Mv41 Form PDF Details

Mv41 form is a very important document in the Czech Republic. This document is used to identify the taxpayer and their tax situation. In order to complete this form, you will need to know your personal identification number and have information about your taxable income. The Mv41 form must be filed by taxpayers every year, even if they do not owe any taxes. Failing to file this form can result in penalties and fines. Make sure you are familiar with the requirements for filing this form so that you can complete it correctly.

Here are several details you might want to analyze before you start using the mv41 form.

QuestionAnswer
Form NameMv41 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesform mv41 a for pa, mv 41 pa, mv41 form, mv 41 form penndot

Form Preview Example

MV-41 (7-21)

www.dmv.pa.gov

APPLICATION FOR CORRECTION OF VEHICLE RECORD OR VERIFICATION OF VEHICLE IDENTIFICATION NUMBER

For Department Use Only

Bureau of Motor Vehicles • Harrisburg, PA 17106-8283

SEE INFORMATION ON REVERSE

Title Number

Registration Plate Number

Is lienholder an ELT Participant?

Financial Institution Number

 

 

r YES

r NO

 

 

 

 

 

 

CHECK (3) APPLICABLE BLOCK BELOW

rCorrection or Verification of Vehicle Identification Number - Complete Sections A, B and F.

rApplication for State Replacement Vehicle Identification Number Plate/Decal - Complete Sections A, C (MUST be completed by a Police Officer) and F.

r

r

Correction of Body Type, Number of Axles, or Other Corrections to the Vehicle Title or Registration Data - Complete Sections A, D and F. (If the vehicle has been modified, such as the addition or removal of axles, or you are requesting a change to the manufacturer weight specifications, Form MV-426B must be completed.)

Verification of Gross Vehicle Weight Rating (GVWR) or Gross Combination Weight Rating (GCWR) by Inspection Mechanic Only - Complete Sections A, E and F.

 

A

VEHICLE OWNER INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Last Name (or Full Business Name)

 

First Name

 

 

 

 

Middle Name

PA DL/Photo ID#

 

 

 

 

 

Date of Birth

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

or Bus. ID#

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Co-Owner Last Name

 

First Name

 

 

 

 

Middle Name

PA DL/Photo ID#

 

 

 

 

 

Date of Birth

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Current Street Address

 

 

 

 

 

 

 

 

City

 

 

 

 

State

 

 

Zip Code

 

 

Please use the “County Codes” listing found on the back of this application and list the numerical code for your county of residence.

 

County Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B

CORRECTION OR VERIFICATION OF VEHICLE

 

 

C

APPLICATION FOR STATE REPLACEMENT VIN PLATE

 

 

IDENTIFICATION NUMBER

 

 

 

 

 

 

Original Vehicle Identification Number (if known)

 

 

 

 

 

 

 

 

 

 

To be used only to correct typographical error of one digit, transposition

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

of two digits, or if engine number has been erroneously recorded as the

 

Reason for Replacement of VIN Plate:

 

 

 

 

 

 

 

 

 

 

VIN OR for the purpose of VIN verification.

 

 

r Lost

 

r Stolen

 

r Defaced

 

 

r Never Received

 

 

ATTACH TRACING HERE OR HAVE AUTHORIZED NOTARY PUBLIC

 

 

 

 

 

 

 

 

r Other - Please Explain: ________________________________________

 

 

EMPLOYED BY A FULL AGENT OR MOTOR VEHICLE DEALER, OR

 

 

 

INSPECTION MECHANIC COMPLETE THE VERIFICATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VERIFICATION BY POLICE OFFICER (Local or State Police)

 

 

INFORMATION BELOW.

 

 

 

 

 

 

 

 

Record Correct VIN

 

 

 

 

 

 

Signature of Police Officer

 

 

 

Badge Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of Notary Public or Inspection Mechanic

 

DIN/Mechanic #

 

 

Department Name

 

 

 

Telephone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D

VEHICLE DATA THAT REQUIRES CORRECTION - Check only the block(s) and list the information that needs correcting due to an

 

 

error in the title application or to a change in the use of the vehicle.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

r Make of Vehicle

 

r Body Type

r Year

 

r Seating Capacity

r Unladen Weight

 

r Fuel Type

 

 

Correct to:

 

Correct to:

 

Correct to:

 

Correct to:

 

Correct to:

 

 

 

 

 

Correct to:

 

 

r Odometer - See Instructions on Reverse side

 

r Registered Gross Vehicle Weight

 

 

 

 

 

r Registered Gross Combination Weight

 

 

r Other

 

 

Correct to:

 

Correct to:

 

 

 

 

 

 

 

Correct to:

 

 

 

 

 

Correct to:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E

VERIFICATION OF WEIGHT RATING - Inspection Mechanic Only

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GVWR

 

 

 

 

 

 

 

GCWR

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

No. of Axles

Was additional axle installed?

 

NOTE: If additional axle was added, Form MV-426B must be completed.

 

 

 

 

 

 

 

 

r Correct to:

r YES r NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of Inspection Mechanic

 

 

 

 

 

 

 

 

 

 

 

 

Inspection Mechanic Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

F

CERTIFICATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I/We hereby certify under penalty of law that ALL information is TRUE and CORRECT and that I/we 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 one year (18 Pa.C.S. Section 4904[b]).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of Owner or Authorized Person

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of Co-Owner or Title of Authorized Person

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Applicant’s Telephone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMATION

NOTE: To correct or change the name listed on a Pennsylvania Certificate of Title, use Form MV-41A. In addition, if the vehicle has been modified in any manner, Form MV-426B must be used.

If the title is being held by a lienholder that participates in the Electronic Lien and Titling Program (ELT), there will be no title attached.

GENERAL

lIndividuals 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.).

lIf this application is processed, and the requested title, registration, or both are not received due to loss in the mail, the vehicle owner may apply for a free duplicate title on Form MV-38O, and free replacement of registration by completing Form MV-44 within 90 days of the date of original issuance. The lienholder, if applicable, must use Form MV-38L and a Pennsylvania Motor Vehicle Dealer must use Form MV-38D.

lFee for issuance of a corrected title: $58. DO NOT SEND CASH. Make check or money order payable to the Commonwealth of

Pennsylvania and mail the completed application to: PA Department of Transportation, Bureau of Motor Vehicles, P.O. Box 68593 Harrisburg, PA 17106-8593.

IF THE 1ST BLOCK IS CHECKED ON REVERSE - Certificate of title and $58 title fee must be attached. NOTE: Certificate of title and fee are not required when used for verification of VIN only.

lThis application can only be used to correct typographical error of one digit, transposition of two digits, or if the vehicle’s engine number has been erroneously recorded as the Vehicle Identification Number (VIN).

lVerification of the VIN can be done by authorized vehicle safety inspection mechanics and notaries public employed by a full agent or motor vehicle dealer.

IF THE 2ND BLOCK IS CHECKED ON REVERSE - Certificate of title and $58 title fee MUST be attached.

lOriginal Vehicle Identification Number (VIN) will be used on state replacement VIN plate unless original number cannot be determined. A corrected title and registration card will be issued indicating that a VIN plate has been replaced.

lSection C on the front of this application must be completed by a police officer. The police officer verifying the original Vehicle Identification Number (VIN) must sign their name and list the badge number, department name, and telephone number.

IF THE 3RD BLOCK IS CHECKED ON REVERSE

lCurrent certificate of title is not required when applying for a correction of the registered gross weight and there have been no alterations to the vehicle. Certificate of title and $58 title fee MUST be attached for all other corrections.

lIn addition to the title fee (if applicable), appropriate increase fee for the difference in registration weight and seating capacity must also be attached if registration is desired.

lCurrent certificate of title must be attached when applying for a correction of the odometer reading. Notarized statements from the previous owner and the applicant listed in Section A on this application are required. In addition, copies of past 2 years inspection records or repair bills that cover the time of the odometer discrepancy must be attached. In many instances, the inspection records or repair bills include the vehicle odometer reading at the time of vehicle safety inspection or repair, which will help substantiate the actual mileage being requested.

NOTE: When changing the body type from off road vehicle (ORV)/low speed vehicle (LSV) to neighborhood electric vehicle (NEV), the vehicle must meet the equipment requirements and standards as set forth in 49 CFR 571.500 and shall be equipped with the following: (1) brakes adequate to control the movement of and to stop the vehicle; (2) an odometer; (3) a speedometer; (4) the original manufacturer's Vehicle Identification Number (VIN); (5) a windshield wiper; (6) a horn and (7) a battery charge indicator.

For more information regarding NEVs, please refer to the Neighborhood Electric Vehicle Fact Sheet found on our website at www.dmv.pa.gov.

IF THE 4TH BLOCK IS CHECKED ON REVERSE

lVerification of Gross Vehicle Weight Rating (GVWR) and Gross Combination Weight Rating (GCWR) must be completed by authorized inspection mechanics only in the spaces provided in Section E.

 

 

 

 

 

COUNTY CODES

 

 

 

 

01

- Adams

13

- Carbon

25

- Erie

37

- Lawrence

49

- Northumberland

61

- Venango

02

- Allegheny

14

- Centre

26

- Fayette

38

- Lebanon

50

- Perry

62

- Warren

03

- Armstrong

15

- Chester

27

- Forest

39

- Lehigh

51

- Philadelphia

63

- Washington

04

- Beaver

16

- Clarion

28

- Franklin

40

- Luzerne

52

- Pike

64

- Wayne

05

- Bedford

17

- Clearfield

29

- Fulton

41

- Lycoming

53

- Potter

65

- Westmoreland

06

- Berks

18

- Clinton

30

- Greene

42

- McKean

54

- Schuylkill

66

- Wyoming

07

- Blair

19

- Columbia

31

- Huntingdon

43

- Mercer

55

- Snyder

67

- York

08

- Bradford

20

- Crawford

32

- Indiana

44

- Mifflin

56

- Somerset

 

 

09

- Bucks

21

- Cumberland

33

- Jefferson

45

- Monroe

57

- Sullivan

 

 

10

- Butler

22

- Dauphin

34

- Juniata

46

- Montgomery

58

- Susquehanna

 

 

11 - Cambria

23

- Delaware

35

- Lackawanna

47

- Montour

59

- Tioga

 

 

12

- Cameron

24

- Elk

36

- Lancaster

48

- Northampton

60

- Union

 

 

Visit us at www.dmv.pa.gov or call us at 717-412-5300. TTY callers — please dial 711 to reach us.

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completing pennsylvania motor vehicle mv 41 form part 1

Include the necessary information in the Badge, Number D, IN, Mechanic Department, Name Telephone, Number Make, of, Vehicle, Correct, to Body, Type, Correct, to Year, Correct, to Seating, Capacity, Correct, to Un, laden, Weight, Correct, to r, Fuel, Type, Correct, to Other, Correct, to G, VW, R GC, WR No, of, Axles, Correct, to and r, Signature, of, Inspection, Mechanic part.

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