Form Mv 41A PDF Details

In order to file your taxes this year, you will need to use Form Mv 41A. This form is used to calculate the amount of your Massachusetts Adjusted Gross Income, or MAGI. The MAGI is used to determine your eligibility for certain tax credits and deductions. You can find Form Mv 41A on the Massachusetts Department of Revenue's website. Be sure to download and print a copy if you plan on filing by paper. Alternatively, you can file online using MassTax Connect. If you have any questions, be sure to consult the instructions booklet or contact the Department of Revenue. happy filing!

QuestionAnswer
Form NameForm Mv 41A
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other nameslienholder, title, pa mv41a, Pennsylvania

Form Preview Example

No Title Will Be Attached
Pending Divorce -

MV-41A (8-07)

Commonwealth of Pennsylvania

Department of Transportation

Bureau of Motor Vehicles

Harrisburg, PA 17104-2516

APPLICATION FOR CORRECTION

OR CHANGE OF NAME

Side A: Marriage or Divorce - No new title requested.

Side B: Any reason for name change - New title requested

FOR DEPARTMENT USE ONLY

This side of the application can only be used if the name change is a result of marriage, divorce or pending divorce.

If your vehicle is currently registered and you only want a corrected registration card but not a corrected certificate of title, or your lienholder participates in the Electronic Lien Title Program, use this side of the application. No fees are required with this option.

If you or your lienholder want a corrected certificate of title, then use Side B.

Side A - No new title will be produced

REASON FOR NAME CHANGE: Check Appropriate Block Below

MarriageDivorce

Other (Please explain) _________________________

Attach a copy of the written notice to resume a prior surname. The notice must include the caption and docket number of the proceeding in the divorce and be date stamped from the Court.

If your title is being held by a lienholder that participates in the Electronic

Lien and Titling Program (ELT) check here.

(Check with your lienholder to determine if they participate in the ELT Program.)

A VEHICLE INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Title Number

 

 

 

 

Registration Plate Number

 

 

 

 

 

 

 

 

 

 

B APPLICANT INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Correct Last Name (or Full Business Name)

 

First Name

 

Middle Name

PA DL/Photo ID #

Date of Birth

 

 

 

 

 

 

 

or Bus. ID#

 

 

 

 

 

 

 

 

 

 

Correct Co-Owner Last Name

 

First Name

 

Middle Name

PA DL/Photo ID #

Date of Birth

 

 

 

 

 

 

 

 

 

 

Current Street Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

State

Zip

 

 

 

 

 

 

 

 

 

 

 

 

 

C FORMER NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Last Name (or Full Business Name)

 

 

First Name

Middle Name

 

 

 

 

 

D CERTIFICATION - I/We hereby certify under penalty of law that all information given on this application is true and correct. (Date must be listed)

 

 

 

 

 

 

 

 

 

 

Signature of Owner or Authorized Person

 

 

Signature of Co-Owner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Applicant’s Telephone No.

 

Date

 

 

 

 

 

()

THIS APPLICATION MAY BE PHOTOCOPIED

MESSENGER NO.

APPLICATION FOR CORRECTION OR CHANGE OF NAME

FOR DEPARTMENT USE ONLY

CERTIFICATE OF TITLE AND $22.50 TITLE FEE IS REQUIRED WITH THIS OPTION.

You will receive a corrected certificate of title and registration card that reflects your name change.

NOTE:

If your name is changed by permission of court, attach a certified copy of the court order.

 

If you desire to use a name other than (1) birth name, (2) spouse’s surname, or (3) a name given through a court order, you must

 

provide a copy of a Social Security Card (or records) together with copies of documents from two other sources issued in the

 

desired name such as:

 

Tax Records

 

Selective Service Card

 

Passport

 

Any form of photo I.D. issued by a governmental agency

 

Baptismal Certificate

 

Banking Records

Side B - New title will be produced

REASON FOR NAME CHANGE: Check

Appropriate Block Below

Marriage

Court Order

Divorce

Other (Please explain)__________________________________

Pending Divorce - Attach a copy of the written notice to resume a prior surname. The notice must include the caption and docket number of the proceeding in the divorce and be date stamped from the Court.

If the title is not attached, an additional title fee of $22.50 is required and Section D must be completed below. In addition, if your original title has a lien recorded, the lienholder must complete Section F.

If your title is being held by a lienholder that participates in the Electronic

Lien and Titling Program (ELT) check here.

No Title Will Be Attached

(Check with your lienholder to determine if they participate in the ELT Program.)

A VEHICLE INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Title Number

 

 

 

 

Registration Plate Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B APPLICANT INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Correct Last Name (or Full Business Name)

First Name

 

Middle Name

PA DL/Photo ID #

Date of Birth

 

 

 

 

 

 

 

 

 

or Bus. ID#

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Correct Co-Owner Last Name

 

First Name

 

Middle Name

PA DL/Photo ID #

Date of Birth

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Current Street Address

 

 

 

City

State

 

Zip

 

 

 

 

 

 

 

 

 

 

 

C FORMER NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Last Name (or Full Business Name)

 

 

First Name

 

 

Middle Name

 

 

 

 

 

 

 

 

 

 

 

D APPLICATION FOR DUPLICATE TITLE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APPROPRIATE BLOCK

 

Lost/Destroyed

Stolen

Defaced

Never Received

 

 

MUST BE CHECKED:

 

 

 

 

 

 

 

(Certificate must be

(Complete address

 

 

 

 

 

 

 

attached)

 

 

 

 

 

 

 

 

 

above)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ECERTIFICATION - I/We hereby certify under penalty of law that all information given on this application is true and correct. (Date must be listed.)

 

Signature of Owner or Authorized Person

Signature of Co-owner

Date

 

 

 

 

FLIENHOLDER NOTARIZATION - Complete only if Section D is completed and a lien is recorded on the title.

 

SUBSCRIBED AND SWORN

 

 

 

Signature of Authorized Person

 

 

TO BEFORE ME:

MO.

DAY

YEAR

 

 

 

 

 

 

 

 

 

 

 

 

S

 

 

 

 

Title of Authorized Signer

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE OF PERSON ADMINISTERING OATH

 

 

 

 

 

T

 

 

 

Telephone Number (

)

 

 

 

 

 

 

 

 

 

 

 

 

 

A

DO NOT NOTARIZE UNLESS

 

 

Messenger No.

 

 

 

 

 

 

 

MSIGNED BY LIENHOLDER IN

PRESENCE OF NOTARY

P

THIS APPLICATION MAY BE PHOTOCOPIED.

 

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This PDF form requires particular data to be entered, hence be sure to take your time to provide precisely what is required:

1. To begin with, when filling out the name, start out with the page containing next fields:

with completion process described (stage 1)

2. Once the last section is completed, go to enter the applicable details in these - Last Name or Full Business Name, First Name, Middle Name, D CERTIFICATION IWe hereby, Signature of Owner or Authorized, Signature of CoOwner, cid Applicants Telephone No, Date, THIS APPLICATION MAY BE PHOTOCOPIED, and MESSENGER NO.

Last Name or Full Business Name, Date, and cid Applicants Telephone No of with

3. Completing REASON FOR NAME CHANGE Check cid, Side B New title will be produced, cid Marriage cid Divorce cid, cid Court Order cid Other Please, number of the proceeding in the, cid If the title is not attached, original title has a lien recorded, If your title is being held by a, No Title Will Be Attached, cid, Check with your lienholder to, A VEHICLE INFORMATION, Title Number, Registration Plate Number, and B APPLICANT INFORMATION is essential for the next step, make sure to fill them out in their entirety. Don't miss any details!

Completing part 3 of with

4. To move ahead, this fourth part requires filling out a handful of blank fields. Included in these are Last Name or Full Business Name, First Name, Middle Name, D APPLICATION FOR DUPLICATE TITLE, APPROPRIATE BLOCK MUST BE CHECKED, cid LostDestroyed, cid Stolen, cid Defaced, Certificate must be attached, cid Never Received, Complete address above, E CERTIFICATION IWe hereby, Signature of Owner or Authorized, Signature of Coowner, and Date, which you'll find vital to going forward with this particular document.

Step no. 4 for submitting with

It is easy to get it wrong when filling in the D APPLICATION FOR DUPLICATE TITLE, so ensure that you look again before you finalize the form.

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