Form MVD-404 "Request for Duplicate Dealer License" - Maine

This version of the form is not currently in use and is provided for reference only.
Download this version of Form MVD-404 for the current year.

What Is Form MVD-404?

This is a legal form that was released by the Maine Department of the Secretary of State - a government authority operating within Maine. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2016;
  • The latest edition provided by the Maine Department of the Secretary of State;
  • 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 MVD-404 by clicking the link below or browse more documents and templates provided by the Maine Department of the Secretary of State.

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Download Form MVD-404 "Request for Duplicate Dealer License" - Maine

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Department of
the Secretary of State
Bureau of Motor Vehicles
Patty A. Morneault
Matthew Dunlap
Deputy Secretary of State
Secretary of State
David W. Guilmette
Director, Office of Investigation
& Dealer Licensing
Request for Duplicate Dealer License
(Also applies to: Auction, Loaner, Recycler, Transporter, Trailer Transit,
Manufacturer and Mobile Crusher License)
Fee: $2.00
Legal Business Name: __________________________________________________________________
DBA
: _____________________________________________________________________
(if applicable)
Physical Address: ______________________________________________________________________
(Street)
(City/Town)
(Zip)
License Number: _______________________ Phone Number: ________________________________
I hereby request a duplicate dealer license for the dealership described above. I certify that the original
was:
Lost
Stolen
Mutilated (i.e. torn, burned, spillage on license, etc.)
Please make check or money order payable to Secretary of State and mail to Bureau of Motor Vehicles,
Dealer Licensing, 101 Hospital Street, 29 State House Station, Augusta, ME 04333.
Or
Payment may be paid by credit card:
VISA
Or
MASTERCARD
Credit Card Number: ________________________________________
Application may be faxed to:
Expiration Date: ___________________________________________
(
207) 624-9126
Card Holder’s Name: _______________________________________
Signature
Official Title
Date
MVD-404 Rev 01/2016
101 Hospital Street, #29 State House Station, Augusta, Me 04333-0029 Tel. (207) 624-9000 Ext. 52143 Fax: (207) 624-9126 TTY Users call Maine relay 711
Department of
the Secretary of State
Bureau of Motor Vehicles
Patty A. Morneault
Matthew Dunlap
Deputy Secretary of State
Secretary of State
David W. Guilmette
Director, Office of Investigation
& Dealer Licensing
Request for Duplicate Dealer License
(Also applies to: Auction, Loaner, Recycler, Transporter, Trailer Transit,
Manufacturer and Mobile Crusher License)
Fee: $2.00
Legal Business Name: __________________________________________________________________
DBA
: _____________________________________________________________________
(if applicable)
Physical Address: ______________________________________________________________________
(Street)
(City/Town)
(Zip)
License Number: _______________________ Phone Number: ________________________________
I hereby request a duplicate dealer license for the dealership described above. I certify that the original
was:
Lost
Stolen
Mutilated (i.e. torn, burned, spillage on license, etc.)
Please make check or money order payable to Secretary of State and mail to Bureau of Motor Vehicles,
Dealer Licensing, 101 Hospital Street, 29 State House Station, Augusta, ME 04333.
Or
Payment may be paid by credit card:
VISA
Or
MASTERCARD
Credit Card Number: ________________________________________
Application may be faxed to:
Expiration Date: ___________________________________________
(
207) 624-9126
Card Holder’s Name: _______________________________________
Signature
Official Title
Date
MVD-404 Rev 01/2016
101 Hospital Street, #29 State House Station, Augusta, Me 04333-0029 Tel. (207) 624-9000 Ext. 52143 Fax: (207) 624-9126 TTY Users call Maine relay 711