Zoning Letter_4240 E. 96th StreetR+r. INDIANA SECRETARY OF STATE
_ ZONING AFFIDAVIT AUTO DEALER SERVICES DIVISION
State Form 55936 (R 112-17) 302 West Washington Street, Room E-111
Indianapolis, IN 46204
Telephone: 317-234-7190
Fax: 317-233-1915
Dealers fros.in. qv
INSTRUCTIONS: 1. Complete in blue or black ink or print completed affidavit.
2. Section 1 must be completed by the applicant.
3. Section 2 must be completed by the zoning official with jurisdiction over the described real property. if no person or officer has
jurisdiction, the applicant must submit a written statement by the executive of the unit in which the real property is located
indicating that the proposed location is zoned for the operation of the business for which the applicant seeks a license.
4. The completed affidavit must be mailed, faxed, oremaifed to the Indiana Secretary of State Auto Dealer Services Division.
Your license application cannot be processed until a completed affidavit or written statement is received.
SECTION 1- TO BE COMPLETED BY APPLICANT
Name in which the Dealer license will be issued {Doing Business As (DBA) name) Legal name of the business (Buslness Entity name)
Genesis of Carmel Napleton Carmel Motors, LLC
Street Address (Proposed Business Location number and street) City Slate ZIP Code County
4240 E. 96th Street Indianapolis IN 46240 Hamilton
License Type
❑ Automobile Auction ❑ Converter Manufacturer ❑ Manufacturer
❑ Automotive Mobility i°� New or Used Dealer ❑ Transfer
❑ Automotive Salvage Racycler ❑ Distributor ❑ Watercraft
Type of Activities to lake place at the location
(Check all that apply.)
e Selling new and used vehicles
❑ Selling used vehicles ❑Selling motor vehicles to dealers located in Indiana as a distributor
usedvehicles
❑ Wrecking or dismantling vehicles for resale of their major component parts
❑ Selling I Motor Driven Cycles
❑ Selling Watercraft Motorcycles / Motor
Watercraftaft Trailers ❑ Rebuilding salvage, wrecked or dismantled vehicles
❑ Dkposfag of recydWe materials to a scrap metal processor or outer appropriate facility
❑ Selling
[I Selling ATV / UTV! Snowmobiles ❑ Adding to, subtracting from, or modifying a proviously assembled motor vehicle
[I Providing a facility for the purchase and sale of rnotor vehicles on the basis of bids (Auction)
[I Selling RVs
[I Selling Manufactured Homes ❑ Manufaclufing or assembling now motor vehicles or mn ajor componet parts
❑ Possessing two (2) or more Inoperable vehicles subject to regislratlon for more than thirty (30) days
[I Selling used major component parts of vehicles
❑ ❑ Engaging In the business of storing, disposing, salvaging or recycling of vehicles, vehicle hulks Or the
Selling adapted vehicles
❑ Title Transfer/Financlal Institution I Insurance Company parts of vehicles
Zoning (Select one of the following)
M There is a person or official charged with enforcing zoning ordinances for the above described property (must complete Section 2).
❑ There is no person or official charged with enforcing zoning ordinances for the above described property (must submit a written statement as described
in instruction #3 above).
I hereby certify, under the penalty, of perjury, that I am authorized to make this application and that the answers and information contained
in this app cation are true and co rect.
Signatu oFApp rn
Date Signed (mndddryyyy)
Printed Name of Applicant
Edward F. Napleton _
SECTION 2- TO BE COMPLETED BY ZONING OFFICIAL
I, the undersigned, swear or affirm without sfipulation that the above described property complies with local zoning ordinances or other
local ordinances for the type of business indicated above. I understand that making a false statement may constitute the crime of perjury.
Signature of Zoning Official F �
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Date (mmrddtyyyy)
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Printed Name at Zoning OfgdaI T111Y
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