Form Mv 371 PDF Details

Understanding the MV-371 form is crucial for retired individuals in Pennsylvania seeking financial relief in the vehicle registration process. This form serves as an application for a discounted $10.00 processing fee, a benefit aimed at easing the financial burden for retired citizens. To qualify, applicants must provide detailed personal information, including proof of income, such as Social Security, SSI payments, retirement benefits, pensions, and other forms of income, ensuring their total gross income does not exceed $19,200. Additionally, the form outlines eligibility criteria, clarifying that the applicant must be retired, receiving specified pension payments, and must be listed as the owner or co-owner and principal operator of the vehicle in question. The vehicle must meet specific requirements, including being a passenger car or truck with a registered gross weight of no more than 9,000 lbs. The MV-371 form also requires the applicant to certify the accuracy of the provided information under penalty of law, emphasizing the serious legal implications of any misstatements. With a clear comprehension of these stipulations, retired persons can benefit significantly from this financial concession, provided they meet the outlined criteria and submit the application correctly alongside the necessary vehicle registration forms.

QuestionAnswer
Form NameForm Mv 371
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesonline vehicle registration for retired mv 37 form download pdf mp, pa fee registered, pa mv 371 form, online vehicle tegistration for retired mv 37 form

Form Preview Example

MV-371 (6-16)

 

APPLICATION FOR A RETIRED PERSON’S $10.00 PROCESSING FEE ON A VEHICLE REGISTRATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ELIGIBILITY INFORMATION ON REVERSE

 

 

 

 

 

 

 

 

 

 

A.

 

APPLICANT’S LAST NAME

 

 

FIRST NAME

 

 

 

MIDDLE NAME

PA DL/PHOTO ID#

 

DATE OF BIRTH

 

 

 

 

 

 

 

 

STREET ADDRESS

 

 

 

 

CITY

 

 

 

 

STATE

 

ZIP

 

 

B.

 

CO-APPLICANT’S LAST NAME

 

 

FIRST NAME

 

 

 

MIDDLE NAME

PA DL/PHOTO ID#

 

DATE OF BIRTH

 

 

C.

 

TITLE NUMBER

 

 

VEHICLE IDENTIFICATION NO

 

 

 

MAKE OF VEHICLE

 

 

REGISTRATION PLATE NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INCOME INFORMATION

 

 

 

 

 

 

 

 

 

Total Gross Income During

 

the Past Calendar Year

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D.

 

. . . . . .1. SOCIAL SECURITY, SSI PAYMENTS, RETIREMENT BENEFITS

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2. PENSIONS AND ANNUITIES

 

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3. INTEREST DIVIDENDS AND CAPITAL GAINS

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4. OTHER INCOME

 

 

 

 

 

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Total. . . . Income.

 

 

 

 

 

 

 

 

 

 

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Did you pay the $10 Processing Fee for your last renewal?

Yes

No

 

(Add 1 thru 4)

 

 

 

 

 

 

 

 

 

I certify under penalty of law that ALL information contained herein is TRUE and CORRECT and that I am retired and receiving Social Security and/or other pension and income as listed in Section D.

 

 

E.

 

My total gross income for the previous year did not exceed $19,200 and unless I am physically or mentally incapable of driving, I am the principal driver of this vehicle. I further certify that my signature

 

 

 

authorizes the PA Department of Transportation to verify my/our income and that my occupation is “retired” through

 

 

 

 

 

 

 

Internal Revenue Service income tax filings and that I understand that any misstatement of fact is a misdemeanor of

 

 

 

 

 

 

 

 

the third degree punishable by a fine up to $2,500 and/or imprisonment up to 1 year (18 PA. C.S. Section 4904{b}).

Applicant Signature

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ELIGIBILITY REQUIREMENTS AND INSTRUCTIONS FOR THE $10.00 PROCESSING FEE

1. You must be retired and receiving Social Security or other pension payments as described in Section D on the front of this application, regardless of age. Part-time employment is permitted if you are retired from your principal occupation.

If you receive only unemployment compensation or public assistance, or are a student or other individual who is not retired, you do not qualify.

2. Total gross income from all sources must not exceed $19,200. Other income includes Business/Rental Income, Wages, Public Assistance and Unemployment Compensation.

3. To be eligible for the retired status processing fee, the applicant must meet the qualifications above and the applicant must be listed as an owner on the vehicle’s registration. The vehicle may be owned jointly, however, the applicant must be the principal operator of the vehicle, unless physically or mentally incapable of operating the vehicle. The vehicle must be a passenger car or truck with a registered gross weight of not more than 9,000 lbs. Only one vehicle per qualified applicant may be registered for the retired status processing fee.

4. This application must be submitted in conjunction with Form MV-1, MV-4ST, MV-105, MV-120 or MV-140.

5. NOTE: Individuals should list their PA Driver’s License (PA DL) or Photo ID# in the space provided. Return the completed application with your vehicle registration application and include a $10 check or money order made payable to PA Department of Transportation. DO NOT SEND CASH.

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