AUGUST 2009 MOTOR VEHICLE AND DRIVER LICENSE FORMS MOTOR VEHICLE FORMS * AFTER A FORM # MEANS IT IS AVAILABLE ON THE INTERNET TO COMPLETE OR DOWNLOAD FORM EDITION NUMBER FORM NAME DATE MV-1 APPLICATION FOR CERTIFICATE OF TITLE... 8-08 MV-1L* APPLICATION FOR LESSEE INFORMATION... 8-07 MV-1S* SCHOOL BUS/SCHOOL VEHICLE USE APPLICATION... 1-04 MV-2* MV-3* MV-4ST MOTOR-HOME CERTIFICATE OF COMPLIANCE FOR VAN MINIVAN VEHICLES... 8-07 MOTOR VEHICLE VERIFICATION OF FAIR MARKET VALUE BY THE ISSUING AGENT... 8-08 PENNSYLVANIA VEHICLE SALES AND USE TAX RETURN/APPLICATION FOR REGISTRATION... 7-07 MV-6* APPLICATION FOR NON-REPAIRABLE OR SALVAGE CERTIFICATE... 4-09 MV-6SV* MV-7* INSURANCE COMPANY APPLICATION FOR CERTIFICATE OF SALVAGE FOR STOLEN VEHICLE... 2-03 SALVAGE DEALER/SCRAP PROCESSOR BUSINESS REPORT OF VEHICLES CONSIDERED SCRAP MATERIAL & NOT TO BE TITLED FOR RECONSTRUCTED -... 12-08 MV-8* SELF CERTIFICATION FOR PROOF OF RESIDENCY... 7-07 MV-9* MV-11* COMPLIANCE OR EXEMPTION FOR THE PENNSYLVANIA CLEAN VEHICLES PROGRAM... 5-09 APPLICATION FOR PERMANENT ANTIQUE, CLASSIC OR COLLECTIBLE REGISTRATION PLATE... 6-09 MV-13ST* AFFIDAVIT OF GIFT... 4-09 MV-14EV* APPLICATION FOR EMERGENCY VEHICLE REGISTRATION PLATE... 8-08 MV-16* APPLICATION FOR CANCELLATION OF CERTIFICATE OF TITLE -... 8-08 MV-27* DEALER ASSIGNMENT COVERING A VEHICLE REQUIRED AND HELD FOR RESALE. 4-05 MV-27A* MV-27B* MV-37* MV-38A* MV-380* WEEKLY NOTIFICATION OF DEALER ACQUISITION COVERING VEHICLES ACQUIRED FOR RESALE FROM ANOTHER DEALER OR MANUFACTURER... 12-07 WEEKLY NOTIFICATION OF DEALER ACQUISITION COVERING VEHICLES ACQUIRED FOR RESALE FROM AN INDIVIDUAL (NON-DEALER)... 12-07 APPLICATION FOR LIEN HOLDER AUTHORIZATION TO PARTICIPATE IN THE DEPARTMENT S ELECTRONIC LIEN AND TITLE SYSTEM... 4-09 AUTHORIZATION TO PRINT TITLE AND RELEASE TO DEALER/OWNER AT DEALER AUCTION... 9-08 APPLICATION FOR DUPLICATE CERTIFICATE OF TITLE BY OWNER... 8-08 1
MV-38D* APPLICATION FOR DUPLICATE CERTIFICATE OF TITLE BY A REGISTERED DEALER... 9-03 MV-38L* MV-39* MV-41* LIEN HOLDER S APPLICATION FOR DUPLICATE TITLE OR TO RECORD, RENEW, REMOVE A LIEN, OR TO CORRECT LIEN INFORMATION... 5-05 NOTIFICATION OF ASSIGNMENT/CORRECTION OF VEHICLE TITLE UPON DEATH OF OWNER... 7-97 APPLICATION FOR CORRECTION OR CHANGE OF VEHICLE RECORD OR VERIFICATION OF VEHICLE IDENTIFICATION NUMBER... 10-08 MV-41A* APPLICATION FOR CORRECTION OR CHANGE OF NAME... 8-07 MV-44* APPLICATION FOR DUPLICATE REGISTRATION CARD, TRANSFER OF REGISTRATION PLATE OR REPLACEMENT OF REGISTRATION PLATE, RENEWAL OR CLASS STICKER... 1-09 MV-63* NOTIFICATION OF CHANGE OF ADDRESS... 6-09 MV-70S* BUREAU OF MOTOR VEHICLE - SCHEDULE OF FEES -... 2-06 MV-77* MV-90 MV-91 MV-120 APPLICATION FOR FARM VEHICLE REGISTRATION PLATE OR FOR FARM VEHICLE 2 YEAR CERTIFICATE OF EXEMPTION... 11-06 SURRENDER OF REGISTRATION PLATE TO A DECENTRALIZED MESSENGER AGENT... 1-04 APPLICATION FOR REPLACEMENT OF PLATE AFTER A VOLUNTARY SURRENDER OF PLATE BY OWNER... 1-04 TEMPORARY REGISTRATION PLATE CERTIFICATE OF TEMPORARY TRANSFER CARD... 10-08 MV-125* DISCREPANCY CORRECTION ROUTING SHEET... 12-08 MV-127 BUSINESS UNIT DIVIDER... 7-08 MV-140* REQUEST FOR REGISTRATION RENEWAL... 8-08 MV-140SV* APPLICATION FOR SEASONAL VEHICLE REGISTRATION RENEWAL... 2-08 MV-141* RETURNED REGISTRATION PLATE... 1-03 MV-145* APPLICATION FOR PERSON WITH A DISABILITY OR HEARING IMPAIRED REGISTRATION PLATE OR A PERSON WITH A DISABILITY MOTORCYCLE PLATE PLATE... 2-08 MV-145A* PERSON WITH A DISABILITY PARKING PLACARD APPLICATION... 5-09 MV-145V* MV-150* APPLICATION FOR DISABLED VETERAN, SEVERELY DISABLED VETERAN REGISTRATION PLATE OR SEVERELY DISABLED VETERAN MOTORCYCLE PLATE DECAL... 8-08 APPLICATION FOR SPECIAL U.S. MILITARY VETERAN REGISTRATION PLATE... 2-08 MV-161* VEHICLE INQUIRY ACCESS AUTHORIZATION... 7-06 2
MV-162* MV-190* APPLICATION FOR UNCLAIMED REGISTRATION CARD, LICENSE PLATE, RENEWAL STICKER, WEIGHT CLASS STICKER, CERTIFICATE OF TITLE OR CERTIFICATE OF SALVAGE (FOR BONDED MESSENGER USE ONLY)... 6-09 COMMERCIAL IMPLEMENT OF HUSBANDRY OR IMPLEMENT OF HUSBANDRY SUPPLEMENTAL APPLICATION... 3-02 MV-217* APPLICATION FOR CERTIFICATE OF TITLE AFTER DEFAULT BY OWNER -... 3-03 MV-217A* APPLICATION FOR FINANCIAL INSTITUTION FOR CERTIFICATE OF TITLE AFTER DEFAULT BY OWNER... 1-09 MV-221* STATEMENT OF NON-OPERATION OF VEHICLE(S)... 9-07 MV-349 MV-351* MV-351A* MV-353* MV-359* MV-371* APPLICATION FOR VEHICLE DEALER REGISTRATION PLATES FOR DEALERS LICENSED BY DEPARTMENT OF STATE... 2-07 APPLICATION FOR TEMPORARY REGISTRATION PLATES BY MOTOR VEHICLE DEALERS AND FULL AGENTS... 2-09 APPLICATION FOR REPLACEMENT OF TEMPORARY REGISTRATION PLATES... 3-03 APPLICATION FOR REPLACEMENT OF DEALER OR MISCELLANEOUS MOTOR VEHICLE BUSINESS REGISTRATION PLATE, CARD OR RENEWAL STICKER... 1-07 APPLICATION FOR MISCELLANEOUS MOTOR VEHICLE BUSINESS REGISTRATION PLATES... 3-09 APPLICATION FOR RETIRED PERSON S $10.00 PROCESSING FEE OF A VEHICLE REGISTRATION... 9-07 MV-402* APPLICATION FOR SUN SCREENING CERTIFICATE OF EXEMPTION... 2.08 MV-421* MV-426B* EMISSION INSPECTION AND MAINTENANCE (I/M) PROGRAM VERIFICATION... 1-04 MV-426B APPLICATION FOR RECONSTRUCTED, SPECIALLY CONSTRUCTED, COLLECTIBLE, MODIFIED, FLOOD, RECOVERED THEFT VEHICLES AND STREET RODS... 8-08 MV-511B* REQUISITION FOR DRIVER/VEHICLE FORMS... 4-08 MV-511M* ON-LINE MESSENGER ORDER FORM... 4-03 MV-549* APPLICATION FOR REGISTRATION FEE EXEMPTION... 6-99 MV-550* APPORTIONED REGISTRATION APPLICATION - SCHEDULE A... 6-07 MV-550A* APPORTIONED SCHEDULE FOR NEW ACCOUNT... 3-07 MV-551* APPORTIONED REGISTRATION APPLICATION SCHEDULE B... 12-06 MV-552A* APPORTIONED REGISTRATION SUPPLEMENT APPLICATION... 1-05 MV-555* PENNSYLVANIA APPORTIONED REGISTRATION APPLICATION... 3-09 MV-558* REPLACEMENT OF APPORTIONED REGISTRATION APPLICATIONS... 3-07 MV-590* 20 DAY HUNTER PERMIT... 4-08 MV-670* APPLICATION TO ESTABLISH A FLEET ACCOUNT... 3-01 3
MV-671 REPLACEMENT OF FLEET REGISTRATION CREDENTIALS... 8-01 MV-673* FLEET REGISTRATION SUPPLEMENT APPLICATION... 8-01 MV-674* APPLICATION TO CHANGE INFORMATION ON FLEET ACCOUNT OR FLEET VEHICLE... 01-02 MV-700* APPLICATION FOR REFUND... 4-09 MV-904* APPLICATION FOR SPECIAL REGISTRATION PLATE... 4-09 MV-910* APPLICATION FOR SPECIAL PA STEELWORKER REGISTRATION PLATE... 2-08 MV-911* APPLICATION FOR SPECIAL FUND LICENSE PLATE... 2-08 MV-912* APPLICATION FOR GOLD STAR FAMILY REGISTRATION PLATE... 2-08 MV-913* APPL. FOR VICTORY JUNCTION (NASCAR) REGISTRATION PLATE... 4-09 MV-950* NOTIFICATION OF ASSIGNMENT OF SECURED INTEREST IN A VEHICLE -... 9-08 MV-950A* MV-1005* NOTIFICATION OF ASSIGNMENT OF SECURED INTEREST IN A VEHICLE TO A DEALER... 9-08 REQUEST FOR OPTIONAL REGISTRATION AT A WEIGHT EXCEEDING THE GVWR... 8-05 VR REJECTION/TRANSMITTAL SHEET FOR INSURANCE SUSPENSIONS... NON-COMMERCIAL DRIVER LICENSE FORMS DL-1AOL* ACKNOWLEDGMENT OF OUT-OF-STATE LICENSE STATUS... 4-01 No Date DL-5* MOTORCYCLE LEARNER S PERMIT APPLICATION TO ADD/EXTEND/REPLACE CHANGE/CORRECT... 8-08 DL-6* TEN-YEAR HISTORY INFORMATION... 2-07 DL-13* INITIAL REPORTING FORM... 7-09 DL-15* OCCUPATIONAL LIMITED LICENSE INSTRUCTIONS AND PETITION -... 1-09 DL-15A* LIMITED LICENSE AFFIDAVIT... 1-09 DL-16LC* ACKNOWLEDGMENT OF SUSPENSIONS/REVOCATION/DISQUALIFICATION AS REQUIRED UNDER SECTION 1541 OF THE VEHICLE CODE... 2-07 DL-17* STATEMENT OF NON-OWNERSHIP OF VEHICLE(S)... 2-07 DL-20* PROBATIONARY LICENSE (PL) PETITION... 12-08 DL-21SC* SELF-CERTIFICATION OF VEHICLE(S) OWNED/OPERATED... 4-07 DL-31* APPLICATION TO ADD/EXTEND/REPLACE/CHANGE/CORRECT NON-COMMERCIAL LEARNER S PERMIT... 7-08 DL-31OLL* APPLICATION TO EXTEND AN OCCUPATIONAL LIMITED LICENSE... 12-08 DL-54B* APPLICATION FOR CHANGE/CORRECTION/REPLACEMENT OR RENEWAL OF 4
PENNSYLVANIA IDENTIFICATION CARD... 12-08 DL-58EF* DL-59* DL-80* DL-80OP* APPLICATION FOR REPLACEMENT OF A VALID WITHOUT PHOTO LICENSE WITH A PHOTO LICENSE UPON RETURN OF THE DRIVER TO PENNSYLVANIA... 1-09 APPLICATION FOR CHANGE FROM JUNIOR DRIVER S LICENSE TO A REGULAR NON-COMMERCIAL LICENSE... 12-08 APPLICATION FOR CHANGE/CORRECTION/REPLACEMENT OF NON- COMMERCIAL DRIVER S LICENSE, LEARNER S PERMIT OR CAMERA CARD... 12-08 APPLICATION FOR CHANGE/CORRECTION/REPLACEMENT OF OCCUPATIONAL LIMITED LICENSE (OLL) OR PROBATIONARY LICENSE (PL)... 12-08 DL-81* NON-DRIVER PHOTO IDENTIFICATION CARD - APPLICATION FOR PENNSYLVANIA DRIVERS... 12-08 DL-82* OUT-OF-STATE ADDRESS EXEMPTION... 1-09 DL-100* DL-100A* REQUEST FOR VOLUNTARY SURRENDER OF DRIVER S LICENSE OR LEARNER S PERMIT... 4-09 REQUEST FOR CANCELLATION OF DRIVER S LICENSE OR LEARNER S PERMIT... 4-09 DL-102* REPORT OF EYE EXAMINATION... 3-09 DL-125EXP MESSENGER DISCREPANCY SUBMITTAL SHEET... No date DL-130* REQUEST FOR LETTER OF CLEARANCE... 2-07 DL-135* REQUEST FOR VEHICLE INFORMATION... 8-08 DL-143* NON-COMMERCIAL DRIVER S LICENSE RENEWAL APPLICATION... 12-08 DL-143PL* PROBATIONARY LICENSE (PL) RENEWAL APPLICATION... 12-08 DL-176* MILITARY STATUS ENDORSEMENT CARD APPLICATION FOR PENNSYLVANIA DRIVER S LICENSE... 4-09 DL-180* NON-COMMERCIAL LEARNER S PERMIT APPLICATION... 12-08 DL-180C* PARENT/GUARDIAN CERTIFICATION FORM... 7-08 DL-180RCD* APPLICATION FOR PENNSYLVANIA COMMERCIAL DRIVER S LICENSE BY OUT-OF-STATE CDL DRIVER... 7-09 DL-180TD* PARENT/GUARDIAN CONSENT FORM... 6-08 DL-201* CERTIFICATE OF MOTOR VEHICLE JUDGMENT... 4-08 DL-288* HAZARDOUS MATERIALS ENDORSEMENT... 9-08 DL-298* SERVICEPERSON REQUEST FOR NON-COMMERCIAL PENNSYLVANIA DRIVER S LICENSE... 3-09 DL-503* REQUEST FOR DRIVER INFORMATION... 8-08 DL-3731* APPLICATION FOR IGNITION INTERLOCK LICENSE/RETURN OF REGULAR 5
DRIVER LICENSE... 12-08 DL-3805* IGNITION INTERLOCK EMPLOYMENT EXEMPTION AFFIDAVIT... 8-05 DL-601MRT MESSENGER REJECTION/TRANSMITTAL SHEET (HALF SHEET)... 5-02 DL-6114A AUTHORIZATION FOR RELEASE OF DRIVER RECORD INFORMATION... 9-08 DL-8611* REQUEST FOR ORGAN DONOR DESIGNATION ON PENNSYLVANIA DRIVER S LICENSE OR PHOTO ID CARD... 2-07 COMMERCIAL DRIVER LICENSE FORMS DL-31CD* COMMERCIAL LEARNER S PERMIT APPLICATIONS... 5-09 DL-80CD* DL-100CD* APPLICATION TO REPLACE/CORRECT COMMERCIAL DRIVER S LICENSE... 12-08 APPLICATION FOR REVISION OR RETURN OF CDL CLASSIFICATION... 12-08 DL-143CD* COMMERCIAL DRIVER S LICENSE RENEWAL APPLICATION... 12-08 DL-143PL* PROBATIONARY LICENSE (PL) RENEWAL APPLICATION... 12-08 DL-398* MILITARY COMMERCIAL DRIVER S LICENSE (CDL) SKILLS TEST WAIVER APPLICATION... 3-09 OTHER FORMS * NOTARY PUBLIC APPLICATION -... 5/17/07 * ORM-1DL - FRAUDULENT MISUSE OF ID/DRIVER S LICENSE CREDENTIALS... 1-06 * ORM-1VR - FRAUDULENT MISUSE OF MOTOR VEHICLE CREDENTIALS... 1-06 MESSENGER SUBMITTAL/REJECTION SHEET FOR RETURN CHECK CASES -... VR REJECTION/TRANSMITTAL SHEET FOR INSURANCE SUSPENSIONS... 2-03 AUTHORIZATION FOR USERID, SIGN-ON FOR DL & C AND/OR BMV CARATS SYSTEMS... 6 No Date NO DATE * H1105F - BIRTH CERTIFICATE....8-07 PUBLICATIONS PUB95* PENNSYLVANIA DRIVER S MANUAL... 5-09 PUB95S* PENNSYLVANIA DRIVER S MANUAL (SPANISH EDITION)... 12-08 PUB117* PENNSYLVANIA SCHOOL BUS DRIVER S MANUAL... 5-08 PUB 147* MOTORCYCLE OPERATOR MANUAL... 9-07 PUB 223* COMMERCIAL DRIVER S MANUAL... 9-06 PUB 265* COMMERCIAL DRIVER MANUAL (SPANISH VERSION)... 8-06 PUB 288* HAZARDOUS ENDORSEMENT RENEWAL MANUAL... 9-06 PUB 457* AGENT SERVICE HANDBOOK... 6-06 PUB 458* REQUIREMENTS FOR A MISCELLANEOUS DEALER... 11-08 PUB 460* SALVOR MANUAL... 3-07 PUB 463* CARD AGENT PACKET... 6-08 PUB 479* FLEET REGISTRATION INSTRUCTION MANUAL... 2-08 PUB 490* MOTORCYCLE OPERATOR MANUAL (SPANISH VERSION)... 9-07
PUB 612* MESSENGER MANUAL... 6-08 DEPARTMENT OF REVENUE FORM REV-65BA+* PETITION FORM (REFUND FORM)... 12-08 REV-227LE+* PENNSYLVANIA SALES AND USE TAX CREDIT CHART... 7-08 7