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Home > Licenses and Permits > MOSES > Enrollment Instructions

Instructions for Business/Corporation Agent Enrollment Applications

Section 1

  1. Please enter the name of the Agency (business), with branch or location identifier if there is more than one location.
  2. Please enter the name of the store or location manager, if different than the owner’s name. This person will be considered the Agent.
  3. If you are currently an Agent, please enter your current Agent number(s).
  4. Enter the actual physical location of the store or location (the 911 address).
  5. Please enter the Maine sales tax number for that store or location, if applicable.
  6. Please enter the correct, complete Agency mailing address.
  7. Please enter the Agency fax number.
  8. Please enter the legal town, state and country of Agency location (the municipality/state/country to which the agency pays any applicable taxes).
  9. Please enter the telephone number and extension for the Agent listed in question 2, above.
  10. Please enter Agent email address (if any) for Agent listed in question 2, above.

Section 2

  1. Please enter the name of the corporation, parent organization or complete business name.
  2. Please enter the Federal Employer Identification Number.
  3. Please enter the corporate mailing address.
  4. Please enter the name of the appropriate corporate contact, if different from the owner or responsible corporate officer.
  5. Please enter name of the business owner or responsible corporate officer.
  6. Please enter the Social Security Number of the owner or responsible corporate officer.
  7. Please enter the telephone number and extension of the corporate contact.
  8. Please enter the home address of the owner or responsible corporate officer.
  9. Please enter the date of birth of the owner or responsible corporate officer.
  10. Please enter the corporate contact fax number, if applicable.
  11. Please enter the previous address of the owner or responsible corporate officer.
  12. Please enter the telephone number and extension of the owner or responsible corporate officer.
  13. Please enter the corporate contact email address, if applicable.

Section 3

  1. Please indicate your preferred method for selling licenses/registrations. An electronic Agent will be an online MOSES Agent, may sell a wide variety of licenses and registrations, and will make weekly electronic payments. Manual Agents may sell paper check-off licenses and renewal registrations. The schedule for manual Agent payments will be based upon the volume of their sales. (See ‘Agent Agreement’ for further details.)
  2. Please indicate whether your agency (business location) is open year round, and the last day of your business week. If you are not open year round, please enter your approximate opening and closing dates. In addition, please indicate on what date you would like your inventory for the new year to be shipped to you. 
  3. Please indicate your hours of operation. If you are open 24 hours a day, 7 days a week, or Monday through Friday, 8 A.M. to 5 P.M., check the appropriate box. If not, check ‘Other’ and indicate the days and hours you are open in the table on the right.
  4. Please indicate all authority types that you would like permission to sell, subject to Department approval.

Section 4

  1. Please enter the name of your bank or credit union.
  2. Please enter the fax number of your bank or credit union.
  3. Please enter the telephone number of your bank or credit union.
  4. Please enter the mailing address of your bank or credit union.
  5. Please enter the name of the individual at your bank or credit union that should be contacted in case of billing problems.
  6. Please list the exact name shown on the bank account from which your payments will be made, and whether it is a checking or savings account.
  7. Please list the telephone number and extension of the individual named in question 32.
  8. Please enter the bank account number from which payments will be made.
  9. Please enter your bank or credit union ABA (American Bankers Association) number. (On a check, the ABA number is a nine-digit number located on the bottom left side of the check. This number uniquely identifies your banking institution.)
  10. If you will be electronically billed, please attach a VOIDED check to the application. (The pre-printed routing numbers printed on the check are used to ensure correct set-up of your electronic payments.) 

Please don't forget to sign and date your application!

Instructions for Municipal Agent Enrollment Forms

Note: If you currently have a license and a registration Agent account, please complete only one enrollment form, but list both Agent numbers in block 4.

Section 1

  1. Please enter the short name of the municipality and the position of the individual who will act as Agent for the municipality (Ex: “Augusta Town Clerk”). If ‘Other’ is chosen, please list the applicable position. (Ex: “Phillips Selectman”).
  2. Please enter the name of the individual who will be responsible for IF&W sales and act as the Agent.
  3. Please the list the physical (911) address of the office from which licenses/registrations will be sold.
  4. If you are currently an Agent, please enter your current Agent number(s).
  5. Please list the Agency mailing address.
  6. Please enter the Agency fax number.
  7. Please enter the legal town, state and country of Agency location.
  8. Please enter the telephone number and extension for the Agent listed in question 2, above.
  9. Please enter Agent email address (if any) for Agent listed in question 2, above.

Section 2

  1. Please list the full municipal name. (Example: “City of Bath”, “Town of Dexter”, etc.)
  2. Please enter the main telephone number and extension for the municipality.
  3. Please enter the municipal fax number.
  4. Please enter the name and position of the municipality’s appointing officer.
  5. Please list the telephone number and extension for appointing officer.
  6. Please list the appointing officer’s email address.
  7. Please list the contact address for the appointing officer.
  8. If you provide boat registrations and you wish to allow another municipality or organization to collect excise tax for you, please list that municipality or organization’s name and Agent number.

Section 3

  1. Please choose the method you will use for selling licenses/registrations. An electronic Agent will be an online MOSES Agent, able to sell a wide variety of licenses and registrations; a manual Agent will sell paper check-off licenses and registration renewals.
  2. Please indicate whether your Agency will service town residents only, or any consumer.
  3. Please indicate whether you will b open year round, and the last day of your business week. If you are not open year round, please enter your opening and closing dates. In addition, please indicate on what date you would like your inventory for the new year to be shipped to you. 
  4. Please indicate your hours of operation. If you are open 24 hours a day, 7 days a week, or Monday through Friday, 8 A.M. to 5 P.M., check the appropriate box.  If not, check ‘Other’ and indicate the days/hours you are open in the matrix on the right.
  5. Please indicate all authority types that you would like permission to sell, subject to Department approval.

Section 4

  1. Please circle the payment method you will use: electronic or check.  (Electronic payments may be initiated by either the Department or your municipality.)
  2. If electronic payment is chosen in number 23, please indicate whether the Agent or IF&W will initiate the payment.
  3. Please enter the name of your bank or credit union.
  4. Please enter the fax number of your bank or credit union.
  5. Please enter the telephone number of your bank or credit union.
  6. Please enter the mailing address of your bank or credit union.
  7. Please enter the name of the individual at your bank or credit union that should be contacted in case of billing problems.
  8. Please list the exact name shown on the bank account from which your payments will be made, and whether it is a checking or savings account.
  9. Please list the telephone number and extension of the individual named in question 28.
  10. Please enter the bank account number from which payment will be made.
  11. Please enter your bank or credit union ABA (American Bankers Association) number. (On a check, the ABA number is a nine-digit number located on the bottom left side of the check. This number uniquely identifies your banking institution.) 

Please don't forget to have the agent and the appointing official sign and date the application!