Get Form 96 0506 Ignition Interlock Arizona

Filling out the Form 96 0506 Ignition Interlock in Arizona online is essential for those seeking to apply for an ignition interlock installer application. This guide provides you with clear and detailed instructions to ensure a smooth completion process.

Follow the steps to complete the ignition interlock installer application.

1. Press the ‘Get Form’ button to acquire the form and access it in the online editor.
2. Begin by filling out the 'Company Name' section with the official name of your business.
3. Insert the 'Application Date' in the format of month/day/year to indicate when you are submitting the form.
4. Provide the 'Street Address' where your business is located, followed by the 'City,' 'State,' and 'Zip' code.
5. If your mailing address differs from your business address, complete the 'Mailing Address' section with the necessary details.
6. Select your 'Business Type' by indicating whether you are an Individual, Partnership, Corporation, or LLC.
7. Fill in the 'Contact Person Name' with the first, middle, and last name of the person who will be the primary contact for the application.
8. Enter the 'Phone Number' and 'Fax Number' where you can be reached.
9. In the 'Ignition Interlock Device Model Number' section, indicate the model and the name under which the device will be marketed.
10. Provide the name, date of birth, and title of the applicant or appropriate person associated with the application.
11. Complete the 'Residence Address' with the state, city, and zip code of the applicant.
12. Certify the accuracy and completeness of the information provided by checking the respective boxes indicating your agreement.
13. Include the name and signature of the manufacturer representative, and ensure that a notary or authorized MVD agent countersigns.
14. Once all sections are completed, save your changes and consider downloading or printing the form for your records.

Complete your documents online today to ensure you meet all requirements efficiently!