Form MV-436A at a glance
What it is: This is Form MV-436A, the Inspection Sticker and Insert Order Form.
A filled-in Form MV-436A example: a station orders inserts and stickers
How to fill out Form MV-436A, box by box
Tap a group of boxes to open it, and a picture to see it full size.
The station (box A)
Under A, fill in the Station Name and the Station Number.
Fill in the Station Street Address. A P.O. Box number may be used in addition to the actual address, but cannot be used as the only address. Then fill in the Telephone Number.
Fill in the City, State and Zip Code, and the E-Mail Address.
Safety and emissions inserts, by month (box B)
Under B, INSERTS - NO CHARGE: Inserts should be ordered in conjunction with sticker orders. Quantities may be adjusted at the discretion of PennDOT.
For Safety Inserts and Emissions Inserts, place the number of packs desired in the spaces for each of the Months Needed. Each pack contains 50 inserts.
Special inserts and replacement plate cards (boxes C and D)
Under C, SPECIAL INSERTS - NO CHARGE, and under D, REPLACEMENT OF ILLEGIBLE REGISTRATION PLATE CARDS: Please order in conjunction with stickers. For E/Exempt Inserts, W/Waiver Inserts, T-Dot Inserts (TEMP) and Form MV-46I, fill in the Quantity, in multiples of 10.
Stickers: emissions (box E) and safety (box F)
Under E, EMISSIONS STICKERS - NO CHARGE: Shipping and handling charge applies. For Emissions Stickers (IM), fill in the Quantity, in multiples of 10: Minimum order of 10 stickers.
Under F, SAFETY STICKERS - CHARGE: For each Type, fill in the Quantity and the Amount.
Annual Inside (AI): Order in multiples of 10 ($12 each). Annual Inspection: Passenger vehicles, trucks, emergency vehicles, and certain vans.
Annual Outside (AO), in multiples of 10 ($12 each): Motorcycles and all trailers.
Semi-Annual Inside (SI): Order in multiples of 10 ($10 each). Semi-Annual: School buses, certain vehicles under contract with schools, mass transit vehicles, and certain vans and farm vehicles.
Signature, totals and shipping (box G)
Under G, SIGNATURE: As listed on the current Form MV-500.
Fill in the Authorized Signature, the Operator’s # and the State.
Fill in Print Name as Above and the Date.
Fill in Total Amount for Stickers and Minus Credit Balance, then Subtotal.
Shipping and Handling Charge: $5.00.
The last line is Total Amount Due - Stickers/Postage.
More rules for Form MV-436A
BMV Fees: This form may require a fee. Please review the instructions below carefully prior to submitting the application. For a complete listing of motor vehicle fees, refer to Form MV-70S, "Bureau of Motor Vehicles Schedule of Fees," found on our website at www.pa.gov/dmv. DO NOT SEND CASH.
Sticker orders should be verified against the receipt. Discrepancies should be reported immediately by calling PennDOT at 717-705-2182. Please allow 14 days for delivery.
Common questions about Form MV-436A
Where do I file it?
Please make check/money order payable to the Commonwealth of Pennsylvania and return to: PennDOT, Bureau of Motor Vehicles, Sticker Processing Unit, P.O. Box 68697, Harrisburg, PA 17106-8697.
Sources
[1] Form MV-436A (8-25), Inspection Sticker and Insert Order Form, Pennsylvania Department of Transportation (PennDOT) (the Official source link on this page).
