www.dmv.pa.gov APPLICATION FOR PERMANENT ANTIQUE, …

1 Check (4) block below to indicate type of registration plate desired as defined on the reverse side of this form:qANTIQUEqclAssicqcOllEcTiblE -The vehicle must be currently branded as a collectible vehicle or the vehiclemust follow procedures as outlined in Form APPlicANT(s) iNfOrmATiONb vehicle DEscriPTiON AND gENErAl iNfOrmATiONc cOllEcTiblE vehicle iNfOrmATiONE sElf-cErTificATiON AND sigNATurED OPTiONAl PErsONAliZATiON rEquEsT (NOTE:additional $104 Fee Required.)Last Name (or Full Business Name)Street addressCityStateZip CodeFirst NameMiddle NameDaytime Telephone NumberDescribe in detailhow the vehicle has been modified to qualify as a collectible vehicle as defined on the reverse side of this form.

2 All engine andexhaust system modifications must be described in detail and two additional color photographs are required. One photo of the engine compartmentthat shows the qualifying engine modifications and the other of the exhaust system that shows the modified changes or the new exhaust system thatwas installed must be included. NOTE:If the change is not engine related, , low slung 1950 s type vehicles, an additional color photograph of thevehicle must be included. Please use additional pages if more space is required:The fee for any of the above registration plates is $78, plus a certificate of title fee of $53 and a $5 fee for local use, if applicable.

3 Refer to theFee For Local use Fact Sheet on our website at The use of antique , classic and collectible registration plates is governed bySection 1340 of the Pennsylvania vehicle Code which states: It is unlawful for any person to operate a motorcycle or vehicle with ANTIQUE, classic or collectible registration plates for general daily transportation. Permitted use shall be limited to participation in club activities, exhibits,tours, parades, occasional transportation and similar uses. Occasional transportation and similar uses is defined as no more than oneday a : If you are applying to display a vintage registration plate on your antique or classic vehicle , you must complete Form MV-11V, APPLICATION to Display a Vintage Registration Plate," and submit with appropriate fees.

4 NOTE:Collectible vehicles are not eligible to display avintage registration buses and trucks are eligible for antique and classic registration plates, buses mAY NOTbe used to transport passengers andtrucks mAY NOThaul and classic registration plates are not available for motorized pedalcycles or motor your title is being held by a lienholder and it is an Electronic Lien Title (ELT), check here. (No Paper Title Will Be Attached) ( )Title NumberInsurance Company Name - (Copy of valid Proof of Insurance must be attached.)Policy NumberPolicy Effective DatePolicy Expiration DateVehicle Identification NumberMake of VehicleModel YearBody TypeSignatureSignature of Co-Owner/Title of authorized SignerqCo-Owner Last NameFirst NameMiddle NamePa DL/Photo ID#or Bus.

5 ID#Date of BirthPa DL/Photo ID#Date of BirthThe vehicle has been maintained in or restored to a condition that is essentially the same as that which a vehicle of that particular year and model wouldhave been in at the time it was originally manufactured and both interior and exterior are in good condition including paint, chrome, wheels and understand that this vehicle must be maintained in compliance with Pennsylvania Equipment signature below hereby certifies under penalty of law that the information contained herein is TRuE aND CORRECT. WArNiNg:unsworn falsificationto authorities is a misdemeanor of the third degree punishable by a fine of up to $2,500 and/or imprisonment up to 1 year (18 Section 4904[b]).

6 MV-11 (7-17) APPLICATION fOr PERMANENT antique , clAssic Or cOllEcTiblErEgisTrATiON PlATEFor Department Use OnlyBureau of motor Vehicles Special Tag Unit Box 68293 Harrisburg, PA 17106-8293 The number of allotted letters or numbers in combination varies depending on the selected registration plate type. Pre-printed letterconfigurations or designated letter(s) appear on personalized registration plates based on the type of registration plate the reverse side of this APPLICATION for additional information. Only one hyphen or space is permitted as part of the available spaces other special characters are available.

7 Please use capital letters and print Odometer : When requesting a numeric character of zero, please show as " " instead of the alpha character "O." Since this is an electronically fillableform, after printing the form, please be sure any zero is marked with a "/."THIRDCHOICESECONDCHOICEANTiquE, clAssic AND cOllEcTiblE VEHiclEsThe following rules govern the issuance of antique , classic and collectible registration Definitions a. antique motor vehicle - a motor vehicle , but not a reproduction thereof, manufactured more than 25 years prior to the current year which has beenmaintained in or restored toa condition which is substantially in conformance with manufacturer specifications.

8 B. Classic motor vehicle - a motor vehicle , but not a reproduction thereof, manufactured at least 15 years prior to the current year which has beenmaintained in or restored toa condition which is substantially in conformity with manufacturer specifications and appearance. any classic motorvehicle registered under Section 1340 (relating to antique , classic and collectible registration plates) on the effective date of the amendment to thisdefinition which fails to qualify as a classic motor vehicle pursuant to these provisions may retain such classic registration unless another type ofregistration is applied for and issued for the vehicle .

9 C. Collectible motor vehicle - a reconstructed motor vehicle , but not a reproduction thereof, substantially modified from the manufacturer s originalspecifications and appearance and maintained ina collectible condition as determined by the Department of Transportation. NOTE:Generally,substantial changes to the engine and exhaust systems must be done to qualify the vehicle as a collectible motor vehicle . If the extensive changesare other than engine, be sure to give very detailed and specific information in Section C on the front of this form. In addition, the vehicle must primarilybe used for show and must appear to be in show condition in the photographs submitted with the Expiration of antique , classic and collectible registration Platesantique, classic and collectible registration plate are PERMANENT and are issued for the life of the vehicle while it is owned by the present owner.

10 If the presentowner sells the vehicle , the registration plate remains with the seller/owner and may be used on another qualified vehicle , provided the proper $78 registrationand $53 title fees are paid. However, if ownership is transferred between spouses, or between parent and child, the original registration plate may betransferred in the usual manner with a $53 title fee and $9 transfer the owner sells the vehicle and wants to give the new owner the registration plate, the seller must write a letter of release for the registration plate and giveit to the new owner. The new owner should forward the letter to the Bureau of motor Vehicles, along with all appropriate documents and fees when applyingfor title and registration of the vehicle .