Mva Is 109 Form – Fill Out and Use This PDF

The MVA IS 109 form is a comprehensive document issued by the Motor Vehicle Administration in Maryland for the reporting of various types of complaints related to motor vehicle operations and sales, including but not limited to, unlicensed sales, dealer complaints, and foreign registration issues. Individuals filing the report are required to provide detailed information regarding their complaint, the subject of the complaint, and any vehicles involved, under the penalty of perjury, ensuring the accuracy and truthfulness of the provided information. This process facilitates a systematic approach by the MVA’s Investigative Division in addressing and resolving public grievances.

To streamline the reporting of your motor vehicle-related complaint, click the button below to fill out the MVA IS 109 form.

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Mva Is 109 Form PDF Details

In the realm of motor vehicle administration, where regulation of sales, registrations, and dealer conduct is paramount for consumer protection and order, the MVA IS-109 form emerges as a critical tool. Issued by the Motor Vehicle Administration in Glen Burnie, Maryland, this form is designed for individuals aiming to report various types of complaints including unlicensed sales, dealer complaints, foreign registrations, and a broad category of general complaints. It meticulously captures the complainant’s details, from name and contact information to a declaration under penalty of perjury affirming the truthfulness of the provided information. Importantly, it details the subject of the complaint by requiring information on their name, contact details, associated vehicles including year, make, and color, and optionally, their place of employment and vehicle tag numbers. The form also allows for the recording of the time of day the subject is most likely to be found at home or work and offers space for additional comments that might support the complaint. Moreover, for MVA use only, it contains sections for the complaint's reception, forwarding, actions taken, and final remarks, prioritizing accountability and resolution. This form not only builds a bridge between the public and regulatory bodies but also underlines the significance of lawful operations within the vehicle industry. For those needing further assistance, it provides contact information and encourages Maryland residents to utilize the MVA’s resources, highlighting the commitment to accessible and responsive consumer protection.

Question	Answer
Form Name	Mva Is 109 Form
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	mva investigative, form md 109, maryland motor complaint, form is109

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MOTOR VEHICLE ADMINISTRATION

6601 Ritchie Highway, N.E.IS-109 (12-13) Glen Burnie, Maryland 21062

Investigative Division Complaint Report

Type of complaint: q Unlicensed Sales q Dealer Complaint q Foreign Registration q General Complaint

Person Making Complaint

Your Name: ________________________________________________________________________________________ Date:_______________________

Address:_______________________________________________________________________________________________________________________

City: ____________________________________________________________ State: ____________________________ Zip Code: __________________

Phone (Home): _______________________________Phone (Business):________________________________ Other (cell): _______________________

Signed: _______________________________________________________________________________________________________________________

I certify under penalty of perjury that the information contained herein is true and correct to the best of my knowledge, information, and belief.

Subject of Complaint

Subject’s Name: __________________________________________________ Phone #: _____________________________________________________

Address:_______________________________________________________________________________________________________________________

City: _____________________________________________________________ State: ________ Zip Code: ___________ Placard #_________________

Vehicles Involved: Year ___________________ Make ____________ Color ________________ Tag # _________________________________________

Year_________________Make______________________Model _________________ Color __________________ Tag # __________________________

Place of Employment for Subject (if known): _______________________________________________________________________________________

Time of day/night when subject is mostly at home or work (if know): __________________________________________________________________

Additional Comments:___________________________________________________________________________________________________________

_______________________________________________________________________________________________________________________________

Additional Information On Complaint

_______________________________________________________________________________________________________________________________

Use Back Of Form

MVA USE ONLY

Complaint received by: Agent/Employee: __________________________________________________________________________________________

Complaint Forwarded To: _________________________________________________Date Forwarded:________________________________________

Action Taken (Remarks, Forwarded to, Conclusion Reached, Etc):

_______________________________________________________________________________________________________________________________

Signature: _______________________________________________________ Title:_____________________________ Date:_______________________

For more information, please call: 410-768-7000 (to speak with a customer agent).

TTY for the hearing impaired: 1-800-492-4575. Visit our website at: www.MVA.Maryland.gov

Additional Information

_______________________________________________________________________________________________________________________________

Apply to... Apply to register to vote with your driver’s license transaction. For details ask your customer service representative.

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Mva Is 109 Form – Fill Out and Use This PDF

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