Free TC-759, Application for Utah Motor Vehicle Business License - Utah

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Utah State Tax Commission

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TC-759
Rev. 7/09

Application for Motor Vehicle Business License
Complete entire form and return it to the Motor Vehicle Enforcement Division at: 210 North 1950 West, Salt Lake City, UT 84134. Telephone: 801-297-2600 Make check or money order payable to Utah State Tax Commission Business organization
Sole proprietorship Partnership Corporation LLC LLP S-Corp

If located in Utah, provide Utah sales tax number:

__________________ _ _ _ _ _ _ _

License type
Manufacturer ($102) Distributor ($61) Crusher ($102) Dismantler ($102) Transporter ($51) Body shop ($112)

Company Information
Company name Address City Mailing address (if different from street address) City Utah License number Telephone number State State ZIP Code ZIP Code

Owner(s), Partner(s) or Corporate Officers Information
Name Home address City Hair color Name Home address City Hair color Name Home address City Hair color Name Home address City Hair color Eye color State Height Eye color State Height Title Social Security Number ZIP Code Weight Eye color State Height Title Social Security Number ZIP Code Weight Eye color State Height Title Social Security Number ZIP Code Weight Title Social Security Number ZIP Code Weight Home phone Driver's license number and state Date of birth Gender Male Home phone Driver's license number and state Date of birth Gender Male Home phone Driver's license number and state Date of birth Gender Male Home phone Driver's license number and state Date of birth Gender Male Female Female Female Female

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Sole Proprietors

TC-759, page 2

You must provide the following information if you are a sole proprietor applying for the license shown on page 1 of this application. Under state and federal law we cannot issue a license to any person who does not provide this information.

Check one: 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# or SSN: ________________ Alien #: ________________
The Alien Registration Number (A#) and the I-94 (arrival/departure) number are issued by the U.S. Citizenship and Immigration Service.

Signature

Complete the rest of this form by hand after it is printed.

I hereby apply for this license. I certify 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* _____ _ _ _ _ ____________________________________ _ _ _ _ _ Printed name of signer __________________ Date

*The signer must be an owner, partner or corporate officer, or have power of attorney. Submit a copy of POA, if applicable.

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