Form 5110 - Application For Dealer Educational Seminar Certification

Download a blank fillable Form 5110 - Application For Dealer Educational Seminar Certification in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form 5110 - Application For Dealer Educational Seminar Certification with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

Reset Form

Print Form

MISSOURI DEPARTMENT OF REVENUE

This form must be completed

DEALER LICENSING SECTION

by a company/individual

301 W HIGH ST ROOM 370 PO BOX 43

FORM

seeking approval from the

JEFFERSON CITY MO 65105

Department of Revenue to

5110

(573) 526-3669 FAX (573) 751-4789 Dealerlic@dor.mo.gov

provide Dealer Educational

Seminars to used motor

APPLICATION FOR DEALER EDUCATIONAL

(REV. 09-2011)

vehicle dealers being

SEMINAR CERTIFICATION

licensed for the first time.

Seminar providers must be a recognized business or school with a lawful presence in the state of Missouri with demonstrable

experience in providing professional education, including consumer protection laws, to used motor vehicle dealers. Any provider

seeking approval must be able to provide tangible evidence that such requirements are met.

BUSINESS NAME (REQUIRED)

TELEPHONE (REQUIRED)

(__ __ __) __ __ __ – __ __ __ __

STREET ADDRESS (REQUIRED)

CITY

STATE

ZIP CODE

__ __ __ __ __

MAILING ADDRESS

CITY

STATE

ZIP CODE

__ __ __ __ __

E-MAIL ADDRESS (REQUIRED)

BUSINESS WEB ADDRESS (REQUIRED)

CONTACT PERSON (REQUIRED)

INSTRUCTORS – Each provider must have a minimum of two (2) instructors meeting departmental requirements. Each instructor

must meet one of the following requirements. Please attach a separate sheet of paper with the name of each

instructor and their qualifications to this application.

• Have at least two years experience in the motor vehicle dealer industry with expertise in all areas addressed in

“Contents of Seminar” listed below;

• Held a position for at least one year with a professional organization associated with the automobile

dealer business such as an instructor or a policy writer with Missouri Automobile Dealers Association or

Missouri Independent Automobile Dealers Association; or

• Have at least one year of experience as an investigator involving the compliance of state and federal motor

vehicle dealer laws.

CONTENTS OF SEMINAR – Each four hour seminar curriculum must include all Missouri dealer laws as found in Sections 301.550

to 301.573 RSMo, the rules promulgated to implement, enforce, and administer these sections and any other rules and regulations

promulgated by the Department of Revenue as well as deceptive and unfair trade practices and UCC regulations as found in other

Missouri statutes. Detailed training in compliance with the Federal Trade Commission’s Used Car Rule, federal privacy protection

requirements under the Gramm-Leach-Bliley Privacy Protection Act, the Truth in Lending Act, the Equal Credit Opportunity Act, the

USA Patriot Act, cash reporting requirements under Treasury Department rules, and all other laws, both federal and state, regulating

the business of selling and financing motor vehicles. (See more requirements on back.)

OTHER REQUIREMENTS — Seminar providers must complete the following steps after each seminar is completed.

4 Issue a certificate of course completion in the potential dealership’s name that successfully completes the seminar;

4 Maintain copies of the course completion certificates for 12 months;

4 Electronically submit the names of the persons/dealerships that have completed the seminar and the date of completion to the

Department of Revenue within five working days of completing the course; and

4 Submit a new Application for Dealer Educational Seminar Certification by September 1 of each year.

The Director may revoke or refuse to issue or renew a certification of a provider for conducting a seminar not in compliance with 12 CSR 10-26.210,

for failing to hold a scheduled seminar, or for any one or any combination of the causes outlined in 12 CSR 10-26.210. A Department representative

may attend a seminar without notice to the seminar provider.

I hereby certify that the educational seminar shall meet the requirements outlined in this application. The seminar shall include, but is not limited to the dealer

requirements of Sections 301.550 to 301.573 and the rules promulgated to implement, enforce and administer Sections 301.550 to 301.573. All information

regarding this request is true and accurate, and is made without any intent to defraud. I understand that if I fail to comply with all rules and regulations related

to dealer educational seminars, failure to hold scheduled or rescheduled seminars, or provide false information to the Director, my certification will no longer

be valid upon notice by the Director.

SIGNATURE (REQUIRED)

TITLE

DATE (REQUIRED)

__ __ / __ __ / __ __ __ __

DOR -5110 (09-2011)