Mv 427 Penndot PDF Form Customize Form Here

Mv 427 Penndot PDF Form

The MV-427 PennDOT form is a crucial piece of documentation for automotive service stations in Pennsylvania, serving as an application for those seeking to become certified safety inspection stations. It outlines a comprehensive checklist of items that must be submitted for the application to be considered complete, including specific forms like MV-427A for emissions inspection stations, proof of liability insurance, and details concerning the inspection area and ownership. The form not only guides applicants through the process with an instruction sheet but also highlights the importance of accuracy and completeness to avoid rejection.

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Overview

The MV-427 PennDOT form is essential for businesses aiming to operate as a safety inspection station in Pennsylvania. This detailed packet isn't just a form; it's a comprehensive application process designed to ensure that all safety inspection stations meet the state's stringent requirements before they start operations. Applicants must fill out the MV-427 form with precision, which involves providing exhaustive information about the inspection station, including, but not limited to, the nature of the application (be it for a new station, a change of ownership, relocation, or reappointment after suspension, amongst other scenarios). This process is underscored by the necessity of submitting a range of documents alongside the MV-427, such as proof of liability insurance or bond, copies of utility bills, photos of the premises, and a list of certified inspectors, all aimed at verifying the station's readiness and capacity to carry out inspections according to PennDOT standards. In addition, two separate MV-427 forms must be completed if applying for both safety and emissions inspections, clearly indicating the specialization of each application to prevent processing errors. It's a rigorous process, designed to leave no stone unturned in ensuring that all vehicles inspected in Pennsylvania meet the safety and emissions benchmarks set forth by the state, thereby safeguarding the well-being of its road users.

Preview - Mv 427 Penndot Form

Safety Station Application Check List

Upon submission of the station information packet, all items below must be included. If information is incomplete, the packet will be rejected. A letter will be sent to the applicant, notifying them of the deficiency. Additionally, included in the packet is an instruction sheet detailing how to complete form MV-427.

MV-427 (If applying for a safety and emission inspection, station must complete one form for safety and a separate form for emission. (Do NOT check both safety and emissions on the same form. One form should only specify SAFETY and the other form, if necessary, should only specify EMISSIONS).

MV-427A (must complete two separate forms if applying for a safety and emission inspection station).

MV-443 list of certified safety inspectors (include inspector number).

If you have completed section E Letter of Authority on form MV-427 and the person listed in section E is not listed on the form MV-427 as owner or is not listed as an owner/corporate officer on form MV-427A, you must include a separate document to provide that person’s name and driver’s license number with the packet. (If you are providing an out-of-state driver’s license number, you must also provide date-of-birth with the information.)

MV-500

Certificate of liability insurance or bond: Attach proof of insurance or a bond, in the amount

of at least $10,000.00, providing compensation for any damage to a vehicle during an inspection. A

“ Garage Keeper’s Legal Liability Policy” is acceptable. This proof of insurance or bond MUST include station name, physical location, and amount of coverage and period of coverage.

Must have a valid insurance policy with PennDOT listed as the Certificate Holder, using the address below

Copy of lease or deed

Copies of utility bills (most recent electric and phone bill)

Photos of the interior and exterior of the inspection area, sticker security area, and office area.

Must have a valid Employer Identification Number (EIN) or Social Security Number (SSN)

Must have a valid State Sales Tax Number

The completed packet should be mailed/emailed to:

Pennsylvania Department of Transportation

Vehicle Inspection Division

P O Box 68696

Harrisburg, PA 17106-9003

ATTN: Troy Roadcap, Manager

EMAIL: stationappointments@pa.gov

MV- 4 2 7

I NSPECTI ON STATI ON APPLI CATI ON

I NSTRUCTI ONS

USE: This application should be completed when applying for a new inspection station, and when any changes occur to an existing station, such as; change of location, change of ownership, and reappointment after a suspension, etc.

COMPLETI ON OF FORM: When properly completed and approved, this application will serve as your appointment certificate. Please use black ink and print clearly or type. PROVI DI NG FALSE, I NACCURATE, OR I NCOMPLETE I NFORMATI ON WI THI N THE APPLI CATI ON AUTOMATI CALLY I NVALI DATES THI S CERTI FI CATE.

Section A: I ndicate the reason for this application.

New inspection station: A business which is not currently an inspection station.

Reappoint After Cancel: A previously cancelled station reopens. (WRI TE THI S REASON I N THE BLOCK MARKED “ OTHER” ) NOT APPLI CABLE FOR PREVI OUS ENHANCED EMI SSI ON STATI ONS.

Reappointment after Suspension: A business that had its inspection privileges suspended and wishes to reopen as an inspection station after the suspension has been served.

Change of Location: An existing inspection station that is moving to a new location or is remodeling the existing location to provide additional space.

Change of Ownership: When a new owner(s) takes over an existing inspection station or when a corporation changes President and the person was never listed as a Corporate Officer in the past. (WRI TE THI S REASON I N THE BLOCK MARKED “ OTHER” )

Change of Authority: When a person in charge of an inspection station changes, but the ownership of the company remains the same. ( Section E should be completed at this time.)

Change of Mailing Address: When a business wants to update an existing mailing address that is different than the physical location.

Add Mailing Address: When a business wants its mail to be delivered to an address other than the physical location of the garage. (WRI TE THI S REASON I N THE BLOCK MARKED “ OTHER” ) .

Delete Mailing Address: when a business wants to delete an existing mailing address other than its physical location. (WRI TE THI S REASON I N THE BLOCK MARKED “ OTHER” ) .

Change of address by Post Office: When the business address of the station is being changed by the United States Post Office, or other agency.

Company to Corporation: A sole proprietorship or partnership incorporates. (WRI TE THI S REASON I N THE BLOCK MARKED “ OTHER” ) .

Change of Trade Name: An existing inspection station making a name change only. (See Company to Corporation above it the station is incorporating) .

Adding or changing a station type: When a general station adds motorcycle, a fleet station changes to a general station and vice versa. (WRI TE THI S REASON I N THE BLOCK MARKED “ OTHER” ) .

Add or Drop Partner: When a business adds or drops a partner(s) . (WRI TE THI S REASON I N THE BLOCK MARKED “ OTHER” ) .

Section B: Complete this section with the following information.

Business name: I ndicate the name under which you will operate. (list both names is you trade under a

different name; ie. Smith’s Garage, inc. T/ A Mike Smith Automotive.

Business address: I ndicate the actual location of the business. Must be a street address, no post office boxes in this space. I f you want to use a PO Box, complete the mailing address box in this section.

Telephone number: Provide the business telephone number including area code.

• Ow ner’s name: List the owner of the business. I f business is a partnership list on partner. I f the business is a corporation, list a corporate officer. A regional or district manager is also acceptable.

Driver License# : Provide the owner’s driver’s license number. I f license is issued from a state other than

Pennsylvania, please list the correct state abbreviation after the operator number: e.g., 123038483949 NJ (for operator number from New Jersey) .

Mailing address ( if different from the business address) : May be indicated in the space provided. I f you wish to receive mail from the Department at your business address, the mailing address segment of Section B should remain blank.

Section C: This section provides additional information about your business.

I ndicate if you are the sole proprietor, a partnership, or a corporation. (Commonwealth stations should check corporation) .

I ndicate your Federal I D number and Sate Sales Tax number in the appropriate boxes. I f you have submitted applications to these agencies and have not received your identification numbers, you may write “ APPLI ED FOR” in the appropriate boxes, and then submit your number(s) to the Department when they are received.

I ndicate the size of the I nspection area where inspection are performed (ie. 22ft x 28 ft or if more than one bay, e.g., Bay 1 22ft x 28 ft Bay 2 22ft X 62 ft, etc.)

I ndicate the one category most appropriate for your business.

I ndicate the type(s) of station you wish to operate which should coincide with the type(s) of vehicles you will be inspecting. I f applying for a safety station and an emission station you must complete a separate application for each type. (Do not mark safety and emission on the same application) .

I ndicate the type(s) of station you wish to operate and check the appropriate box(es) for any type(s) of vehicles you will be inspecting at your business.

Section D: First section should be completed when you own another inspection station. Second section should be completed when you need to cancel a previous inspection station.

First Section – Provide the station number(s) of other station(s) you own.

Second Section – Provide the current station number and/ or name of station being cancelled due to change of location, change of ownership or change of station type, ie. Fleet to General.

Section E: This section should be completed by the owner or a corporate officer ONLY when a person OTHER THAN an owner or a corporate officer is responsible for operating the business in the owner/ corporate officer’s behalf.

I MPORTANT: PRI NT ALL PARTS OF SECTI ON E, EXCEPT for the signature of the owner/ corporate officer.

Section F: DO NOT WRI TE I N THI S SPACE.

Section G: The application must be signed by the owner/ corporate officer at the time of application submission. I N THOSE CASES WHERE SECTI ON E HAS BEEN COMPLETED, THE PERSON AUTHORI ZED BY THE OWNER/ CORPORATE OFFI CER MUST SI GN THE APPLI CATI ON.

 

MV-427 (2-08)

 

 

 

 

 

 

 

INSPECTION STATION

 

 

FORDEPARTMENTUSEONLY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PLEASE TYPE OR PRINT CLEARLY.

 

 

 

CERTIFICATE OF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INCIDENT# ____________________________

 

THIS APPLICATION WILL SERVE AS

 

 

 

 

APPOINTMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YOUR CERTIFICATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A

CHECK THE PROPER BLOCK:

 

 

New Inspection Station

 

 

Re-appointment after suspension

 

Change of Location

 

Change ofAuthority within a Company or a Corporation

 

Change of MailingAddress

Change ofAddress by Post Office

 

Change of Trade Name

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B

NAME AND ADDRESS OF BUSINESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Business

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Business StreetAddress

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

 

 

 

 

County

 

 

 

 

 

 

 

 

State

 

 

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Telephone #

 

Owner’s Name

 

 

 

 

 

 

 

 

Driver’s License #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MailingAddress (if different than above)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

 

 

 

 

County

 

 

 

 

 

 

 

 

State

 

 

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

BUSINESS INFORMATION

CHECK ✔ OWNERSHIP CLASS:

Sole Proprietorship (A)

Partnership (B) Corporation (C)

 

Federal ID #

 

 

 

 

State Sales Tax #

 

 

 

 

 

Size of InspectionArea

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Category ✔ Check One:

Garage (A)

 

Manufacturer (E)

 

Gas Station (B)

 

New Dealer (C)

 

Used Dealer (D)

 

Station Type: Motorcycle (A)

 

 

 

 

Fleet (C)

 

 

 

 

General (E)

 

Enhanced Safety

 

Commonwealth (F)

 

 

 

 

Emission (X)

 

Trailer (D)

 

 

Inspection (J)

 

Type of vehicles you will be inspecting:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Passenger Cars

 

 

Light Trucks

 

Trailers 10,000 lbs or less

 

 

Trucks over 17,000 lbs.

 

Buses

 

 

Motorcycles

 

Trailers over 10,000 lbs.

 

 

Trucks 17,000 lbs. or less

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D

Station number of other Station(s) presently owned:

 

 

 

Station number and/or name of current Inspection Station:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E

LETTER OF AUTHORITY

 

 

 

F

 

 

 

CERTIFICATION

 

Thisletterauthorizes_______________________________________

 

 

Certificate ofAppointment as an Official Inspection Station

 

 

(Print Name of person signing the application)

 

 

 

 

Pursuant to the provisions of the Vehicle Code, 75 Pa.C.S. Sections 4721,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4723 or 3368,Act of June 17, 1976, No. 81, as amended.

 

________________________________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Title)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

residing at _______________________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(home street address)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

________________________________________________________

 

 

 

(NOT VALID WITHOUT SEAL)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(city/town)

 

(county)

 

 

 

(state)

(zip)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

to be responsible for all inspection operations performed at the above

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

station.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

_______________________________________ _______________

 

 

This certificate may be suspended or cancelled at any time if the provisions

 

 

 

of the Vehicle Code or the inspection regulations are not being complied

 

(Signature of owner or officer)

 

 

 

 

 

 

 

 

(Date)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

with or if the business is being improperly conducted.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

_______________________________________

 

 

 

 

 

Any change at a designated Official Inspection Station automatically

 

(Title)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

invalidates this Certificate.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

G

Application Date:

 

 

 

 

 

 

 

Appointment Date:

 

 

 

 

Inspection

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Station #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Iverifythatthefactssetforthonthisapplicationwerecheckedafterthecompletionoftheformandaretrueandcorrect.Thisverificationismadesubject

 

to the penalties of Section 4904 of the Crimes Code (18 Pa.C.S. § 4904) relating to Unsworn falsification to authorities.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Applicant Signature:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Department Investigator:

 

 

 

 

 

 

 

 

 

 

Troop/Station

 

 

 

 

 

 

Badge #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WHITE - Business Copy

YELLOW - Bureau of Motor Vehicles Copy

PINK - Investigator Copy

MV-427A (4-12)

Station Application

Supplemental Information

For Department Use Only

ATTACHMENT 1

PLEASE TYPE OR PRINT CLEARLY

A.STATION NAME: _____________________________________________________________________________________

B.INSURANCE ACKNOWLEDGEMENT:

I understand that a bond or certificate of insurance in the amount of $10,000 is required for each inspection station. I also understand that failure to maintain this bond or insurance will result in cancellation of my inspection station.

Yes ______ No ______

C.ADDITIONAL INFORMATION:

1.LIST ALL OWNERS, PARTNERS OR CORPORATE OFFICERS (NOTE: Individuals should list thier PA Driverʼs License (PA DL) or Photo ID# in the space provided. Business should list their Business ID# (Bus.ID) where indicated (i.e. E.I.N.)

NAME

TITLE

PA DL/PHOTO ID#

DATE OF BIRTH

 

 

 

 

STREET ADDRESS

CITY

STATE

ZIP

 

 

 

 

NAME

TITLE

PA DL/PHOTO ID#

DATE OF BIRTH

 

 

 

 

STREET ADDRESS

CITY

STATE

ZIP

 

 

 

 

NAME

TITLE

PA DL/PHOTO ID#

DATE OF BIRTH

 

 

 

 

STREET ADDRESS

CITY

STATE

ZIP

 

 

 

 

NAME

TITLE

PA DL/PHOTO ID#

DATE OF BIRTH

 

 

 

 

STREET ADDRESS

CITY

STATE

ZIP

 

 

 

 

2.Has this business or the owners, partners or officers thereof ever been a dealer, miscellaneous motor vehicles business, messenger service, inspection station or issuing agent in this or any other state?

Yes _____ No _____

If yes, list name(s), location(s), and identification number(s).

_________________________________________________________________________________________________

_________________________________________________________________________________________________

3.Is this application for a change of ownership or was this location previously an inspection station?

Yes _____ No _____

If yes, list previous station name(s), address(s) and identification number(s).

_________________________________________________________________________________________________

_________________________________________________________________________________________________

4.Is this inspection station being sold, transferred or leased while the station is suspended or restored pending appeal?

Yes _____ No _____

If yes, were you ever affiliated with this station or are you related in any way to the owner(s)? Yes _____ No _____

5.Have any owners, partners or corporate officers of this business been affiliated with a dealership, miscellaneous motor vehicle business, messenger service, inspection station or issuing agent whose privilege to conduct business as such was suspended, cancelled or revoked or is currently under investigation or received notice to attend a Departmental or court hearing or is awaiting a decision by a hearing officer or a Court?

Yes _____ No _____

If yes, list name, location, and identification number and explain situation.

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

6.Does any owner, partner, corporate officer or any business with which they were previously affiliated, have any outstanding liabilities which are due and owing to the Commonwealth, including but not limited to, taxes, fees, monetary penalties or outstanding paperwork?

Yes _____ No _____

If yes, explain

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

7.Have any owners, partners or corporate officers of this business ever been convicted or administratively sanctioned for violations of Department regulations Chapter 175 or 177 or Chapter 47 of the Vehicle Code?

Yes _____ No _____

If yes, explain

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

8.Have any owners, partners or corporate officers of this business ever remitted uncollectible checks payable to the Department of Transportation or the Commonwealth of Pennsylvania?

Yes _____ No _____

If yes, explain

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

9.Are all owners, partners, officers and management/supervisory employees aware of their responsibilities and obligations relating to the operation of an official inspection station, including but not limited to, record keeping, supervision of employees and customer relations?

Yes _____ No _____

If no, explain

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

I hereby verify that the information set forth above is true and correct to the best of my knowledge, information and belief. This verification is made subject to the penalties of 18 PA. C.C.§4904, relating to unsworn falsification of authorities.

Signature: _________________________________________________________________________________________

Print Name as it Appears Above: _______________________________________________________________________

Title: ________________________________________________________________________________________________

Date: _______________________________________________________________________________________________

MV-443 (3-06)

Commonwealth of Pennsylvania

DEPARTMENT OF TRANSPORTATION

OFFICIAL INSPECTION STATION NUMBER _____________________________

CURRENT LIST OF CERTIFIED

SAFETY INSPECTION MECHANICS

 

OPERATOR’S

MECHANIC

 

NAME

LICENSE

CERTIFICATION

CLASS

 

 

 

EXPIRATION

EXPIRATION

 

 

DATE

DATE

 

1.____________________________________________________________________________________

2.____________________________________________________________________________________

3.____________________________________________________________________________________

4.____________________________________________________________________________________

5.____________________________________________________________________________________

6.____________________________________________________________________________________

7.____________________________________________________________________________________

8.____________________________________________________________________________________

9.____________________________________________________________________________________

10.___________________________________________________________________________________

11.___________________________________________________________________________________

12.___________________________________________________________________________________

13.___________________________________________________________________________________

14.___________________________________________________________________________________

15.___________________________________________________________________________________

16.___________________________________________________________________________________

17.___________________________________________________________________________________

MV-500 (11-10)

www.dot.state.pa.us

Bureau of Motor Vehicles

Vehicle Inspection Division

P.O. 68697 • Harrisburg, PA 17106-8697

Pennsylvania Department of Transportation Authorized Agents for Purchasing Stickers

r NEW

r REVISED (PLEASE CHECK ONE)

 

PRINT NAME AS LISTED ON ID

 

OPERATOR NUMBER

 

SOCIAL SECURITY#

 

OR DRIVER’S LICENSE

 

 

 

(IF NON-PA DRIVER’S LICENSE)

 

 

 

 

 

1.

_____________________________

1.

_____________________________

1.

_____________________________

2.

_____________________________

2.

_____________________________

2.

_____________________________

3.

_____________________________

3.

_____________________________

3.

_____________________________

4.

_____________________________

4.

_____________________________

4.

_____________________________

5.

_____________________________

5.

_____________________________

5.

_____________________________

I hereby authorize the above listed person(s) to sign sticker requisitions and receive Certificates of Inspection for the following Official Inspection Station:

__________________

__________________________________

________________________

(Station Number)

(Station Name)

 

(Telephone #)

______________________________________________________________

____________________

(Signature of Station Owner or Authority) - Station Owner or Authority must be listed in one of the five lines above.

(Title)

______________________________________________________________

____________________

(Print Name As It Appears Above)

 

 

(Date)

REVIEW INSTRUCTIONS ON REVERSE SIDE BEFORE COMPLETING.

THIS FORM MAY NOT BE COPIED OR FAXED

Official Inspection Stations must use this form to authorize purchaser(s) to sign Form MV-436A, "Inspection Sticker and Insert Order Form."

You may submit up to five names to be placed in a computerized signature file for your station. (NO MORE THAN FIVE (5) NAMES ARE PERMITTED). Each name submitted must include, driver’s license number (or government issued photo identification card number) and Social Security number (if non-PA driver’s license).

If the station owner or authority (as listed in sections B or E of the certificate of appointment Form MV-427) or corporate officer, partner, etc. (listed on Form MV-427A) intends to sign Form MV-436A to purchase inspection stickers, his/her name, operator number, and Social Security Number

(if applicable) must also be listed on one of the five (5) designated spaces.

If the REVISED box is checked, you will need to list all persons whom you have previously authorized and wish to remain authorized. Any names that are not on this form will be deleted from the computerized signature file.

Stations which are appointed to perform both safety and emission inspections may submit only one (1) authorization form. The authorized purchasers for these stations will be able to sign Form MV-436A for both safety and emission stickers.

Bonded messengers and members of the Legislature cannot be listed on this form as authorized purchasers.

Return this form to: Bureau of Motor Vehicles, Vehicle Inspection Division, P.O. Box 68697, Harrisburg, PA 17106-8697. If you have questions please call (717) 787-2895.

File Specs

Fact Number Fact Name Description
1 Purpose of Form MV-427 Used for applying for a new inspection station license and for updates to an existing station such as change of location or ownership.
2 Requirements for Application All information packets must be complete upon submission; otherwise, they will be rejected and a notification sent to the applicant.
3 Separate Forms for Inspection Types Applicants must complete separate forms for safety and emission inspections; combining types on one form is not permitted.
4 Insurance or Bond Requirement A minimum of $10,000 in insurance or bond must be provided for compensation for any damage during vehicle inspections.
5 Valid Insurance Policy The policy must list PennDOT as the Certificate Holder.
6 Additional Documentation Applicants must provide copies of a lease or deed, recent utility bills, and photos of the inspection area.
7 Identification Numbers A valid Employer Identification Number (EIN) or Social Security Number (SSN), and a State Sales Tax Number are required.
8 Application Submission Information Completed packets should be mailed or emailed to the Pennsylvania Department of Transportation Vehicle Inspection Division.
9 Governing Law The Vehicle Code, 75 Pa.C.S. Sections 4721, 4723, or 3368, and the Act of June 17, 1976, No. 81, as amended.
10 Penalty for False Information Providing false, inaccurate, or incomplete information within the application automatically invalidates the certificate.

Detailed Instructions for Filling Out Mv 427 Penndot

Successfully applying for or making changes to an inspection station with the Pennsylvania Department of Transportation is a critical process that requires attention to detail and full compliance with all given instructions. The MV-427 form, part of this application process, is designed to ensure that all inspection stations operate under the state's strict guidelines for safety and emissions. It is vital to fill this form out accurately to avoid any potential delays or rejections of your application. Below are clear, step-by-step instructions for completing the form correctly.

  1. Begin by identifying the reason for this application in Section A. Select the option that best describes your situation, whether you are applying for a new station, changing ownership, relocating, and so on. If your reason does not match any of the listed options, write it in the space marked "OTHER".
  2. In Section B, provide the business information required:
    • Name of the business as it will operate or is currently known.
    • Business address, ensuring it is a physical street address (P.O. Boxes are not acceptable here).
    • Telephone number, including area code.
    • Name of the owner or a corporate officer.
    • The owner's or corporate officer’s driver's license number. If the license is issued from outside Pennsylvania, add the state abbreviation.
    • Mailing address, if different from the business address.
  3. Complete Section C by detailing your business structure (sole proprietorship, partnership, or corporation) and providing your Federal ID number and State Sales Tax number. If you have not received your numbers, write "APPLIED FOR" in the respective boxes. Describe the size of the inspection area and select the category and type(s) of station you wish to operate. Also, indicate the types of vehicles you will inspect.
  4. In Section D, if applicable, list any other stations you own and any station numbers or names that are being cancelled due to this application.
  5. Section E is designated for situations where someone other than the owner or corporate officer will be responsible for operating the business. Fill out all parts except for the signature, which must be done by the owner or corporate officer.
  6. Leave Section F blank as it is for Department use only.
  7. Finally, in Section G, the application must be signed by the owner or a corporate officer. If Section E is completed, the authorized person must also sign here. Record the application date as well.

Once the form is fully completed, review it thoroughly for accuracy and completeness. Any omission or error can result in delays or a rejection. After verification, include this form in your station information packet along with all other required documents as specified in the Safety Station Application Checklist, and send it to the Pennsylvania Department of Transportation Vehicle Inspection Division. The approval process involves a comprehensive review of your application and submitted materials. You will be contacted regarding the status of your application, any necessary corrections, or the next steps once the review is complete.

More About Mv 427 Penndot

  1. What is the purpose of the MV-427 form?

    The MV-427 form is used for applying for a new inspection station, making changes to an existing station, such as a change of location or ownership, or reappointing a station after a suspension. Its completion and approval serve as the appointment certificate for the inspection station.

  2. Can the MV-427 and MV-427A forms be used for both safety and emission inspections?

    No, if applying for both a safety and emission inspection station, one must complete separate forms for each type. It is important not to check both safety and emissions on the same form. One form should only specify SAFETY, and a separate form should specify EMISSIONS.

  3. What are the requirements for completing Section E of the MV-427 form?

    Section E must be completed if the person responsible for operating the inspection business is not the owner or a corporate officer listed on the MV-427 or MV-427A forms. A separate document providing that person’s name and driver’s license number, along with their date-of-birth if using an out-of-state license, must be included in the application packet.

  4. What insurance requirements must be met for the application to be accepted?

    An applicant must attach proof of insurance or a bond, with a minimum amount of $10,000.00, to compensate for any damage to a vehicle during an inspection. The proof must include the station name, physical location, coverage amount, and coverage period.

  5. What documentation is required concerning the location of the inspection station?

    The packet must include a copy of the lease or deed for the property, as well as copies of the most recent electric and phone bills to verify the physical location of the business.

  6. What evidence of identification and financial responsibility must be provided?

    An applicant must have a valid Employer Identification Number (EIN) or Social Security Number (SSN) and a valid State Sales Tax Number. Additionally, a list of certified safety inspectors, including inspector numbers (on form MV-443), must be included.

  7. Are photos of the inspection station required?

    Yes, photos showcasing the interior and exterior of the inspection area, sticker security area, and office area must be included in the application packet.

  8. What happens if information provided in the application is found to be false, inaccurate, or incomplete?

    Providing false, inaccurate, or incomplete information within the application automatically invalidates the inspection station’s certificate.

  9. Who is authorized to sign the MV-427 application form?

    The application must be signed by the business owner or a corporate officer. If Section E is completed, the person authorized by the owner or corporate officer must sign the application.

  10. Where should the completed MV-427 and accompanying documents be sent?

    The completed packet should be mailed or emailed to the Pennsylvania Department of Transportation Vehicle Inspection Division at the address or email provided in the instructions.

Common mistakes

Filling out the MV-427 Penndot form correctly is crucial for businesses seeking to become authorized safety and/or emission inspection stations in Pennsylvania. Here are common mistakes made during the application process:

One common error is not providing separate forms for safety and emission inspections. Applicants must complete one MV-427 form for safety and a separate form for emissions, rather than checking both options on the same form. This oversight can lead to the rejection of the application packet.

Another frequent mistake is failing to include a valid Insurance Certificate or bond with the required coverage details. The certificate or bond must be for at least $10,000 and specifically include the station's name, physical location, and coverage period. Neglecting this can halt the application process.

Applicants often omit necessary personal identification details for individuals with significant roles in the business when those individuals are not listed as owners or corporate officers. If someone other than the owner or a corporate officer is responsible for the station's operations, their name and driver’s license number, along with an out-of-state driver's license number (if applicable), need to be included in a separate document within the packet.

A critical but common oversight is providing inaccurate or incomplete business information, including the precise location and contact details. The MV-427 form requires an actual street address, not just a P.O. Box for the business location. Missing or incorrect information here will lead to processing delays or application rejection.

Frequently, the business information section is not fully completed. All relevant checkboxes regarding ownership type, Federal ID number, and State Sales Tax number must be accurately filled. For those who have applied but not yet received their numbers, writing "APPLIED FOR" is necessary.

Forgetting to include a complete list of certified safety inspectors along with their inspector numbers in the application packet is another error. This omission can significantly delay the approval process.

Applicants sometimes misunderstand the requirement for photos of the inspection, sticker security, and office areas. These photographs are mandatory for confirming the suitability of the premises for the intended inspection services.

Last but certainly not least, a common mistake is not signing the application by the owner or corporate officer, especially when Section E has been filled out for a person other than the owner to operate the inspection station. A signature serves as verification of the provided information and an agreement to comply with PennDOT regulations.

Avoiding these mistakes when completing the MV-427 form not only smoothens the application process but also expedites the approval for becoming a recognized inspection station in Pennsylvania.

Documents used along the form

When filing the MV-427 form for Pennsylvania Department of Transportation (PennDOT), understanding the panorama of required paperwork is vital. The MV-427 itself is just a piece of the puzzle for those applying to become a safety inspection station or making various types of amendments to an existing station. Several other forms and documents are necessary to ensure a smooth application process.

  • MV-427A: This form acts as supplemental information to the MV-427. It’s required for detailing the inspection station’s insurance information and provides additional space for listing all owners, partners, or corporate officers associated with the application.
  • MV-443: This form lists all certified safety inspectors who will work at the station. It includes their inspector number, which is crucial for validating the qualifications of individuals performing inspections.
  • Certificate of Liability Insurance or Bond: Providing proof of insurance or a bond, with a minimum coverage of $10,000, is essential. This coverage is to compensate for any damage to vehicles during the inspection process. The document must clearly state the station name, location, coverage amount, and coverage period.
  • Copy of Lease or Deed: Proof of the physical location of the inspection station is required through a lease agreement or property deed to ensure the station has a legitimate and fixed address.
  • Copies of Recent Utility Bills: Submitting the most recent electric and phone bills helps verify the operational status and physical location of the inspection station.
  • Photos: Including photographs of the interior and exterior of the inspection area, sticker security area, and office space is crucial for a visual assessment of the facility’s capabilities and setup.
  • Employer Identification Number (EIN) or Social Security Number (SSN): This is necessary for tax identification purposes. An inspection station must have a valid EIN or SSN to operate legally.
  • State Sales Tax Number: Possessing a valid state sales tax number confirms the inspection station’s registration for tax purposes, emphasizing the legal standing of the business.

Collectively, these documents contribute to a comprehensive application packet for PennDOT, outlining the inspection station’s operational, financial, and legal readiness. Securely compiling and submitting these forms and documents alongside the MV-427 ensures that applicants can navigate the application process more effectively, meeting all regulatory requirements for operating an inspection station in Pennsylvania.

Similar forms

Similar documents to the MV-427 PennDOT form include various applications and documentation required for regulatory compliance, insurance, and operational needs within different industries. Here are ten such documents that bear similarities to the MV-427 in terms of their purpose, requirement for detailed information, and compliance roles:

  • Business License Application: Similar to the MV-427 form, this application often requires detailed business information, ownership details, and operational scope to comply with local or state regulations.
  • FCC Form 601 - License Application for Wireless Telecommunications: This form requires detailed information about the applicant, equipment to be used, and operation specifics, akin to the MV-427's detailed vehicle inspection station requirements.
  • Commercial Insurance Application: Insurance forms require details about the business, coverage needs, and liability information, paralleling the insurance proof needed for the MV-427 PennDOT form.
  • Employer Identification Number (EIN) Application (IRS Form SS-4): Similar to section C of the MV-427, where tax identifications are necessary, applying for an EIN requires detailed business entity information.
  • Building Permit Application: Like the MV-427, these applications necessitate detailed property and ownership information, and they outline structural and functional aspects of a proposed project for regulatory approval.
  • OSHA Form 300 - Log of Work-Related Injuries and Illnesses: Although for a different purpose, this form, like the MV-427, is part of regulatory compliance, demanding detailed recording and reporting.
  • DOT Number Application: Required for commercial vehicle operators, this application shares similarities with the MV-427 in ensuring vehicles meet certain standards and regulations for operational safety and compliance.
  • Alcohol Beverage License Application: This type of application requires detailed information about the business, its owners, and its operations, mirroring the comprehensive nature of the MV-427 form.
  • Zoning Permit Application: Zoning permits require detailed descriptions of the business use, property details, and owner information, akin to the site-specific and operational details required in the MV-427.
  • Environmental Permit Application: Similar to the MV-427’s need for compliance with specific standards, these applications require detailed operational and site information to ensure environmental protection measures are upheld.

Each of these documents, like the MV-427 form, plays a critical role in ensuring businesses meet the comprehensive regulatory, safety, and operational standards set forth by various government agencies.

Dos and Don'ts

When filling out the MV-427 PennDOT form, which is necessary for applying for a safety inspection station, there are several do's and don'ts that applicants should be mindful of. This checklist aims to guide individuals through the process, ensuring that all requirements are met efficiently.

    Do:
  • Complete separate MV-427 forms for safety and emission inspections if applying for both. Each form should exclusively mention either SAFETY or EMISSIONS.
  • Include a completed MV-443 form listing all certified safety inspectors along with their inspector numbers.
  • Attach a certificate of liability insurance or bond, with a minimum coverage of $10,000, clearly stating the station name, physical location, coverage amount, and coverage period.
  • Ensure the provided insurance policy lists PennDOT as the Certificate Holder with the correct address.
  • Provide a copy of your lease or deed to verify the station's physical location.
  • Submit recent copies of utility bills (electric and phone) to further validate the station's operational address.
  • Include photos that accurately represent the interior and exterior of the inspection area, sticker security area, and office space.
  • Make sure to have a valid Employer Identification Number (EIN) or Social Security Number (SSN), and State Sales Tax Number ready and included in your packet.
    Don't:
  • Combine safety and emissions inspections on the same MV-427 form. Each inspection type requires a separate form.
  • Forget to include section E, Letter of Authority, if the individual responsible is not listed as an owner or corporate officer on the MV-427 or MV-427A forms. A separate document providing their name and driver’s license number is necessary.
  • Neglect to attach proof of insurance or bond. This document is crucial for demonstrating financial responsibility for damages that might occur during vehicle inspections.
  • Overlook the importance of including a valid insurance policy with PennDOT listed as the Certificate Holder. This detail is mandatory and ensures compliance with state regulations.
  • Fail to provide a copy of the lease or deed. This document serves as proof of the physical location of the inspection station.
  • Omit recent utility bills from your application packet. These bills serve as additional proof of the operational location.
  • Exclude photos of required areas within the inspection station. Photos are a critical component of the application, offering visual proof of the station’s setup and readiness.
  • Submit your application without ensuring you have the required identification numbers: EIN/SSN and State Sales Tax Number. These identifiers are essential for the legal operation of the station.

Misconceptions

  • One common misconception is that the MV-427 form is only for new inspection stations. In reality, it is also used for existing stations experiencing changes such as relocation, ownership changes, or reappointment following suspension.

  • Many believe that completing the MV-427 form alone is sufficient for application submission. However, a comprehensive station information packet, including items like liability insurance proof, a list of certified safety inspectors, and utility bills, must accompany the form.

  • Some assume that safety and emission inspections can be applied for on the same MV-427 form. Each type of inspection – safety and emissions – requires a separate form, with only one type of inspection specified per form.

  • It's often misunderstood that any member of the inspection station's team can complete Section E of the form. This section is specifically meant to be completed only by the owner or a corporate officer, designating another person to be responsible for inspection operations.

  • A misconception exists that digital signatures are accepted on the MV-427 form. As of the latest known information, signatures need to be handwritten, emphasizing the need for the physical completion and mailing of documents.

  • Some applicants think that an out-of-state license number provided in the documentation needs no additional information. In reality, an out-of-state driver’s license number must be accompanied by the date of birth of the corresponding individual.

  • There’s a belief that once the MV-427 form and its packet are submitted, no further action is required. However, the form clearly states that providing false, inaccurate, or incomplete information can invalidate the certificate, highlighting the need for thoroughness and accuracy.

  • Another misconception is that a Letter of Authority is not crucial unless ownership changes occur. In fact, this letter is necessary when authorizing someone other than an owner or corporate officer to operate the inspection station, reflecting its broad relevance.

  • It's incorrectly assumed that the station’s physical address is optional if a valid mailing address is provided. The form mandates the inclusion of a street address for the business location, underlining the importance of specifying the actual inspection site.

  • Lastly, there's a misunderstanding that the MV-427 form is the final step for becoming an inspection station. This form is part of a broader application process involving the submission of a complete packet and meeting all outlined requirements, cementing the form’s role within a multi-step procedure.

Key takeaways

Understanding the process and requirements for completing the MV-427 Penndot form is crucial for businesses seeking to become an authorized inspection station in Pennsylvania. Here are key takeaways to ensure compliance and smooth submission:

  • Ensure all sections of the MV-427 form are filled out accurately, using black ink.
  • Do not check both "safety" and "emissions" on the same MV-427 form; separate forms must be submitted for each type of inspection.
  • Include the MV-427A form if applying for both safety and emission inspection stations. Two separate forms are required in this case.
  • Attach a list of certified safety inspectors, including their inspector numbers, via form MV-443.
  • If Section E (Letter of Authority) is completed and appoints someone other than the owner or corporate officer, include a separate document providing their name and driver’s license number.
  • Proof of insurance or a bond (minimum of $10,000) must be attached, clearly stating the station name, location, coverage amount, and period.
  • Submit copies of lease or deed, recent utility bills, and photographs of the inspection areas and sticker security area.
  • Valid Employer Identification Number (EIN) or Social Security Number (SSN) and State Sales Tax Number are required.
  • Checklist items, including form completions and additional documents, are crucial for the packet's acceptance.
  • The completed packet should be directed to the address or email provided, ensuring it reaches the Pennsylvania Department of Transportation's Vehicle Inspection Division.

By meticulously following these steps and ensuring the completeness and accuracy of all information provided, applicants can streamline the approval process for becoming a PennDOT-authorized inspection station. Any discrepancies or missing information can lead to delays or rejection of the application, thus it's advised to review the application packet closely before submission.

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