NYSecondHandDealer

Second Hand Dealer Bond Form

Call us at 800-921-1008 with any questions

Principal Information

Name of Applicant

Phone Number

Email

DBA

Billing address same as principal address?

Yes No

Address

State

Billing Address

State

Legal Structure

Note: Bond has a mandatory renewal date of 7/31/Odd Years. Premium for 2 yr. or less is $150.00. New applicants effective after February 1st. of an odd year may combo the short and 2 yr. terms to the next renewal.

Bond Amount

Number of Years

Effective Date

You will receive payment instructions via our office shortly.