Form DBPR AU-4155 "Application for Auction Business Licensure" - Florida

What Is Form DBPR AU-4155?

This is a legal form that was released by the Florida Department of Business & Professional Regulation - 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 July 10, 2012;
  • The latest edition provided by the Florida Department of Business & Professional Regulation;
  • 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 DBPR AU-4155 by clicking the link below or browse more documents and templates provided by the Florida Department of Business & Professional Regulation.

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State of Florida
Department of Business and Professional Regulation
Board of Auctioneers
Application for Auction Business Licensure
Form # DBPR AU-4155
APPLICATION CHECKLIST – IMPORTANT – Submit all items on the checklist below with your
application to ensure faster processing. Always keep a copy of your application and any
supporting documents submitted to the Department.
TRANSACTION
APPLICATION REQUIREMENTS
 Pay $205 fee (make check payable to the Department of
Business and Professional Regulation)
Licensure for Auction
 Complete application
Business
 Supply documentation as requested in background
questions (if applicable)
Please mail your completed application, documentation and required fee(s) to:
Department of Business and Professional Regulation
2601 Blair Stone Road
Tallahassee, Fl 32399-0783
General Information:
Only one business owner should be listed under the Contact Information for the auction business license.
The owner listed will be responsible for all Department inquiries. This owner should also be the individual
who signs the affirmation statement at the end of the application. Pursuant to §468.382, Florida Statutes,
in order for your auction business to be granted licensure, it must be registered with the Florida
Department of State as either a sole proprietorship, partnership, or corporation.
Application Instructions
a. Section I
i.
Check application type.
b. Section II
i.
Fill out each section completely.
ii.
Applicants must furnish their current mailing address.
iii.
The “Doing Business As (D/B/A)” Name will be the actual name of the business
reflected on the license.
iv.
The Contact Information should be the owner who is responsible for the auction business
license and appropriate contact information for that individual. The owner listed in this
section should also be the individual who signs the affirmation statement at the end of the
application.
c. Section III
i.
Business ownership: Provide the name, Social Security number, address, and the
percentage of ownership for all persons holding greater than or equal to a ten percent
ownership interest in the business.
Fla. Stat. § 559.79.
ii.
The names of the business and business owner must match the information on file with
the Florida Department of State.
d. Section IV
i.
Question 1:
(1)
If you answer “yes” to this question, you must complete Section V of the application
and provide a copy of the arrest report, copies of the disposition or final order(s), and
documentation proving all sanctions have been served and satisfied. You must
supply this documentation for each occurrence. If you are unable to supply this
documentation, a certified statement from the clerk of court for the relevant
jurisdiction stating the status of records is required.
(2)
If you are still on probation, you must supply a letter from your probation officer, on
official letterhead, stating the status of your probation.
DBPR AU-4155 Application for Auction Business Licensure
Eff. Date 07/10/2012
Incorporated by Rule: 61-35.005
1 of 7
State of Florida
Department of Business and Professional Regulation
Board of Auctioneers
Application for Auction Business Licensure
Form # DBPR AU-4155
APPLICATION CHECKLIST – IMPORTANT – Submit all items on the checklist below with your
application to ensure faster processing. Always keep a copy of your application and any
supporting documents submitted to the Department.
TRANSACTION
APPLICATION REQUIREMENTS
 Pay $205 fee (make check payable to the Department of
Business and Professional Regulation)
Licensure for Auction
 Complete application
Business
 Supply documentation as requested in background
questions (if applicable)
Please mail your completed application, documentation and required fee(s) to:
Department of Business and Professional Regulation
2601 Blair Stone Road
Tallahassee, Fl 32399-0783
General Information:
Only one business owner should be listed under the Contact Information for the auction business license.
The owner listed will be responsible for all Department inquiries. This owner should also be the individual
who signs the affirmation statement at the end of the application. Pursuant to §468.382, Florida Statutes,
in order for your auction business to be granted licensure, it must be registered with the Florida
Department of State as either a sole proprietorship, partnership, or corporation.
Application Instructions
a. Section I
i.
Check application type.
b. Section II
i.
Fill out each section completely.
ii.
Applicants must furnish their current mailing address.
iii.
The “Doing Business As (D/B/A)” Name will be the actual name of the business
reflected on the license.
iv.
The Contact Information should be the owner who is responsible for the auction business
license and appropriate contact information for that individual. The owner listed in this
section should also be the individual who signs the affirmation statement at the end of the
application.
c. Section III
i.
Business ownership: Provide the name, Social Security number, address, and the
percentage of ownership for all persons holding greater than or equal to a ten percent
ownership interest in the business.
Fla. Stat. § 559.79.
ii.
The names of the business and business owner must match the information on file with
the Florida Department of State.
d. Section IV
i.
Question 1:
(1)
If you answer “yes” to this question, you must complete Section V of the application
and provide a copy of the arrest report, copies of the disposition or final order(s), and
documentation proving all sanctions have been served and satisfied. You must
supply this documentation for each occurrence. If you are unable to supply this
documentation, a certified statement from the clerk of court for the relevant
jurisdiction stating the status of records is required.
(2)
If you are still on probation, you must supply a letter from your probation officer, on
official letterhead, stating the status of your probation.
DBPR AU-4155 Application for Auction Business Licensure
Eff. Date 07/10/2012
Incorporated by Rule: 61-35.005
2 of 7
ii.
Question 2:
(1)
If you answer “yes” to this question, you must complete Section V of the application
and supply copies of the order(s) showing the disciplinary action taken against the
license, or documentation showing the status of the pending action.
e. Section V
i.
Must be completed if answered “yes” to any of the background questions in Section IV.
You must also provide the required supporting documentation per each offense and / or
question that you answered “yes” to.
ii.
Each explanation can only relate to one person and one question.
iii.
Each offense should be listed. Please use additional paper if necessary.
f.
Section VI
i.
Please read and sign the affirmation by written declaration.
ii.
If the applicant fails to sign the affirmation statement, the Department will not process the
application.
iii.
This section should be signed by the owner responsible for handling Department
inquiries.
DBPR AU-4155 Application for Auction Business Licensure
Eff. Date 07/10/2012
Incorporated by Rule: 61-35.005
3 of 7
State of Florida
Department of Business and Professional Regulation
Board of Auctioneers
Application for Auction Business Licensure
Form # DBPR AU-4155
If you have any questions or need assistance in completing this application, please contact the
Department of Business and Professional Regulation, Customer Contact Center, at 850.487.1395.
For additional information see the Instructions at the beginning of this application.
Section I – Application Type
CHECK APPLICATION TYPE
 Licensure as Auction Business [4803/1030]
Section II – Business Information
BUSINESS INFORMATION
Federal Employer ID Number/Social Security Number*
Organization/Applicant Name
Doing Business As (D/B/A) Name
Business Type (Select ONE only)
 Sole Proprietor
 Corporation or LLC  Partnership
MAILING ADDRESS
Street Address or P.O. Box
City
State
Zip Code (+4 optional)
County (if Florida address)
Country
CONTACT INFORMATION OF OWNER
Name
Primary Phone Number
Primary E-Mail Address
Alternate Phone Number
Fax Number
BUSINESS LOCATION ADDRESS
Street Address
City
State
Zip Code (+4 optional)
County (if Florida address)
Country
* The disclosure of your Social Security number is mandatory on all professional and occupational license applications, is solicited
by the authority granted by 42 U.S.C. §§ 653 and 654, and will be used by the Department of Business and Professional Regulation
pursuant to §§ 409.2577, 409.2598, 455.203(9), and 559.79(3), Florida Statutes, for the efficient screening of applicants and
licensees by a Title IV-D child support agency to assure compliance with child support obligations. It is also required by § 559.79(1),
Florida Statutes, for determining eligibility for licensure and mandated by the authority granted by 42 U.S.C. § 405(c)(2)(C)(i), to be
used by the Department of Business and Professional Regulation to identify licensees for tax administration purposes.
DBPR AU-4155 Application for Auction Business Licensure
Eff. Date 07/10/2012
Incorporated by Rule: 61-35.005
4 of 7
Section III – Business Owner Information
BUSINESS OWNERSHIP
Please list all persons with ownership greater than or equal to 10 percent.
Social Security
Name
Address
Percent
Number*
Ownership
1.
2.
3.
4.
5.
* The disclosure of your Social Security number is mandatory on all professional and occupational license applications, is solicited
by the authority granted by 42 U.S.C. §§ 653 and 654, and will be used by the Department of Business and Professional Regulation
pursuant to §§ 409.2577, 409.2598, 455.203(9), and 559.79(3), Florida Statutes, for the efficient screening of applicants and
licensees by a Title IV-D child support agency to assure compliance with child support obligations. It is also required by § 559.79(1),
Florida Statutes, for determining eligibility for licensure and mandated by the authority granted by 42 U.S.C. § 405(c)(2)(C)(i), to be
used by the Department of Business and Professional Regulation to identify licensees for tax administration purposes.
DBPR AU-4155 Application for Auction Business Licensure
Eff. Date 07/10/2012
Incorporated by Rule: 61-35.005
5 of 7
Section IV–Background Questions
BACKGROUND QUESTIONS
1.
 Yes
 No
Has any business owner ever been convicted or found guilty of, or
entered a plea of guilty or nolo contendere to, regardless of
adjudication, a crime in any jurisdiction? This question applies to any
criminal violation of the laws of any municipality, county, state or
nation, including felony, misdemeanor and traffic offenses (but not
parking, speeding, inspection, or traffic signal violations), without
regard to whether you were placed on probation, had adjudication
withheld, were paroled, or pardoned. If you intend to answer “NO”
because you believe those records have been expunged or sealed
by court order pursuant to Section 943.0585 or 943.059, Florida
Statutes, or applicable law of another state, you are responsible for
verifying the expungement or sealing prior to answering "NO."
YOUR ANSWER TO THIS QUESTION MAY BE CHECKED
AGAINST LOCAL, STATE AND FEDERAL RECORDS. FAILURE
TO ANSWER THIS QUESTION ACCURATELY MAY RESULT IN
THE DENIAL OR REVOCATION OF YOUR LICENSE. IF YOU DO
NOT FULLY UNDERSTAND THIS QUESTION, CONSULT WITH AN
ATTORNEY OR CONTACT THE DEPARTMENT.
Has any business owner ever had any license, registration, or permit
2.
 Yes
 No
to practice any regulated profession, occupation, vocation, or
business, revoked, annulled, suspended, relinquished, surrendered,
or otherwise disciplined in Florida or in any other jurisdiction, or is
any such proceeding or investigation now pending?
Section V- Explanations for Background Questions
EXPLANATION
Name this explanation relates to:
This explanation relates to question # (check one):
 1
 2
If Question 1. Offense:
If Question 2. License Type:
County:
State:
Date of Occurrence (mm/dd/yyyy):
Penalty/ Disposition/Outcome:
Have all sanctions been satisfied?
 Yes
 No
Description:
DBPR AU-4155 Application for Auction Business Licensure
Eff. Date 07/10/2012
Incorporated by Rule: 61-35.005