eBay Motors Seller Verification for Condition Guarantee by Seller Program

Please note: All applicants must have a valid State issued vehicle retail dealer license (this form is currently available for US dealers only). Steps for seller verification: Enter all information in the application form below. Please confirm that all of the information you have entered is correct and then click the ‘Submit’ button at the bottom of the page. Submitting complete and accurate information will ensure that your application will be expedited. eBay Motors will send you an automated e-mail to acknowledge acceptance of your application and to provide you with information on next steps. We will do our best to verify your information within 5-7 business days. Certain states, such as GA and MD, may take up to 14 days to verify. *All fields are required unless otherwise specified.

	Applicant Information

Title Mr.Mrs.Ms.	First name	Last name
Phone Number () -Ext.		Email
Position

	eBay Information

eBay User ID

	Dealer License Information (State)

Name of dealership as it appears on State license
D.B.A. ("Doing Business As") name, if different from above
Dealer license number	License Issuing State Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
License expiration date January February March April May June July August September October November December 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013	Type of Dealer FranchisedIndependentWholesale
Number of years in business

	General Manager / Dealer Principle Information

Title Mr.Mrs.Ms.

First name

Last name

Phone Number () -Ext.

Email

Street Address
City	State Select a State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Zip

	Other Dealership Information (optional)

If franchise dealer, name of manufacturer

If franchise dealer and part of a dealer group, name of dealer group

Number of used vehicles your dealership sells per month, on average

Number of employees at dealership

Dealership website address

Additional comments

	Terms

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