Get Mv552a 2020-2024

MV-552A 12-17 Commercial Registration Section P. O. Box 68286 Harrisburg PA 17106-8286 A APPLICANT INFORMATION www. dmv*pa*gov APPORTIONED REGISTRATION SUPPLEMENT APPLICATION For Department Use Only Acct Name of Applicant Business Address City County State Zip USDOT Person to Contact Regarding Application Mailing Address TIN/EIN E-mail Address Registration Year Telephone Number B WEIGHTS q Fax Number Transfer and Transfer with Weight Increase q Correct Information/Update New Vehicle Only Increase Weight on Vehicle Originally Registered at a Lower Weight q Delete Only q Lease Buy Out PA AL AR AZ CA CO CT DC DE FL GA IA ID NC ND NE NH NJ NM NV NY OH Ok OR RI SC IL SD NB IN kS TN NF Tx C VEHICLE ADDITIONS 1 Title Unladen or Chassis Wt. NS LA UT Gross Vehicle Weight ON Gross Combination Weight Vehicle Owner Lessor Name Year Purchase Price Purchase Date UT Spec Truck q YES q NO Make q YES Body Type CO Miles Factory Price I acknowledge that I may lose my operating privilege or vehicle registration for failure to maintain financial responsibility on the currently registered vehicle for the period of registration* My signature attests to my knowledge of all applicable State and Federal Motor Carrier safety laws and regulations. My signature attests to the fact that this vehicle is a motor carrier vehicle and it has a current valid safety inspection* q NO Axles Will the designated carrier responsible for safety change during the year E INSURANCE AND ACKNOWLEDGEMENT Applicant or Authorized Signer Use one of the following designations for the Body Type BS Bus TR Tractor TK Truck Single USDOT - US Department of Transportation Number TIN/EIN - Tax Identification Number/Employee Identification Number Date MN WV Equipment Number MI WI Sk PA Registration Plate Number ME WA QC MD VT PE Vehicle Identification Number MA VA kY FUEL MO WY Seats AB Fuel Is the vehicle a wrecker D Diesel H - Hybrid MB D DELETE OR TRANSFER q DELETE q TRANSFER Current Registration Plate Number MT BC MS G Gas N - Natural Gas NAIC Insurance Company Name Policy Number Effective Date P - Propane O - Other Expiration Date Number of duplicate cab cards for each vehicle in the fleet Section A - Applicant Information Enter the apportioned account number the applicant name that appears on the apportioned account business address and mailing address if the mailing address is different than the business address. Post Office Box addresses may only be used in conjunction with a bona fide numbered street address. Post Office Box addresses alone are not permitted* The Pennsylvania Vehicle Code requires actual or bona fide addresses on applications for title and registration* Also fill in the applicant s USDOT number US Department of Transportation Number contact person TIN/EIN Tax Identification Number/Employee Identification Number e-mail address and registration year telephone number and fax number. Check the appropriate box that best describes the transaction you are requesting. Section B - Weights Enter the maximum weight of the vehicles you wish to register to your apportioned fleet in the boxes labeled for each jurisdiction* Section C - Vehicle Additions the lessee s USDOT number and TIN/EIN* A copy of the lease agreement must be submitted with this application* If a vehicle is being added to the fleet with existing Pennsylvania registration include the registration plate number in this section to obtain credit.