Application For Motor Vehicle Repair Business Form - Miami-Dade County Page 2
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1
2
3Please answer yes or no to the following questions:
Yes
No
Have you or any partners or corporate officers, as applicable, ever failed to comply with the terms of a cease
and desist order, notice to correct a violation, written assurance of compliance, or any other lawful order of the
Miami-Dade County Consumer Protection Division with regard to the operation of a Motor Vehicle Repair
Business? If yes, please provide details on a separate sheet.
Yes
No
Do you owe money to Miami-Dade County, either individually or through any other business? (Unpaid Liens, etc.)
If yes, please provide details on a separate sheet.
Please answer the following question:
List the names of any other corporation, entity, or trade name through which any owner, director or officer has engaged in the
motor vehicle repair business within the past 5 years:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Person Actively in Charge of the Shop:
Name: ______________________________
Title: ____________________________
Home Address: ____________________________
City/State/Zip: _______________________
Home Phone Number: (___)____-_________
Mobile Number: (___) ____-_______
REPAIR CATEGORIES APPLIED FOR
*** Business is required to employ certified mechanics/technicians that are certified in each category of repair
checked off
AUTOMOBILE, LIGHT TRUCKS
HEAVY DUTY TRUCKS OVER
AND TRAILER REPAIRS ***
10, 000 GVW REPAIRS ***
OTHER / MINOR REPAIRS
Engine Repair
Truck Engine Repair - Gasoline
Motorcycle Repairs
Automatic Transmission
Truck Engine Repair - Diesel
Recreational Trailer Repair
Manual Transmission
Truck Drive Train
Oil Change Only
Glass Installation
Front-End (Suspension & Steering)
Truck Brake Repair
Muffler Installation Only
Brake Repair
Truck Suspension & Steering
Electrical & Electronic Systems
Truck Electrical Systems
Tire Installation Only
Alarm/Radio Installation Only
Heating & Air Conditioning
COLLISION & PAINT REPAIRS ***
Window Tinting
Engine Performance (Tune-Ups)
Structural Repairs (Body & Collision)
Vehicle Upholstery
Painting & Refinishing
Vehicle Graphics & Wraps
Non-Structural Repairs
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