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County of Hawaii <br />DEPARTMENT OF FINANCE <br />Vehicle Registration & Licensing Division <br />101 Pauahi Street, Suite No. 5, Hilo, Hawaii 96720 -4224 <br />(808) 961 -8351 • (808) 961 -8330 (FAX) <br />Certificate of Motor Vehicle Dealer of <br />Used Parts and Accessories Form <br />The undersigned Motor Vehicle Dealer of Used Parts and accessories in the County of Hawaii <br />does hereby certify that there have been no changes since the last filing of an application for <br />Motor Vehicle Dealer of Used Parts and Accessories License in respect to: <br />1) Personnel of owners, partners, officers or directors <br />2) Location of offices, or principal place of business <br />3) That no proceeding is pending for the suspension or revocation of the licensee's <br />existing license <br />Business Name <br />Owner Signature <br />Print Owner Name <br />Date <br />For Office Use Only: Sequence No. New No. Issued: Previous No. <br />County of Hawai'i is an Equal Opportunity Provider and Employer. Complaints of discrimination should be sent to: <br />USDA, Director, Office of Civil Rights, Washington, DC 20250 -9410. Or call (202) 720 -5964 (Voice and TDD). <br />Last Updated 10/17/12 <br />