Form HSMV86072 "Modification to Dealer License for Licensed Motor Vehicle, Mobile Home, or Recreational Vehicle Dealers" - Florida

What Is Form HSMV86072?

This is a legal form that was released by the Florida Department of Highway Safety and Motor Vehicles - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2020;
  • The latest edition provided by the Florida Department of Highway Safety and Motor Vehicles;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form HSMV86072 by clicking the link below or browse more documents and templates provided by the Florida Department of Highway Safety and Motor Vehicles.

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Download Form HSMV86072 "Modification to Dealer License for Licensed Motor Vehicle, Mobile Home, or Recreational Vehicle Dealers" - Florida

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STATE OF FLORIDA
DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
PLEASE SUBMIT THIS APPLICATION TO THE REGIONAL OFFICE RESPONSIBLE FOR
YOUR DEALERSHIP
MODIFICATION TO DEALER LICENSE FOR
Entered by:
LICENSED MOTOR VEHICLE, MOBILE HOME, OR
RECREATIONAL VEHICLE DEALERS
Approved by:
Do not use white out or correction tape on this modification form.
Office Use Only
Current License No.:
LICENSE
Licensee Name:
I hereby request the following modifications to my current dealer license:
(Please check and answer all application choices that apply)
ISSUE DATE
PIN Number:
Telephone Number: Office:
Cell:
ETR Providers:
Business E-mail Address:
DATE RECEIVED IN
Recreational Vehicle Endorsement (DH License Only)
Add
Delete
REGIONAL OFFICE
New RV Endorsement
New and Used RV Endorsement
Used RV Endorsement
Add Location:
Selling RV
Used Vehicles Only
New and Used Vehicles
Selling Park Models
DATE COMPLETED
Physical Address:
IN REGIONAL
OFFICE
Mailing Address:
Leased
Owned
Date:
Change of Location:
DATE MAILED TO
Old Address:
HEADQUARTERS
New Address:
Mailing Address:
DATE RECEIVED IN
Leased
Owned
Date:
DEALER LICENSE
Licensee Name Change
d/b/a Name change
SECTION
Former Name:
New Name:
AMOUNT
Deleting Line-Make(s):
Adding Line-Make(s):
Existing Line-Make(s):
CHECK
If you are adding or deleting line-make(s) from your license, please list all line-makes you are currently authorized to sell.
Change of Mailing Address:
CHECK NUMBER
Old Address:
New Address:
CASH
Change of Supplemental Location to Primary Location (where old primary location is closed)
CREDIT CARD
Change of Supplemental Location to Primary Location and Change of Primary Location to
Supplemental Location (where primary and supplemental locations remain open)
PAYMENT NUMBER
New Primary Location Address:
New Supplemental Location Address:
Postal Address Update:
Add
Delete
Park Trailer Endorsement (DH License Only)
FRVIS CUSTOMER
NUMBER
Under penalty of perjury, I do swear and affirm that the information contained in this application is true
and correct and that applicant will abide by all laws of Florida, including Chapters 319 and 320, Florida
SITE INSPECTION
Statutes, and all applicable rules, and procedures of the Department of Highway Safety and Motor Vehicles.
NUMBER
I further certify that I am authorized to bind the application with my signature.
Zone #:
Officer’s Signature
Printed or Typed Name and Title
Date
Insp #:
HSMV 86072 (6/20)
STATE OF FLORIDA
DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
PLEASE SUBMIT THIS APPLICATION TO THE REGIONAL OFFICE RESPONSIBLE FOR
YOUR DEALERSHIP
MODIFICATION TO DEALER LICENSE FOR
Entered by:
LICENSED MOTOR VEHICLE, MOBILE HOME, OR
RECREATIONAL VEHICLE DEALERS
Approved by:
Do not use white out or correction tape on this modification form.
Office Use Only
Current License No.:
LICENSE
Licensee Name:
I hereby request the following modifications to my current dealer license:
(Please check and answer all application choices that apply)
ISSUE DATE
PIN Number:
Telephone Number: Office:
Cell:
ETR Providers:
Business E-mail Address:
DATE RECEIVED IN
Recreational Vehicle Endorsement (DH License Only)
Add
Delete
REGIONAL OFFICE
New RV Endorsement
New and Used RV Endorsement
Used RV Endorsement
Add Location:
Selling RV
Used Vehicles Only
New and Used Vehicles
Selling Park Models
DATE COMPLETED
Physical Address:
IN REGIONAL
OFFICE
Mailing Address:
Leased
Owned
Date:
Change of Location:
DATE MAILED TO
Old Address:
HEADQUARTERS
New Address:
Mailing Address:
DATE RECEIVED IN
Leased
Owned
Date:
DEALER LICENSE
Licensee Name Change
d/b/a Name change
SECTION
Former Name:
New Name:
AMOUNT
Deleting Line-Make(s):
Adding Line-Make(s):
Existing Line-Make(s):
CHECK
If you are adding or deleting line-make(s) from your license, please list all line-makes you are currently authorized to sell.
Change of Mailing Address:
CHECK NUMBER
Old Address:
New Address:
CASH
Change of Supplemental Location to Primary Location (where old primary location is closed)
CREDIT CARD
Change of Supplemental Location to Primary Location and Change of Primary Location to
Supplemental Location (where primary and supplemental locations remain open)
PAYMENT NUMBER
New Primary Location Address:
New Supplemental Location Address:
Postal Address Update:
Add
Delete
Park Trailer Endorsement (DH License Only)
FRVIS CUSTOMER
NUMBER
Under penalty of perjury, I do swear and affirm that the information contained in this application is true
and correct and that applicant will abide by all laws of Florida, including Chapters 319 and 320, Florida
SITE INSPECTION
Statutes, and all applicable rules, and procedures of the Department of Highway Safety and Motor Vehicles.
NUMBER
I further certify that I am authorized to bind the application with my signature.
Zone #:
Officer’s Signature
Printed or Typed Name and Title
Date
Insp #:
HSMV 86072 (6/20)
Completion Guidelines for Dealer License Applicants to
Modify Their Existing License, Form HSMV 86072
PLEASE SUBMIT THIS APPLICATION TO THE REGIONAL OFFICE RESPONSIBLE FOR YOUR DEALERSHIP
Modifications are requested only by dealers who are already licensed by the Department.
Correct modification box must be checked by the licensed applicant if they are submitting an
application to modify certain information on their license.
Do not use white out or correction tape on this form.
A copy of the driver license of a corporate officer of the dealership must be submitted with
the application for all modifications to a license. The following documents are required by
the Department for modifications to an existing license:
PIN REQUESTS
If a dealer’s confidential PIN number is lost, stolen or misplaced an officer or director of the
company will need to request a new confidential PIN number by selecting the PIN number
category.
• Complete form HSMV 86072, Modification to Dealer License for Licensed Motor
Vehicle, Mobile Home, or Recreational Vehicle Dealers;
• A letter on letterhead from the dealership requesting the confidential PIN number
changed and why the change is needed.
• A Current copy of the Driver License of the person requesting the change.
There is no fee for this transaction. The confidential PIN number will be changed in the Dealer
License Section in Tallahassee. The confidential PIN number will then be mailed to the
applicant.
RECREATIONAL VEHICLE ENDORSEMENT
If an existing Mobile Home dealer requests to add or delete a new or used recreational vehicle
endorsement the following items are needed to complete the transaction. There is no fee for this
transaction.
NEW
• Complete form HSMV 86072, Modification to Dealer License for Licensed
Motor Vehicle, Mobile Home, or Recreational Vehicle Dealers;
• An agreement with the recreational vehicle manufacturer, importer, or distributor of the
models the dealer wants to sell.
USED
• Complete for HSMV 86072, Modification to Dealer License for Licensed Motor
Vehicle, Mobile Home, or Recreational Vehicle Dealers;
SUPPLEMENTAL LOCATION ESTABLISHMENT (Add Location)
Documents required for supplemental location establishment for a licensed independent
dealer (VI), wholesale dealer (VW), salvage dealer (SD) and auctions (VA):
Completed form HSMV 86072, Modification to Dealer License for Licensed Motor
Vehicle, Mobile Home, or Recreational Vehicle Dealers;
True copy of lease agreement/proof of ownership or property tax;
A copy of the original Surety Bond, Irrevocable Letter of Credit, or an original
continuation certificate in the amount of $25,000 for the licensing period that was
submitted with the primary location;
A copy of the garage liability insurance certificate which shall include, at a minimum,
$25,000 combined single-limit liability coverage including bodily injury and property
damage protection and $10,000 personal injury protection; OR A general liability
insurance policy coupled with a business automobile policy, which shall include, at a
minimum, $25,000 combined single-limit liability coverage including bodily injury and
property damage protection and $10,000 personal injury protection that was submitted
with the primary location;
Please Note: Salvage Dealers (SD) are exempt from Garage Liability Insurance
Requirements.
Surety Bond Rider (If the supplemental location has a new fictitious name);
Division of Corporations registration if a fictitious name is going to be added to the
supplemental location;
Fee $50 for the supplemental location. and
A copy of the driver license of a corporate officer of the dealership.
Documents required for supplemental location establishment for licensed Mobile Home
Dealers (DH), Mobile Home Brokers (BH), and Recreational Vehicle Dealers that sell Used
Recreational Vehicles (RU):
Completed form HSMV 86072, Modification to Dealer License for Licensed Motor
Vehicle, Mobile Home, or Recreational Vehicle Dealers;
True copy of Lease agreement/proof of ownership or property tax;
Mobile home dealers must submit a copy of the original Surety Bond, Irrevocable Letter
of Credit, or an original continuation certificate in the amount of $25,000 for the
licensing period that was submitted with the primary location;
Please note: Mobile home dealers with more than four supplemental locations must
submit an original surety bond, original irrevocable letter of credit, or original
continuation certificate in the amount of $50,000;
Recreational Vehicle Dealers must submit copy of surety bond or original continuation
certificate in the amount of $10,000 for the licensing period that was submitted with the
primary location with primary location.
Please Note: Recreational vehicle dealers with more than four supplemental locations
must submit an original surety bond or original continuation certificate in the amount of
$20,000;
Recreational vehicle dealers must submit a copy of the Garage Liability Certificate at a
minimum of $25,000 combined single limit liability coverage including bodily injury and
property damage protection and $10,000 personal injury protection that was submitted
with the primary location;
Mobile home dealers and mobile home brokers that sell recreational vehicles must submit
a copy of the Garage Liability Certificate at a minimum of $25,000 combined single limit
liability coverage including bodily injury and property damage protection and $10,000
personal injury protection that was submitted with the primary location;
Mobile Home dealers which sell park trailers are exempt from submitting garage liability
insurance coverage.
Surety Bond Rider (If the supplemental location has a new fictitious name);
Division of Corporations registration if a fictitious name is going to be added to the
supplemental location;
Fee of $50 for the supplemental location. And
A copy of the driver license of a corporate officer of the dealership.
Documents required for supplemental location establishment for recreational vehicle
dealers that sell new Recreational Vehicles (RV):
Completed form HSMV 86072, Modification to Dealer License for Licensed Motor
Vehicle, Mobile Home, or Recreational Vehicle Dealers;
Manufacturers letter of approval if the supplemental location is going to sell new
recreational vehicles;
True copy of lease agreement/proof of ownership or property tax;
A copy of the original surety bond or an original continuation certificate in the amount of
$10,000 for the licensing period that was submitted with the primary location;
Please Note: Recreational vehicle dealers with more than four supplemental locations
must submit an original surety bond or original continuation certificate in the amount of
$20,000;
A copy of the Garage Liability Certificate at a minimum of $25,000 combined single
limit liability coverage including bodily injury and property damage protection and
$10,000 personal injury protection that was submitted with the primary location;
Surety Bond Rider (If the supplemental location has a new fictitious name);
Division of Corporations registration if a fictitious name is going to be added to the
supplemental location;
Fee of $50 for the supplemental location; and
A copy of the driver license of a corporate officer of the dealership.
PLEASE NOTE: Mobile home dealers with more than four supplemental locations must submit
an original surety bond, original irrevocable letter of credit, or original continuation certificate in
the amount of $50,000.
Recreational vehicle dealers with more than four supplemental locations must submit an original
surety bond or original continuation certificate in the amount of $20,000.
Documents required for supplemental location establishment for a licensed franchise
dealer (VF) if exemption(s) or no exemption(s) under section 320.642, Florida Statutes, is
claimed:
Completed form HSMV 86072, Modification to Dealer License for Licensed Motor
Vehicle, Mobile Home, or Recreational Vehicle Dealers;
Manufacturers letter of approval if the supplemental location is going to sell new line-
make(s);
Final order from the Department if the supplemental location is going to sell new line-
make(s);
True copy of Lease agreement/proof of ownership or property tax;
Fee of $50;
A copy of the original Surety Bond, Irrevocable Letter of Credit or an original
continuation certificate in the amount of $25,000 for the licensing period that was
submitted with the primary location;
A copy of the Garage Liability Certificate at a minimum of $25,000 combined single
limit liability coverage including bodily injury and property damage protection and
$10,000 personal injury protection that was submitted with the primary location;
Surety Bond Rider (If the supplemental location has a new fictitious name). and
A copy of the driver license of a corporate officer of the dealership.
CHANGE OF LOCATION
Documents required for change of location for a licensed independent dealer (VI),
wholesale dealer (VW), salvage dealer (SD) and auctions (VA):
Completed form HSMV 86072, Modification to Dealer License for Licensed Motor
Vehicle, Mobile Home, or Recreational Vehicle Dealers;
A copy of the garage liability insurance certificate with the new address which shall
include, at a minimum, $25,000 combined single-limit liability coverage including bodily
injury and property damage protection and $10,000 personal injury protection; OR A
general liability insurance policy coupled with a business automobile policy, which shall
include, at a minimum, $25,000 combined single-limit liability coverage including bodily
injury and property damage protection and $10,000 personal injury protection that was
submitted with the primary location;
Please Note: Salvage Dealers (SD) are exempt from Garage Liability Insurance
Requirements.
True copy of lease agreement/proof of ownership or property tax;
Original license or affidavit from dealer if license is lost;
Fee of $50; and
A copy of the driver license of a corporate officer of the dealership.
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