Pa Application Plate Form PDF Details

In Pennsylvania, vehicle owners have the option to customize their vehicle's appearance and personal identification through the use of specialized registration plates. The Pa Application Plate form, identified as MV-904, serves as a multifunctional document facilitating the acquisition of personalized, amateur radio operator, or press photographer registration plates, as outlined on the Pennsylvania Department of Transportation (PennDOT) website. Applicants can choose from various types including personal, dealer, or commercial registration plates, with fees varying from $76 for a Personal Registration Plate to $100 for personalized commercial or dealer plates, and a nominal fee of $11 for amateur radio operator or press photographer plates, with an additional $100 for personalization. Essential applicant and vehicle information must be provided, such as names, addresses, vehicle identification, and pertinent licensing details. Specific sections of the form cater to the unique requirements for each plate type, ensuring that all applicants, from amateur radio enthusiasts to professional press photographers, can tailor their plates to suit their identity or professional affiliation. Notably, personalized plate choices are subject to certain character limits and rules, underlining the importance of clarity and uniqueness in selection. This comprehensive approach not only facilitates the expression of personal identity or professional stance but also adheres to regulatory standards and procedures set by the PennDOT, ensuring a seamless application process.

QuestionAnswer
Form NamePa Application Plate Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesform mv 904, mv 904 site dmv pa gov, pennsylvania personalized, mv 904

Form Preview Example

MV-904(7-17-14)

www.dmv.state.pa.us

aPPliCatiOn FOR PERSOnaliZED, aMatEUR RaDiO OPERatOR, OR PRESS PHOtOGRaPHER REGiStRatiOn PlatE

For Department Use Only

Bureau of Motor Vehicles • PO Box 68293 • Harrisburg, PA 17106-8293

CHECK BLOCK FOR TYPE OF PLATE DESIRED:

q Personal Registration Plate - Complete Sections A, B and E. Fee: $76

q Personalized Dealer Registration Plate - Complete Sections A, B and E. Fee: $100

q Personalized Commercial Registration Plate - Complete Sections A, B, and E. Fee: $100

q amateur Radio Operator Registration Plate - Complete Sections A, C and E. Fee: $11

q Press Photographer Registration Plate - Complete Sections A, D and E. Fee: $11 (An additional $100 fee for personalization.)

a

aPPliCant anD VEHiClE inFORMatiOn (liSt inFORMatiOn CURREntlY SHOWn On titlE OR REGiStRatiOn CaRD)

 

 

 

 

 

 

 

 

 

Last Name (or Full Business Name)

First Name

Middle Name

 

PA DL/Photo ID# or

Date of Birth

 

 

 

 

 

 

Bus. ID#

 

 

 

 

 

 

 

 

 

 

Co-Owner Last Name

First Name

 

Middle Name

 

PA DL/Photo ID#

Date of Birth

 

 

 

 

 

 

 

 

 

Street Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

State

 

Zip Code

Daytime Telephone Number

 

 

 

 

 

 

 

Home ______________________

 

Vehicle Identification Number

 

 

 

Title Number

 

 

 

 

 

 

 

 

Office ______________________

 

 

 

 

 

 

 

 

 

Make of Vehicle

 

Current Plate Number

Expiry Date

 

 

 

 

 

 

 

 

nOtE: In conjunction with replacement of your plate, you will receive one registration card. If additional registration cards are desired, the fee is

 

$1.50 for each card. number of Duplicate Registration Cards Requested @ $1.50 each ________.

 

B PERSOnaliZED REGiStRatiOn PlatE inFORMatiOn

Personalized registration plate choices may contain up to SEVEn letters or numbers in combination. OnlY one hyphen or space is permitted but not both. No other special characters are available. Please print clearly. Additional instructions are listed on the reverse side of this application.

FIRST CHOICESECOND CHOICETHIRD CHOICE

EXaMPlES . . .

 

 

B

U

l

l

-

D

O

G

 

W

E

l

0

V

E

 

 

U

 

S

P

a

 

C

E

 

 

 

 

C

R

E

8

i

V

E

 

 

 

 

nOtE: When requesting a numeric character of zero, please show as "0" instead of the alpha character "O.''

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

aMatEUR RaDiO OPERatOR REGiStRatiOn PlatE inFORMatiOn

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I am the holder of a valid Amateur Radio Station License (copy must be attached) issued by the Federal Communication Commission

 

 

dated _______________________ and have been assigned call letters _____________________________________ .

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D

PRESS PHOtOGRaPHER REGiStRatiOn PlatE inFORMatiOn

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I certify that I am employed full time by _____________________________________________________________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF FIRM

 

 

 

 

 

 

 

 

 

 

 

 

____________________________________________________________________________________________________________________

 

 

 

STREETADDRESS

 

 

 

 

 

 

CITY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STATE

 

ZIP CODE

 

 

as a newspaper, newsreel or television news photographer. The motor vehicle for which the Press Photographer plates are requested will be used

 

 

in pursuit of my regular employment in covering news events.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(THE FOLLOWING INFORMATION IS TO BE COMPLETED BY THE EMPLOYER)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I certify that _____________________________________________________________________ is employed as a newspaper, newsreel, or

 

 

television news photographer.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

x

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE OF EMPLOYER

 

 

 

PRINTED NAME OF EMPLOYER

 

 

 

 

 

DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E aPPliCant(S) SiGnatURE

I/(We) certify that all information given on this application is true and correct.

x

SIGNATURE OF OWNER OR AUTHORIZED SIGNER

SIGNATURE OF CO-OWNER

DATE

iMPORtant inFORMatiOn

1.PERSOnaliZED REGiStRatiOn PlatE

•Standard personalized registration plates may contain up to seven letters and numbers in combination. nOtE: This form is only used for a personalized standard issued plate or personalized dealer or commercial registration plates. If applying for a special personalized plate, you must use the appropriate application for that type of registration plate.

•Motorcycle personalized registration plates may contain up to five letters or five letters and numbers in combination.

•Ahyphen or space is not recognized as part of the registration plate configuration and does not count as one of the letters or numbers. An extra box is provided if you wish to include a hyphen or space as part of your configuration. Only one hyphen or space is permitted, but not both. If you do not wish to include a hyphen or space, DO NOT USE THE EXTRA BOX. Note: No additional special characters are available.

•When requesting a numeric character of zero, please list as "0" instead of the alpha character of "O".

•Radio and television stations may be issued personalized registration plates containing the station call letters assigned by the Federal Communications Commission (FCC).

•The Keystone logo does not appear on personalized registration plates.

2.aMatEUR RaDiO OPERatOR

•One plate will be issued with your FCC assigned call sign. If you desire a second amateur Radio Operator Plate, your FCC call sign plus a hyphen and the #2 will be issued. A copy of your Amateur Radio Station License must be attached.

•Fee is $11.

3.PRESS PHOtOGRaPHER

•Issued to a person who is employed full time as a newspaper, newsreel, or television photographer or cameraman.

•The vehicle must be registered in the name of the press photographer or jointly by the press photographer and a co-owner.

•Only one set of press photographer plates will be issued to any applicant.

•Fee is $11. (nOtE:An additional $100 fee is due if requesting personalization of the Press Photographer registration plate.)

4.GEnERal inFORMatiOn

•PennDOT reserves the right to limit or reject certain requests.

•Personalized registration applicants must have a valid registration plate which the applicant shall retain pending receipt of the requested personalized registration plate.

•Requests for personal registration plates are restricted to passenger vehicles, motorcycles, trailers, motor homes, or trucks with a registered gross weight of not more than 14,000 lbs.

•If applying for a personalized dealer or commercial registration plate, you must complete the appropriate form to apply for the dealer or commercial registration plate and attach to this application.

•Your telephone number will be held in confidence and used only in the event of a problem with your application.

•Separate applications must be filed for each special registration plate (Personal, Amateur Radio Operator, Press Photographer).

•Registration on your vehicle must be current in order for PennDOT to process your request. THE FEE COVERS THE COST OF YOUR PERSONALIZED REGISTRATION PLATE ORDER ONLY AND WILL NOT RENEW YOUR VEHICLE’S REGISTRATION. If your registration has expired or expires in the next three months, please include your completed renewal application Form MV-105, "Pennsylvania Registration RenewalApplication," or Form MV-140, “Request for Registration," and a separate check or money order in the amount of your registration renewal fee. Payment is to be made by check or money order payable to the Commonwealth of Pennsylvania. PlEaSE DO nOt SEnD CaSH.

•To check personalized registration plate availability, visit PennDOT’s Driver and Vehicle Services website, www.dmv.state.pa.us and select the Personalized registration PlateAvailability link from the list of services under the Online Driver and Vehicle Services heading. Personalized Registration plates will not be reserved until PennDOT receives payment and a completed application, and approves your requested registration plate configuration [number(s) and/or letter(s)]. Please note that registration plate requests are processed on a first-come, first-served basis. Although a requested registration plate configuration may show as being available on the website, it is possible that a request for the same registration plate configuration may have already been submitted by another customer and may not be available when your application is processed.

•To replace a defaced personalized plate that is NOT destroyed (cut, burned or defaced beyond recognition), you must submit Form MV-904 indicating a replacement plate containing the same combination of letters and numbers is being requested along with a picture or tracing of the plate for identification purposes. The old plate can continue to be used until the new replacement plate is received. The charge for the replacement will be $76 for a personalized plate or $111 for an Amateur Radio Operator plate or a Press Photographer plate. If an immediate replacement plate is needed, you must also submit Form MV-44, “Application for Duplicate Registration Card, Replacement of Registration Plate, Renewal Sticker or Weight Class Sticker,” and a $11 replacement fee.Astandard plate will be issued until the replacement plate can be provided.

•If your personalized plate is lost or stolen, the combination of letters and numbers cannot be reproduced. You need to apply for a new plate containing a new combination of letters and numbers. If you would like to order a new plate, please apply by completing this form. If an immediate replacement special registration plate is needed, you must also submit Form MV-44 and a $11 replacement fee. A standard plate will be issued until the special replacement registration plate can be provided.

•Personal registration plates will be manufactured on the basis of this application. no refund of fee will be issued when an applicant cancels a request after the order is placed with the manufacturer.

•If a personalizedregistration platehashad noactivity (such as renewal oratransfer) for a period of five years, the owner may re-activate the plate or PennDOT can re-issue that same configuration to an applicant other than the original plate owner. The requested configuration cannot be re-issued if it has been reported lost or stolen. No other personalized plates will be duplicated except when defaced.

•This application with check or money order should be mailed to: Pennsylvania Department of Transportation, Bureau of Motor Vehicles, Special Tag Unit, P.O. Box 68293, Harrisburg, PA 17106-8293.

•Allow eight to 10 weeks for delivery.

Visit us at www.dmv.state.pa.us or call us at:

In state: 1-800-932-4600 u TDD: 1-800-228-0676 u Out-of-State: 1-717-412-5300 u TDD Out-of-State: 1-717-412-5380

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mv 904 conclusion process detailed (step 1)

2. Given that the last section is completed, you have to put in the essential details in C aMatEUR RaDiO OPERatOR, I am the holder of a valid Amateur, dated and have been assigned call, D PRESS PHOtOGRaPHER REGiStRatiOn, I certify that I am employed full, NAME OF FIRM, STREET ADDRESS, ZIP CODE, CITY, STATE, as a newspaper newsreel or, THE FOLLOWING INFORMATION IS TO BE, I certify that is employed as a, SIGNATURE OF EMPLOYER, and PRINTED NAME OF EMPLOYER so you can move on to the next stage.

Completing part 2 of mv 904

Regarding CITY and D PRESS PHOtOGRaPHER REGiStRatiOn, make certain you don't make any errors in this current part. The two of these could be the most important fields in this page.

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