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Home My WebLink AboutApplication APPLICANT 2/17/2011 . < llco"., . AP L1CATION R I THREE YEAR VEHICLE DEALER CERTIFICATE , . AS A DEALER OR REBUILDER OF VEHICLES I EFFECTIVE DATE EXPIRATION DATE DEAlER NUI.IBER DA8480 II this is a renewal. do not complete the fee information. Use the attached >- CERTIFICATE FEE billing list to calculate your fees. The billing list MUST be submitted with your renewal application. Original Certificate (Includes one plate)................................. Additional Locations @S230.00 ..................... (Supplemental Application fonn 735.372 required for each location) Additional plates @S54.00 .............................. fJcl/JCDv/f./';, N+v ",-;-f' ~r"".'t'i\ - 0=']. DA8480 I :v.lJflX.114toomAllU:O~Io;:Q11 tRWll-'N)IlQ'!O'R'ttIt':UUlIVlCU ..' 1llOSUH..'1EH!LSil(1oI0I'il'c:Pi~nu . CUSTOMER NUMBER S 1,012.00 S LJ ORIGINAL "" RENEWAL , LAT~ FEE , SUP~LEMENl ALS , P.:=N~VAL PI.-ATES S , ADOFIONAL PLATES TOTAL S I TOTAL = $ TE~toRARYPLATES BUSINESS NA E AND ADDRESS An alterationofLine3voidslocotiDno rowll, LEGAL NAME OF APPLICANT (OWNER. PARTNERSHIP. LLC OR CORPORATION NAME) OREGON REGISTRVINUMBER tlF LLC OR CORPORATION) 1 A STREET AUTO SALES INC 2 ~~T~~fIt'~J~g~~~iE~NESS NAME. FlU IN REGISTRY NO) OREGON RoGISIRYINO E(~~W61~~;~~8E q /11 r!' TYPE OF OPERATION 5 CHECK ORGANIZATION TYPE: 01 Individual CITY Sft2.lfI), IClTY fiELO IZlPZn~7 7 ISTATE I COUNTY t'i,u..... ZIP CODE tF"YES," SERVICE FACIUT( lOCATlOa {STRE=T A..'1DNUMSER) I j I: COl'?OfatiOI'l. Ust ths s~t~ cr.d;r i'i1 01 LLC' iiJiI I . ,.~kh """""SO Is Im:c:po:.,.d: b!.J Partnership ~ Corporation: U I New Vehicles ~I Used Vehicles I f-JI Yes [gj No If "Yes," name thelmakes >- II we sell NEW RECREATIONAL VEHICLES: Pi Yes jgJ No I ICITY I LOCA nON APPROVAL (If renewal, required otlly if dealer is changitlg business location) Certification of Local Zoning and Business Regulatory Compliance. OAS 822.005 requires a vehicle dealer license. unless exempt under ORS 922.015, for any person who: I (a) Buys. sells. brokers. trades or exchanges vehicles either outright or by means of any conditional sale. bailment, lease, security interest. consignment or otherwise; OR I (b) Displays a tlew or used vehicle. trailer, or semitrailer for sale; OR .. .. '. (cj Acts as any type of agent lor the owtler 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. I THE CERTIFICATION BELOW IS TO BE COMPLETED BY THE LOCAL ZONING OFFICIAL. Your approval below should be based upon whether the applicant can do ANY of the activities listed in (a) through (c) above under your ordinances. at the location of the business given on Line 3. Pursuant to ORS 922.025, applicant meets requirements below. I As rhe zoning official for the locality in which this business is Iocaled. I verify by my signalure below rhallhe location of Ihis business as sla,ed on !his application, complies with any land use ordinances and business reguJaI.oPj ordinances of the city or ccumy. as appropriate pulWartllo OAS 822.025. o COUNTY OF: i~(~PHONEt"7J.#-)3D I W1n.= II we primarily sell: 6 7 8 II we are a franchise dealer: ZI? CODS \"" \1 Piare S'~1'1::p or sCalllhere IIMTE d- V I Date Received: , . 11 APPROVED CITY OF SPRINGFIELD FEB 1 7 2011 Original Submittal ~IJU:IJ _ 93g91 n 0 fQf11; 11 q f e rll1ltrt' It DilL{ 1\/ Mprpvuj Met s 0 / If' tI . . DAB4BO I VEHICLE DEALER CALCULATION SHEET I IMPORTANT INSTRUCTIONS - PLEASE READ THREE YEAR RENEWAL Attached is your plate renewal billing list. You must renew at lea~t one plate. If you no longer have any plates in your possession, then you must order at least one. Please check the list carefu'lIy. If there is a plate listed that you nb longer have, line through the number and explain what happened to it (i.e. lost, stolen, destroyed, etc.) , I If you have a plate not listed, write the plate number at the end of/the list. 1. (A) Write the number of plates in your posession which you wish to renew. (B) Multiply line 1A by $42.00 = 2. (A) Write the number of additional plates you wish to order. (B) Multiply line 2A by $54.00 = 3. (A) Write the number of supplemental (additional) locations where you will be operating. (B) Multiply line 3A by $230.00= 4. Certificate Fee 5. Add lines 1 B, 2B, 3B, 4. This is the total fee required to renew your certificate and plates. 1 (A) I '1. 1 (B) 1$ '3Lj- 2 (A) I 0 2 (B) 1$ 0 3 (A) I 6 4. 5. I I I I I I 1$ 958.00 I 1$ /t1yl./ ] 3 (B) 1$ IF RENEWING BETWEEN 2/15/2011 AND 3/17/2011, ADD THE LATE RENEWAL FEE OF $100.00. >- If the total fee on line 5 is less than $1000.00, please read the instructions at the top of this page and recalculate the amoun1t. . I When the application, bond, certificate of insurance, photo ID, cehificate of completed education requirement (or certificate, of exemption) and billing list have been completed, return them along with the appropriate fee to: DMV Business Licensing Unit 1905 Lana Avenue NE Salem, OR 97314-2350 If you have any questions, please call (503) 945-5052. Date Received: FEB 1 7 2011 Original Submittal DA8480 INCIPAL'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. I OAR 735-150-0010(26) defines the principal of a dealership as "an owner, partner, corporate officer or other person who controls or manages the business organization or the employees or agents of thd business organization: I Please provide the following information about all owners listed on this application and other principal(s) of the business: '. , 12 Has any principal of this dealership been financially or operationally involved in anyljurisdiction. including Oregon, with a vehicle dealership whose license or right to apply for a license ""as revoked or is currently suspended? o NO 0 YES, revoked currently suspended. If "YES," complete Sectidn 13. I 13 NAM. OF OEAJ...i'lSh1P I PMlNCIPAt.S N""~. , o lEFt UCE..s\lSE NUMBER SiAiE WHER~ SUS?ENDEDI ?.fVOj(@! DATE OF SUS?::NSJON / ,EVOCA nON I -=XPIRATION OF SUSPENSION 14 Have you ever been an owner or principal on a vehicle dealer license in Oregon (excluding current application)? I vi NO I I YES: If "YES." complete Section 15. I 15 NAM. 9F OOALERSHIP I PPJNCIPA.t'S NAM. I I OWNER INFORMATION AND CERTIFICATION I I False certification is a Class B misdemeanor under ORS 162.085 and is punishable ~y six months in jail, a fine of up to $1.000 or both. In addition, civii penalties and DMV sanctions against you or your dealer certificate may be Imposed. With this in mind.. . I CERTIFY. . . . I am Ihe owner. a partner. limited liability company member or corporate officer of this dealership and my name is listed on Ihis application. I . ALL information on this application is accurate and complete. I . I deal in vehicles and conduct business al the location given on Line 3 of this application. , . The dealership will comply with all applicable laws and administrative rules. I . . Ilwe hereby certify that the persons named in Ihis application are not acting as the alter ego, in the place of, or on behalf of, any other person or persons in seeking Ihis license. I BUSINESS LOCATION INFORMATION: I Property is (check one): 0 OWNED [BLEASED 1 RENTED: LEASE OR RENTAL PERIOD: C/.Jp.-J ~Nj. If property Is 'Leased I Rented" complete the following: I' : H::LEPHONE NUMBER: I ( S'I!) <::;'>'1- !/..r ISTATtl~ 'ZIPc~E7 I DEALER UCENSE NUMSER PRO?E.RTY OWNeRS ADOR_SS /3 CJ 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 Ihese options except as requirkd by law. . Snowmobile dealers must aei as DMV agents for Oregon residents. . , . .. Accept applications and fees for Iitles and registrations of vehicles they sell, and only charge fee amounts set by Oregon Revised Statutes and Oregon Administrative Rules. I . Perform vehicle idenlification number inspections on vehicles they sell, except a dealer may not perform an inspection under Ihose situations described in OAR 735-22-007(5)(a-q). II . Issue temporary registration permits for unregislered vehicles they sell. . Agent status can be placed on probation, suspension or revoked as allowed in Oregon Adr9atetRenaived: 735-150.0120 for non-compliance of any Oregon Revised Stalule of the Oregoh Vehicle Code. . By signing this application on Page 3. the dealer becomes an agent of DMV a~d agrees to COrlilflN.i."ilh.aJJ..011 administrative rules and all dealer related slatutes in the Oregon Vehicle Code.! rt:tl 1ft. I . Pag.2 I Ongina u ml I I ....----.rl /- 16 17 18 DA8480 - . . . Complete the section(s) below and sign. (Be sure to attach a separate sheet to show additional owners,) . list the primary owner, partners, LLC members or corporate officers below. . If a member of a limited liability company (LLC) is a corporation, the president m~st provide information below. , . If a partner of a partnership is a corporation, the president must provide information below. , . I . By signing below, Ilwe certify that the answers provided on Page 2 are true and accurate information. I . If corporation or LLC, the Oregon registered agent name and addresses required below. OREGON REGISTERED AGENT NAME II (ELEPMONE )IUM8ffi OREGON MEGISTEP.ED AG~ MAlLING ADDRESS CITY I I STATE I ZI? coos OREGON REGISTERE:D AGENT STREET ADDRESS CITY I I STATE I ZiP CODE OWNERSHIP INFORMATION I PRINT NAME 0; OWNEFi. PARTNER-LtC MEMBER OR CORPORATE O::F"iC~ I TITLE , I RESiDENCE. TELEPHONE NUMBER GUTHRIE, DAVID A I PRESIDENT II ( ) (541) 744-1346 DA OF SIRTH I ORIVER tlCENSE NU~."EER I STA,,, OF ISWAN1E RE lDEo'lCE ADDRESS I CITY . I STATE ZIP CODE 85245 OLAND LANE EUGENE 97405 idA ING ADDRESS {IF DIFFERl:.NT) I CITY I STATE ZIP COO= A CE ll~ OWNER SHO'NNON LINE ,QA80VE IIDAT1 1-) (J /1 X - PRI IT r~AME OF OVVNER. PA.G.TNER. LtC MEMEE::l: OR CORPORATE OFFICE.l:l TITlE I J RESlDENCS TELEPHONE NUM8EH: I II( ) DATe OF BIRTH I DAIVER liCENSE NUMBER I STATE OF ISSUANjE RESiDENCE ADDRESS I CITY I STATE ZIP CODE MAILING ADDRESS (IF DIFFERENT) ICITV I STATE: ZIP COOE CERTIFYING SIGNATURE OF OVINER SHOWN ON LINE 24 ABOVE IIDAE .- Iv PRINT NAME OF ~y1INER. PARTNER. LtC M5ME5R OR CORPORATE O~FiCER I TITLE II (ESIDENCS )ElEPHONE NUMBER DATE OF BIRTH I DRiVER liCENse NUM9ER I ST A, " OF ISSUANG1E RESIDENCE ADDRESS I CITY I STATE ZIPCOOE MAILING ADDRESS (IF DIFFEM:ENi) IGITY I STATE: ZIP CODE CERTIFY1NG SIGNATURE 0:= OWNER SHOWN ON LINE 29 AEOVE II00TE X PRiNT NAME 0; OWNER. PA.:nNER. ltC MEMBER OR CORPORATE OFRCER I TITLE II (E5IDENGE )ElEPHONE NUMBER DATE OF' BIRTH I DRIVER LICENSE NU.\{EER I STATE OF 'SSU""Ci RESIDENCE ADDRESS I CITY I STATE: ZIP GODE MAILING ADDRESS {IF DI!=FEREN I) I CITY I " ~ CERTlf'YING SIGNATURE OF OWNER SHOWN ON lINE 'l4 ASOVE II DATE FEB 17 X 2011 Page 3 (Over for Photo 10"')1 Original Submittal ~ 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38