Mv 402 Form PDF Details

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.

QuestionAnswer
Form NameMv 402 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesapplication for window tint medical exemption, penndot window tint exemption form, penndot tint permit, pa window tint medical exemption form

Form Preview Example

MV-402 (2-08)

Commonwealth of Pennsylvania

Department of Transportation

Vehicle Inspection Division

P.O. Box 68697

Harrisburg, PA 17106-8697

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 right-rear windows: __________________

 

 

 

Number of additional driver side left-rear windows: _______________________

 

 

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

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