption is true and correct.
PRINT NAME OF CERTIFYING OWNER/PARTNER/CORPORATE OFFICER
TITLE
SIGNATURE OF CERTIFYING OWNER/PARTNER/CORPORATE OFFICER
DATE
X
735-7024 ( 4-18)
DMV
REQUEST FOR DMV LOCATION
REQUIREMENT EXEMPTION
DEPARTMENT OF TRANSPORTATION
DRIVER AND MOTOR VEHICLE SERVICES
1905 LANA AVE NE, SALEM OREGON 97314
(OAR 735-150-0030)
DEALER CERTIFICATE # EXPIRATION DATE
INSTRUCTIONS (DEALER PLEASE READ)
Pursuant to OAR 735-150-0030 (2), DMV is only authorized to grant exemptions for restrictions based
on ordinance or zoning requirements. All other requests will be denied.
Complete (print or type) and submit to: Business Regulation, 1905 Lana Ave NE, Salem OR 97314.
A DMV Investigator or manager will review your request. A signed copy of the request will be returned to you.
An approved request must be kept at your business location. Failure to do so may subject you to a civil
penalty or administrative sanction.
Approved exemptions are valid only for the dealer certificate number and location listed. A new exemption
must be applied for if there is a change in name, address or dealer certificate number.
SECTION 1 – NAME AND LOCATION OF DEALER BUSINESS
DEALER CERTIFICATE #
EMAIL ADDRESS
NAME OF DEALERSHIP
STREET ADDRESS (BUSINESS LOCATION)
CITY STATE
ZIP CODE COUNTY
SECTION 2 – EXEMPTION
Any dealer wanting an exemption from all or part of the requirements in (a) through (c) below MUST check
the appropriate box(es) below and provide a clear and complete reason for the request.
I am requesting an exemption from the requirement(s) listed below:
a) Have sufficient space to display one or more vehicles of the type the dealer has been issued a
certificate to sell.
b) Provide a means for the public to contact the dealer or an employee of the dealer at all times during
the dealer's normal business hours.
c) Have displayed an exterior sign permanently affixed to the land or building which identifies the
dealership by the name shown on the dealer's business certificate.
NOTE: You MUST attach to this form a letter or other evidence from the appropriate zoning authority which
specifically and clearly show the restriction the exemption request is based on.
SIGNATURE
I certify that I am an owner, a partner, a member of LLC or a corporate officer of this dealership. I understand
that Oregon Administrative Rules require a dealer business location to comply with each of the three
conditions listed above. However, the business location of the dealership, as shown in Section1, is unable to
meet the requirements. Copies of city or county ordinances or zoning requirements preventing compliance are
attached. I hereby request the exemptions marked in Section 2.
NOTE: This exemption does not constitute a variance on state, county or city land-use restrictions or laws.
Violation of zoning laws/restrictions could result in cancellation of your dealer certificate.
PRINTED NAME OF PERSON SIGNING THIS FORM TITLE
SIGNATURE DATE
X
(DMV Use Only)
Request in Section 2: a) Approved Denied b) Approved Denied c) Approved Denied
(Investigator to check all applicable boxes). If applicable, the dealer must comply with reasonable alternatives (attached).
PRINTED NAME OF INVESTIGATOR / MANAGER TITLE
INVESTIGATOR’S / MANAGER’S SIGNATURE DATE
735-7178 (12-20)
X