Get Pa Mv-511b 2014

MV-511B 12-14 www. dmv.state. pa.us REQUISITION FOR MOTOR VEHICLE FORMS AND DRIVER PUBLICATIONS DATE For Department Use Only Bureau of Motor Vehicles 1101 South Front Street Harrisburg PA 17104 1. List quantity for each form/pub needed* Please assess your form needs carefully. Over ordering results in increased costs to the commonwealth. 2. To obtain Forms MV-1 MV-4ST MV-120 authorized agents are required to place their DIN/Agent Number authorized agents notary stamp and signature or verification information in the space provided on this form* NOTE Verification information is only valid for 85-86-87 DIN numbers that also issue temporary registration plates. All other authorized agents must place a notary stamp and signature where indicated* AN AUTHORIZED AGENT IS AN AGENT UNDER CONTRACT WITH PENNDOT. To obtain Form MV-355 dealers are required to list their DIN Number. 3. Print or type name and address to which forms are to be mailed in the space provided* Be certain that the address is clear and complete. NOTE You must have a street address. P. O. Box only addresses are not accepted* FORM NO. MV-1 MOTOR VEHICLE FORMS FORM TITLE QUANTITY Application for Certificate of Title Only An Authorized Agent May Obtain UNIT OF ISSUE PUB PACK 200 2 Pack Limit PUB 95 Vehicle Sales and Use Tax Return/Application for MV-4ST Registration Only An Authorized Agent May Obtain Temporary Registration Plate or MV-120 Card Only An Authorized MV-355 Dealer Registration Permit Total Packs of Forms Ordered NOTE Orders for Forms MV-1 MV-4ST and MV-120 will not be filled without DIN/Agent Number authorized agents notary stamp and signature or verification information* Number. PLACE NOTARY STAMP HERE MAILING ADDRESS AND AGENT VERIFICATION INFORMATION DIN/AGENT NUMBER ADDRESS STATE PRINTED NAME PA Driver s Manual English Case PUB 95S PA Driver s Manual Spanish PUB 147 Motorcycle Operator Manual English PUB 223 PA CDL Manual English PUB 490 Motorcycle Operator Manual Spanish The most current PUB can be found on our website SHIPPING AND HANDLING FEE INFORMATION For Motor Vehicle forms shipping and handling fees are required* Fees are calculated per pack of forms ordered and mailed* If the order will be carried through and picked by a messenger service no shipping and handling fee is due. NOTE Shipping and Handling fees are not required on Driver License Publications. Up to 2 total packs ordered 5 3 to 4 total packs ordered 10 5 or more total packs ordered 15 Total Packs Ordered SIGNATURE PUBLICATION Please be sure to include the shipping and handling fee with your request. If no fee is included your request will not be filled* TELEPHONE NUMBER BUSINESS NAME CITY DRIVER LICENSE PUBLICATIONS ZIP Amt. List quantity for each form/pub needed* Please assess your form needs carefully. Over ordering results in increased costs to the commonwealth. 2. To obtain Forms MV-1 MV-4ST MV-120 authorized agents are required to place their DIN/Agent Number authorized agents notary stamp and signature or verification information in the space provided on this form* NOTE Verification information is only valid for 85-86-87 DIN numbers that also issue temporary registration plates. .