WV DMV Dealers Request for Additional Location

All fields are required to be filled

1) Name of dealership:

2) Physical street address of dealership:

City:

State:

Zip code:

3) Dealer number:

4) Dealership telephone number:

5) Dealership fax number:

6) Start date of off-premise display/sale:

End date of off-premise display/sale:

7) Location of Display/Sale - Name of facility, street address, city, and zip code are required for the location of the off-premise display/sale

Name of facility:

Street address:

City:

Zip code:

Comments or description to explain the nature of the display/sale:

8) Your email address:

Certificate will be sent to this address

When you submit this form, the information will be transmitted to the WV DMV, and you will be taken to a page which you may print for your records only.

The OFFICIAL PERMIT will be emailed once it is approved.