Form Mv 145V PDF Details

The MV-145V form serves as a vital document for disabled and severely disabled veterans within the Commonwealth of Pennsylvania, offering a means to obtain specialized vehicle registration plates or motorcycle plate decals. Administered by the Department of Transportation's Bureau of Motor Vehicles, the form caters to individuals who have served in the military and are living with disabilities connected to their service. With eligibility requirements clearly outlined on the form, applicants can determine if they qualify for either a Disabled Veteran Plate or a Severely Disabled Veteran Plate, along with the corresponding registration benefits such as special parking privileges. Furthermore, this application encompasses a variety of crucial sections such as vehicle owner information, certification from the Veterans Administration Regional Office, and a statement that must be sworn and notarized, ensuring all provided information's accuracy and completeness. By facilitating access to these specialized plates and decals for veterans, the MV-145V form underscores Pennsylvania’s commitment to honoring the service and sacrifice of its military veterans, while also addressing their mobility needs.

QuestionAnswer
Form NameForm Mv 145V
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesmv 145v, Pennsylvania, Harrisburg, ENTS

Form Preview Example

MV-145V (8-08)

Commonwealth of Pennsylvania

APPLICATION FOR DISABLED

VETERAN, SEVERELY DISABLED

Department of Transportation

Bureau of Motor Vehicles

VETERAN REGISTRATION PLATE OR

1101 South Front Street

SEVERELY DISABLED VETERAN

Harrisburg, PA 17104-2516

 

MOTORCYCLE PLATE DECAL

FOR DEPARTMENT USE ONLY

CHECK ( ) APPROPRIATE BLOCKS BELOW and complete Sections A, B, and C. - See reverse side for eligibility requirements.

Disabled Veteran Plate (NOTE: No Special Parking Privileges). FEE: $7.50.

Severely Disabled Veteran Plate. FEE: $7.50.

Severely Disabled Veteran Motorcycle Plate Decal. NO FEE REQUIRED.

AVEHICLE OWNER INFORMATION (List all information as shown on current registration card)

 

Title Number

Vehicle Identification Number

Current Tag No.

 

 

Telephone Number

 

 

 

 

 

 

 

(

)

 

 

 

 

 

 

 

 

 

 

Last Name

First Name

Middle Name

PA DL/Photo ID#

 

Date of Birth

 

 

 

 

 

 

 

 

 

 

Co-Owner Last Name

First Name

Middle Name

PA DL/Photo ID#

 

Date of Birth

 

 

 

 

 

 

 

 

 

 

Street Address

 

City

 

 

State

 

Zip Code

 

 

 

 

 

 

 

 

 

BCERTIFICATION FROM VETERANS ADMINISTRATION REGIONAL OFFICE ADMINISTRATOR OR HIS/HER DESIGNATED REPRESENTATIVE (Philadelphia or Pittsburgh) OR SERVICE UNIT IN WHICH THE VETERAN SERVED.

This is to certify that veteran, _______________________________, listed above with VA number _____________________________ has service

Name of Veteran

connected disabilities rated at ________% or has the following service connected disability listed on the reverse side of this application under “Eligibility

Requirements”: ____________________. NOTE: If reason code #4 is listed, please indicate the type of device used: __________________________.

 

List Reason Code # Here

Authorized Signature:

Title of Authorized Signer:

C NOTARIZATION AND APPLICANT SIGNATURE - Applicant listed in Section A must sign below.

 

SUBSCRIBED AND SWORN

 

 

I state that I have read and signed this application after its completion, and

S TO BEFORE ME

MO.

DAY

YEAR

I swear or affirm that the statements made herein are true and correct, and

 

 

 

 

 

that any statement made on or pursuant to this application is subject to the

T

 

 

 

 

penalties of 18 PA C.S. Section 4903 9(a)(2) (relating to false swearing),

SIGNATURE OF PERSON ADMINISTERING OATH

which shall include punishment of a fine not exceeding $5,000, or to a term

 

A

 

 

 

 

of imprisonment of not more than two years, or both.

 

 

 

 

 

 

 

 

 

M

DO NOT NOTARIZE UNLESS SIGNED IN

 

 

(

)

 

PRESENCE OF NOTARY

 

 

 

 

Applicant Signature

Telephone Number

 

 

 

 

 

P

 

 

 

 

 

 

 

 

 

 

 

 

Messenger No.

 

 

 

 

 

 

 

THIS APPLICATION MAY BE DUPLICATED

ELIGIBILITY REQUIREMENTS AND GENERAL INFORMATION

Plate Type

Eligibility Requirements

Qualifying Vehicles

Benefits

 

 

 

 

Severely

Disabled Veteran

Plate, Severely

Disabled Veteran

Motorcycle Plate

Decal

“Reason Codes”

Applicant:

(1)is blind.

(2)does not have full use of an arm or both arms.

(3)cannot walk 200 feet without stopping to rest.

(4)cannot walk without the use of, or assistance from, a brace, cane, crutch, another person, prosthetic device, wheelchair or other assistive device.

(5)is restricted by lung disease to such an extent that the person’s forced (respiratory) expiratory volume for one second, when measured by spirometry, is less than one liter or the arterial oxygen tension is less than 60 MM/HG on room air at rest.

(6)uses portable oxygen.

(7)has a cardiac condition to the extent that the person’s functional limitations are classified in severity as Class III or Class IV according to the standards set by the American Heart Association.

(8)is severely limited in his or her ability to walk due to an arthritic, neurological or orthopedic condition.

NOTE: In order to qualify for the free yearly registration, the applicant must have a 100% service- connected disability certified by the U.S. Veteran’s Administration or service unit in which the veteran served.

(1)A passenger vehicle or truck with a registered gross weight of not more than 10,000 lbs. The vehicle must be used by a person with disability or operated exclusively for the use and benefit of the person with a disability.

NOTE: Severely Disabled Veteran Motorcycle Plate Decal is for a motorcycle only.

(1)Parking permitted in spaces designed for disabled persons and for 60 minutes in excess of legal parking period except where local ordinances or police regulations provide for the accommodation of heavy traffic during morning, afternoon or evening hours.

(2)Upon request of a severely disabled veteran, local authorities may erect on the highway as close as possible to the person’s residence a sign(s) indicating that the place is reserved for the person with disability, that no one else may park there unless a person with disability, severely disabled veteran plate or motorcycle plate decal is displayed and that any unauthorized person parking there will be subject to a fine.

Disabled

1) Any service-connected disability certified by U.S.

Same as above.

No special benefits.

Veteran

Veteran’s Administration, or the service unit of the

 

 

Plate

armed forces in which the veteran served; or,

 

 

 

2) same disabilities as listed for Severely Disabled

 

 

 

Veteran

 

 

 

 

 

 

Individuals should list their PA Driver’s License (PA DL) or Photo ID# in the space provided.

This application may only be used by a vehicle owner or co-owner that qualifies for the type of plate or decal indicated on the front of this application.

Only one plate or motorcycle decal per qualified person. NOTE: The decal may only be used on a currently registered motorcycle registration plate.

Disabled Veteran and Severely Disabled Veteran plates may not be personalized.

Should you desire to renew your registration in conjunction with this application, you must complete Form MV-140 or your registration renewal application and return it with this application along with your annual registration fee and the $7.50 replacement registration plate fee (if applicable).

Send completed application to:PA Department of Transportation Bureau of Motor Vehicles 1101 S. Front Street Harrisburg, PA 17104-2516

Visit us at www.dmv.state.pa.us

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