Form T-241 - Application For An Out-Of-State Recreational Vehicle Franchised Dealer Permit
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Georgia Department of Revenue
Motor Vehicle Division
Application for an Out-of-State Recreational Vehicle Franchised Dealer Permit
This application for an Out-of-State Recreational Vehicle Franchised Dealer Permit and applicable fees must be
completed for each out-of-state franchised dealer by the Sponsor of the Recreational Vehicle Rally or Convention
and submitted to the Department of Revenue more than 30 days prior to the rally or convention.
Rally or Convention Sponsor:
Rally or Convention Location:
Street Address:
City:
County Name:
Zip Code:
Sponsors Phone Number(s):
E-mail:
Dates of Rally/Convention:
Sponsor affirms that the Rally or Convention has more than 2,500 registered participants.
Signature:
Date:
I am fully aware that it is a felony, punishable by imprisonment for not fewer than one (1) nor more than three (3) years or a
fine of not less than $1,000 or more than $5,000 or both, to knowingly falsify any information on this form.
Printed Name:
Position:
Address:
City:
County Name:
Zip Code:
Out of State Name and Address of Recreational Vehicle Dealer Requesting Permit: Fee: $500
Signature:
Date:
I am fully aware that it is a felony, punishable by imprisonment for not fewer than one (1) nor more than three (3) years or a
fine of not less than $1,000 or more than $5,000 or both, to knowingly falsify any information on this form.
Business Name:
Street Address:
City:
State:
Zip Code:
Phone Number:
Fax Number:
Printed Name:
Position:
Applications for each Out-of-State Recreational Vehicle Franchised Dealer may be submitted in person during business hours,
8:00 a.m. to 4:30 p.m., Monday through Friday, excluding state holidays. Mail or deliver the completed application with the
required documentation and $500.00 filing fee to:
ATTN: Dealer Registration and Permit Section GA
Department of Revenue/Motor Vehicle Division
P. O. Box 740381
ATLANTA, GA 30374-0381
Telephone: 1-855-406-5221 E-mail:
dealer.tags@dor.ga.gov
Approved
Filing Fee: $500.00 for each out of state RV Dealer
Denied
Date Received:
If denied, indicate date and reason
Form T-241
MVD last update 05/2013
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