Mv 402 form is a document that can be used to notify HMRC of any change in circumstances for a taxpayer. This could include something as simple as a change in address, or something more significant such as the start or end of a self-employment. The form must be filled in and returned to HMRC within one month of the change taking place. Failing to do so may result in penalties. Knowing what changes need to be reported and when is essential for taxpayers, and using Mv 402 form is the best way to ensure this information is tracked correctly.
Below is the details about the file you were seeking to fill in. It can show you just how long it may need to finish mv 402 form, what fields you will have to fill in and a few other specific details.
Question | Answer |
---|---|
Form Name | Mv 402 Form |
Form Length | 2 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 30 sec |
Other names | application for window tint medical exemption, penndot window tint exemption form, penndot tint permit, pa window tint medical exemption form |
Commonwealth of Pennsylvania
Department of Transportation
Vehicle Inspection Division
P.O. Box 68697
Harrisburg, PA
APPLICATION FOR SUN SCREENING CERTIFICATE OF EXEMPTION
FOR DEPARTMENT USE ONLY
THE FOLLOWING QUESTIONS ARE TO BE ANSWERED BY THE APPLICANT
1. Full Name
PA DL/Photo ID # or Bus. ID#
Date of Birth
Daytime Telephone #
NOTE: Individuals should list their PA Driver’s License (PA DL) or Photo ID # in the space provided. Businesses should list their Business ID# (Bus. ID) where indicated (i.e. E.I.N).
2. |
Street Address __________________________________________________________________________ |
||||||||||||
|
City |
|
|
State |
|
Zip Code |
|||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
3. |
Vehicle for which application is being made. Make |
|
|
|
|
|
|
Year |
|||||
|
VIN |
|
|
|
|
Registration Plate |
|
|
|||||
|
Title Number |
|
|
|
|
|
|
|
|
|
|
||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
4. Windows with after market sun screening for which a certificate of exemption is requested:
“PLACE X WHERE NEEDED”
Windshield |
|
|
|
Driver Side: Left Front ______________ |
Left Rear ______________ |
||
Passenger Side: Right Front _____________ |
Right Rear _____________ |
On vans, station wagons and buses list the number of additional rear side windows:
|
Number of additional passenger side |
|
|
|
|
Number of additional driver side |
|
|
|
5. |
When did you purchase this vehicle? |
Date _______________/________/____________ |
||
|
|
Month |
Day |
Year |
6. |
When was the sun screening installed? |
Date _______________/________/____________ |
||
|
NOTE: To be approved for window darkening |
Month |
Day |
Year |
|
products, installation must have been prior to |
|
|
|
|
September 8, 1984. |
|
|
|
6a.If unknown, was sun screening installed prior to |
|
|
|
|
|
your ownership of the vehicle? |
Yes _____________ |
No _______________ |
|
7. When was this vehicle first registered by you |
|
|
|
|
|
in Pennsylvania? |
Date _______________/________/____________ |
||
|
|
Month |
Day |
Year |
8. What is the serial number of the current inspection |
|
|
|
|
|
sticker displayed on this vehicle? |
Number __________________________________ |
I certify under penalty of law that the above facts are true and correct to the best of my knowledge and that the vehicle is equipped with the after market sun screening as indicated.
Vehicle Owner’s Signature ________________________________________________ Date _______________
(When vehicle is registered in more than one name, all signatures must appear above.)
REQUEST FOR MEDICAL EXEMPTION
This portion must be completed by a licensed physician or optometrist when a certificate of exemption is requested due to a physical condition. NOTE: The exemption is valid only for colorless sun screening products that filter ultraviolet rays.
(Please type or print)
PATIENT INFORMATION
Patient Name ___________________________________________ Daytime Telephone # _________________
Street Address _____________________________________________________________________________
City ___________________________________________________ State __________ Zip Code ___________
Brief Description of patients condition: ___________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Suggested Treatment(s): _____________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
PHYSICIAN/OPTOMETRIST INFORMATION
Physician/Optometrist Name ___________________________________________________
Business Affiliation (if any) _____________________________________________________
Business Address ____________________________________________________________
City ___________________________________________ State _____ Zip Code _________
Physician Telephone Number __________________________________________________
I certify under penalty of law that the above facts are true and correct to the best of my knowledge:
Signature _______________________________________ Date _____________________
THE REVERSE SIDE MUST BE COMPLETED BY THE VEHICLE OWNER