Transcription of www.dmv.pa.gov APPLICATION FOR LESSEE INFORMATION
1 OoB VEHICLE OWNER INFORMATION - NOTE: The title will always be in the name of the owner and mailed to the owner or encumbrance VEHICLE INFORMATIOND MAILING INFORMATION - Please read each column LESSEE INFORMATION - Person/Company leasing the vehicle from the vehicle CERTIFICATIONCHECK (4) THE APPROPRIATE BLOCK:Daily Rental Vehicle- Complete Sections A, B and Vehicle- Check the appropriate box below and complete sections indicated:Add LESSEE INFORMATION -Complete Sections A through LESSEE INFORMATION -Complete Sections A and C (if changed), D (if changed) and LESSEE INFORMATION -Complete Sections A and Identification NumberTitle NumberRegistration Plate NumberSignature of Vehicle Owner or Authorized PersonDateLast Name or Full Business NameFirst NameMiddle NameI certify all INFORMATION listed above is TRUE and (12-16) FOR LESSEE INFORMATIONAPPLICATION TO ADD, CHANGE OR DELETE LESSEEINFORMATION FOR A LEASED VEHICLEFor Department Use OnlyBureau of Motor Vehicles PO Box 68593 Harrisburg, PA 17106-8593 NOTE: Any changes in this INFORMATION provided at time of the original APPLICATION will require a new MV-1L to be completed and returned to PennDOT ( , daily rental to long term lease, long term to daily rental).
2 Street AddressCityCountyStateZip CodeApplicant Last Name or Full Business Name First NameMiddle NamePA DL/Photo ID# Date of Birthor Bus ID#Co-Applicant Last NameFirst NameMiddle NamePA DL/Photo ID# Date of BirthCurrent Street AddressCityCountyStateZip CodeCheck the appropriateblock to indicatethe proper combination0 Vehicle OwnerVehicle OwnerVehicle Owner1 Vehicle OwnerLesseeVehicle Owner5 Vehicle OwnerVehicle OwnerLessee6 LesseeLesseeVehicle Owner7 LesseeVehicle OwnerLessee2 LesseeLesseeLesseeRegistration owner - keeps the registration plate when the lease document recipient - receives the registration plate,card, weight class decal, and VIN to renew recipient - receives the registrationrenewal us at or call us at:In state: 1-800-932-4600 uTDD: 1-800-228-0676 uOut-of-State: 1-717-412-5300 uTDD Out-of-State: 1-717-412-5380
