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REQUEST FOR REGISTRATION

If the above vehicle is leased, please list the Lessor s name in the space below. NoTE:If Form MV-1L has never been filed with PennDOT, theleasing company (Lessor) must complete Form MV-1L and return the completed form along with this NumberInsurance Company NamePolicy NumberPolicy Effective Policy ExpirationDateDateStreet AddressLessor NameEligible Applicant's NameEligible Applicant s Actual Income During the Past Calendar YearEligible Applicant's Date of BirthCityStateZip CodeRegistration Plate NumberBody TypeReg. Gross Wt. (if applicable)Last Name (or Full Business Name) First Name Middle Name Reg.

Initial Registration - Request for registration plate. o. Registration Renewal. MV-140 (8-19) REQUEST FOR REGISTRATION . For Department Use Only. Bureau of Motor Vehicles • 1101 South Front Street • Harrisburg, PA 17104-2516. G . PENNSYLVANIA VETERANS TRUST FUND (VTF) AND/OR ORGAN DONOR TRUST FUND (ODTF) DONATION. o. o. o. 1. REGISTRATION

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