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SNOWMOBILE/ATV APPLICATION FOR REGISTRATION AND …

For Department Use Only DCNR SNOWMOBILE/ATV REGISTRATION Section PO Box 8553 Harrisburg, PA 17105-8553 DCNR-43 (8-21) VEHICLE INFORMATIONMake of Vehicle Serial Number/VINYear Name and Number Machine Color Date of PurchaseMake and model including VIN of vehicle traded inEst. Yearly Fuel Usage PURCHASERLast Name (or Full Business Name) First NameMiddle InitialCo-Owner Last Name First NameMiddle InitialStreet AddressCountyPO Box No. (If Applicable) CityStateZip Code SECURITY - When a second lien is required, attach that lien holder's information to the no security Interest, Check (3) here Secured PartyStreet AddressCityState Zip CodeTEMPORARY REGISTRATION - Valid for 45 days from date issued.

16 Repossession Vehicle repossessed by lienholder. Repossession documentation must accompany application. 17 Non-Profit Non-profit entity uses vehicle exclusively for non-profit activities. 18 School Educational institution uses vehicle for business purposes only. 19 Utility Commission PUC-regulated utility uses vehicle for business purposes only.

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COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF …

www.snowatvreg.dcnr.pa.gov

I hereby state under penalty of the Pennsylvania Crimes Code, 18 Pa.C.S. Sections 4902 (relating to perjury) and 4903 (relating to false swearing) that all information in this Affidavit of Ownership is true and correct to the best of my knowledge, information and belief.

  Department, States, Pennsylvania, Pennsylvania department

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