Form HSMV-81401 "Manufactured/Mobile Home Installer License Application" - Florida

What Is Form HSMV-81401?

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 May 1, 2016;
  • 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 printable version of Form HSMV-81401 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 HSMV-81401 "Manufactured/Mobile Home Installer License Application" - Florida

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STATE OF FLORIDA
DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
DIVISION OF MOTORIST SERVICES
2900 APALACHEE PARKWAY,
NEIL KIRKMAN BUILDING, MS 66
TALLAHASSEE, FLORIDA 32399-0640
850/617-3004
MANUFACTURED/MOBILE HOME INSTALLER LICENSE APPLICATION
Pursuant to section 320.8249, Florida Statutes, I hereby make application for a license to install new and/or used
manufactured/mobile homes.
Original
Renewal
Change of Mailing Address
DMS USE ONLY
PRINT/TYPE
License Year
:
License Number
Name
:
Last
First
Middle Initial
Mailing Address
:
Business Phone Number
Date Issued
City
County
State
Zip Code
Physical Address (if different from above):
Bond
Driver License #
Date of Birth:
Insurance
E-Mail Address:
Taken Class
Original Application: $200.00 for Application and License Fees
Passed Exam
(If license is denied for any reason, $150 license
fee will be refunded to applicant.)
Background
Renewal Application: $150.00 for License Fee received by October 1.
(After October 1, additional $50.00 late fee charged.)
Approved/Denied
Change of Address:
No Fee
Initials
PLEASE ATTACH THE FOLLOWING ITEMS TO ORIGINAL APPLICATION
Application Fee
Original Performance Bond for Licensing Period ($5,000)
Original Certificate of Insurance ($100,000 General Liability)
Copy of your Mobile Home Installation Training Course Certificate
Date Received
Original of your Mobile Home Installer Examination Results
Mobile Home Installation Decal Order Form
Check or Money Order made payable to DHSMV for License Fees and Decals
I hereby certify by my signature that I have not been convicted or found guilty of, or enter a plea of
nolo contendere to, regardless of adjudication, a crime in any jurisdiction which directly relates to the
practice of mobile home installation or the ability to practice. That information I have provided in this
License Fee
application is true and correct. I agree to abide by all laws of Florida, including Chapter 320, Florida
Statutes and all applicable rules, policies and procedures of the Department of Highway Safety and
Motor Vehicles.
Date Received
I understand that any false information provided on this form and/or any violations of Florida Statute
320.8249 may result in disciplinary penalties imposed by the department. I further understand that I
must meet all zoning, permitting and occupational license requirements that may be mandated by city
or county ordinances.
Signature
Date
HSMV-81401 (05/16)
STATE OF FLORIDA
DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
DIVISION OF MOTORIST SERVICES
2900 APALACHEE PARKWAY,
NEIL KIRKMAN BUILDING, MS 66
TALLAHASSEE, FLORIDA 32399-0640
850/617-3004
MANUFACTURED/MOBILE HOME INSTALLER LICENSE APPLICATION
Pursuant to section 320.8249, Florida Statutes, I hereby make application for a license to install new and/or used
manufactured/mobile homes.
Original
Renewal
Change of Mailing Address
DMS USE ONLY
PRINT/TYPE
License Year
:
License Number
Name
:
Last
First
Middle Initial
Mailing Address
:
Business Phone Number
Date Issued
City
County
State
Zip Code
Physical Address (if different from above):
Bond
Driver License #
Date of Birth:
Insurance
E-Mail Address:
Taken Class
Original Application: $200.00 for Application and License Fees
Passed Exam
(If license is denied for any reason, $150 license
fee will be refunded to applicant.)
Background
Renewal Application: $150.00 for License Fee received by October 1.
(After October 1, additional $50.00 late fee charged.)
Approved/Denied
Change of Address:
No Fee
Initials
PLEASE ATTACH THE FOLLOWING ITEMS TO ORIGINAL APPLICATION
Application Fee
Original Performance Bond for Licensing Period ($5,000)
Original Certificate of Insurance ($100,000 General Liability)
Copy of your Mobile Home Installation Training Course Certificate
Date Received
Original of your Mobile Home Installer Examination Results
Mobile Home Installation Decal Order Form
Check or Money Order made payable to DHSMV for License Fees and Decals
I hereby certify by my signature that I have not been convicted or found guilty of, or enter a plea of
nolo contendere to, regardless of adjudication, a crime in any jurisdiction which directly relates to the
practice of mobile home installation or the ability to practice. That information I have provided in this
License Fee
application is true and correct. I agree to abide by all laws of Florida, including Chapter 320, Florida
Statutes and all applicable rules, policies and procedures of the Department of Highway Safety and
Motor Vehicles.
Date Received
I understand that any false information provided on this form and/or any violations of Florida Statute
320.8249 may result in disciplinary penalties imposed by the department. I further understand that I
must meet all zoning, permitting and occupational license requirements that may be mandated by city
or county ordinances.
Signature
Date
HSMV-81401 (05/16)