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Get PA MV-359 2018

MV-359 1-15 www. dmv.state. pa.us APPLICATION FOR MISCELLANEOUS MOTOR VEHICLE BUSINESS REGISTRATION PLATES CHECK 4 ALL APPLICABLE q New Application Repair or Towing Change of Name For Department Use Only Bureau of Motor Vehicles P. If business is moved to another location PennDOT must be notified within 10 days of the change. A completed form MV359 and photographs of the new location must accompany this notification. Application for Miscellaneous Motor Vehicle Business INSTRUCTIONS FOR COMPLETING MV-359 1. O. Box 68283 Harrisburg PA 17106-8283 Change of Address Change in Officers TYPE OF MISCELLANEOUS MOTOR VEHICLE BUSINESS YOU ARE APPLYING FOR Financier or Collector-Repossessor copy of banking license required Change of Owner Vehicle Salvage Dealer Watercraft Trailer Dealer A NAME AND ADDRESS OF BUSINESS Exactly as registration is to be issued Transporter Name Federal I. D. Street Address Principal Place of Business Dealer Identification Number City Business Phone B TYPE OF BUSINESS Check One State County Sole Proprietorship zip Code Home Phone of President or Controlling Partner Partnership Corporation THIS LOCATION IS Check One C LIST ALL OWNERS PARTNERS OR CORPORATE OFFICERS Home Address 1. Name Title Owned Leased Driver s License D LIST OTHER BUSINESSES AT THIS LOCATION E INDICATE NUMBER OF REGISTRATION PLATES YOU ARE APPLYING FOR IN THE SPACE PROVIDED BESIDE THE APPROPRIATE CLASSIFICATION All classes of Miscellaneous Motor Vehicle Business - Annual Fee - 52 each plate. No* of Financier or Collector-Repossessor Plates CR x 52 No* of duplicate registration cards x 2 No* of Repair or Towing Plates RT x 52 No* of duplicate registration cards x 2 No* of Vehicle Salvage Dealer Plates WL No* of Transporter Plates TR No* of Watercraft Trailer Dealer Plates WD Total Fees Due BUSINESS DESCRIPTION - Indicate the nature of your business that qualifies your business for the type of registration for which you are making application* F G INSURANCE INFORMATION Insurance Company Name Policy Number Effective Date Expiration Date H ADDITIONAL INFORMATION If this application is a change of ownership explain and list former name of business. Please list DIN Number 2A. Has this business or the owners partners or corporate officers thereof ever been registered as a dealer miscellaneous motor vehicle business or issuing agent in this or any other state q YES q NO If yes list name s location s and identification number s. 2B. Have any owners partners or corporate officers of this business ever been affiliated with a dealership miscellaneous motor vehicle business messenger service or full agent whose registration was suspended cancelled or revoked or is currently under investigation or notice to attend a Departmental or court hearing or is awaiting a decision by a hearing officer of a court If yes explain Do any of the owners partners corporate officers or any business with which they were previously affiliated have any outstanding liabilities which are due and owing to the Commonwealth of Pennsylvania including but not limited to taxes fees monetary penalties or outstanding plates or paperwork Have any owners partners or corporate officers of this business ever been convicted or administratively sanctioned for violations of Department regulations Pennsylvania Crimes Code or Chapters 11 13 or 23 of the Pennsylvania Vehicle Code YES q NO Commonwealth of Pennsylvania Will this business be purchasing or selling any type of vehicles If yes describe type of vehicles I MISCELLANEOUS INFORMATION 1.

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