Mv6 Form PDF Details

Are you looking for a way to make your business processes more efficient and cost-effective? If so, then consider the Mv6 Form – an easy-to-use document that provides an immediate solution to streamlining your office operations. Created by the National Automated Clearing House Association (NACHA), Mv6 is designed to help businesses save time and money while improving accuracy and reliability. In this blog post, we'll take a look at the benefits of using Mv6 forms in your business as well as how they can be used effectively.

QuestionAnswer
Form NameMv6 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesMV-6, assignee, certify, Tenths

Form Preview Example

MV-6(11-13)

 

 

 

www.dmv.state.pa.us

 

 

 

APPLICATION FOR NONREPAIRABLE

 

OR SALVAGE CERTIFICATE

For Department Use Only

 

See Instructions on Reverse

 

 

 

Bureau of Motor Vehicles • 1101 South Front Street • Harrisburg, PA 17104

 

 

 

 

 

Check 4 Proper Block

 

(PRINT OR TYPEALLINFORMATION IN FULL)

 

1. q Original Certificate of Salvage

2. q Duplicate Certificate of Salvage 3. q Original Nonrepairable Certificate

Check here qif vehicle is a total loss due to flood - (salvage certificate will be branded with a “W”.)

Check here qif vehicle is a total loss due to theft - (salvage certificate will be branded with a “N”.) NOTE: Acopy of the police report, indicating that the vehicle was stolen, must be attached or Section E completed.

AAPPLICANT INFORMATION

 

 

LAST NAME (OR FULL BUSINESS NAME)

 

FIRST NAME

MIDDLE NAME

 

 

 

 

PADL/PHOTO ID #

DATE OF BIRTH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OR BUS. ID#

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CO-OWNER LAST NAME

 

FIRST NAME

MIDDLE NAME

 

 

 

 

PADL/PHOTO ID #

DATE OF BIRTH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STREETADDRESS TO WHICH CERTIFICATE IS TO BE DELIVERED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY

 

 

 

 

 

 

 

 

 

 

 

 

 

STATE

 

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B

VEHICLE DESCRIPTION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TITLE NO.

 

 

 

 

 

 

 

 

 

VEHICLE IDENTIFICATION NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YEAR

 

 

MAKE

 

 

OWNER’S NAMEAS PRINTED ON FACE OFATTACHED TITLE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I/We certify to the best of my/our knowledge that the odometer reading is ____ ____ ____ , ____ ____ ____TenthsX miles and reflects the actual

 

 

mileage of the vehicle, unless one of the following boxes is checked:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reflects the amount of mileage in

 

 

 

is NOT the actual mileage.

 

 

 

 

 

 

 

 

 

 

 

q excess of its mechanical limits

 

 

 

q Warning: Odometer discrepancy.

 

 

 

 

 

 

 

 

 

 

WARNING: FEDERALAND STATE LAWS REQUIRETHATYOU STATETHE MILEAGE IN CONNECTION WITH THISAPPLICATION. FAILURE TO COMPLETE OR PROVIDINGAFALSE STATEMENT

 

 

 

MAY RESULT IN FINESAND OR IMPRISONMENT.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C VEHICLE IDENTIFICATION NUMBER VERIFICATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOTE: IF AN OUT-OF-STATE TITLE IS ATTACHED TO THIS APPLICATION, A TRACING OF THE VEHICLE’S IDENTIFICATION NUMBER MUST BE

 

 

 

AFFIXED IN THE SPACE PROVIDED. IFATRACING CANNOT BE OBTAINED, THE VEHICLE’S IDENTIFICATION NUMBER MUST BE LISTEDAND

 

 

 

VERIFIED BYA CERTIFIED INSPECTION MECHANIC OR AUTHORIZED AGENT IN THE APPROPRIATE SPACES BELOW.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LIST OR TAPE VIN

t

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TRACING HERE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DIN/MECHANIC #

 

 

 

 

 

 

 

 

 

AUTHORIZEDAGENT OR CERTIFIED INSPECTION MECHANIC (PRINT NAME)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I CERTIFY THATALEGIBLE TRACING CANNOT BE

t

 

AUTHORIZEDAGENT OR CERTIFIED INSPECTION MECHANIC SIGN HERE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECUREDAND THAT THEABOVE VIN LISTED IN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION C IS CORRECT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D

APPLICATION FOR DUPLICATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REASON:

qLOST

qSTOLEN

qDEFACED

qNEVER RECEIVED

q* OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

(Certificate Must Be

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Attached)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

* PLEASE EXPLAIN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E REPORTED TO STATE POLICE - Complete the following

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INCIDENT NO.

 

 

 

 

DATE

 

 

 

 

STATION

 

TELEPHONE NO.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NATURE OF INCIDENT

 

 

 

 

 

 

 

 

INVESTIGATOR

 

 

 

 

 

 

 

BADGE NO.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

F

SIGNATURES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I/We certify that all information provided on this application is true and correct.

(

)

 

 

 

 

 

 

 

 

8

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE OFAPPLICANT ORAUTHORIZED PERSON

 

 

 

 

 

 

TELEPHONE NUMBER

 

 

 

8

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE OF CO-APPLICANT

 

 

 

 

 

 

 

 

DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSTRUCTIONS

lIf Block 1 is checked: Complete Sections A, B, C (if applicable) and F.

The applicant completing this application must be either the owner whose name appears on the face of the attached certificate of title, or if the title is assigned, the last assignee whose name appears on the reverse side of the title. NOTE: Individuals should list their PA Driver’s License (PADL) or Photo ID# in the space provided. Businesses should list their Business ID# (Bus. ID) where indicated (i.e. - E.I.N.). NOTE: If the certificate of title is assigned to an individual or non- salvage dealer, the signatures must be notarized.

The certificate of title currently in the name of (or assigned to) the applicant must accompany this application.

If an out-of-state title assigned to an individual within PA who is also reassigning to another individual in PAis attached, a title fee of $22.50 must accompany this application.

If an out-of-state title is attached and the title is reassigned to a PA dealer OR the title is assigned to an individual with a PAresidence, then NO FEE IS REQUIRED.

If an out-of-state title is attached, Section C must be completed and a tracing of the VIN must be attached. If the VIN tracing cannot be obtained, the vehicle identification number must be listed and verified by a certified inspection mechanic OR an authorized notary public employed by a full agent or a motor vehicle dealer.

NOTE: If the vehicle is a total loss due to flood, please check the appropriate block. Asalvage certificate will be issued with a “W” brand.

If the vehicle is a total loss due to theft, please check the appropriate block. Asalvage certificate will be issued with a “N” brand.Acopy of the police report, indicating that the vehicle was stolen, must be attached or Section E must be completed.

lIf Block 2 is checked: Complete Sections A, B, D and F.

When a certificate of salvage has been lost, stolen, defaced, or never received, the owner listed on the front of the original certificate may obtain a duplicate. No fee is required.

lIf Block 3 is checked: Complete Sections A, B, C and F.

When a nonrepairable certificate is issued, the vehicle may ONLY be used as a source for parts or scrap and may NOT be issued a certificate of title or certificate of salvage.

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certify conclusion process clarified (portion 1)

2. Soon after this section is done, proceed to type in the relevant details in all these: IF AN OUTOFSTATE TITLE IS ATTACHED, LIST OR TAPE VIN, TRACING HERE t, DINMECHANIC, I CERTIFY THAT A LEGIBLE TRACING, D APPLICATION FOR DUPLICATE, REASON q LOST, q STOLEN, PLEASE EXPLAIN, AUTHORIZED AGENT OR CERTIFIED, AUTHORIZED AGENT OR CERTIFIED, q DEFACED, Certificate Must Be Attached, q NEVER RECEIVED, and q OTHER.

Stage # 2 for filling out certify

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