MANUFACTURE APPLICATION CHECKLIST
OL-21 A, Application, Part A
OL-12, Application, Part C
OL-29, Personal History Question, Part B
.
Livescan DMV8016 (in-state only, call 916-657-6621 for extra forms) or
Fingerprint cards ADM 1316 (out of state only in lieu of Livescan) .Y
Corporation owned business only: Provide a copy of the following if incorporated in a
state other than California:
• Articles of Incorporation
• Certification from state's Secretary of State that the corporation is in good
standing.
Photograph of Facility
Fees
$101.00
application fee
$_ _ _ _ _ _
·l. $ 32.00
for each person w/fingerprint card
$_ __ _ __
$ 50.00
for each branch
$ 71.00
per plate for Auto/Commercial{frailer $ _ _ _ _ __
$ _ _ _ _ __
$ 73.00
per plate for Motorcycle
Check#
Total $_ _ _ _ __
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Drawing/Brochure

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Q--Emission Standards

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Approved Makes:

Optional Items Attached :
0 / List of authorized QLenfranchised dealers
[J ADM 9050

Issuance Information:
Permit Issued

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Date

Rev (12/2008)

By:

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