The MV-427 PennDOT form is a crucial document used for applying to establish or modify an inspection station in Pennsylvania. This form is essential for ensuring compliance with state regulations regarding vehicle safety and emissions inspections. Completing the MV-427 accurately is vital, as any omissions or inaccuracies can lead to delays or rejection of the application.
The MV-427 form is a crucial document for individuals or businesses seeking to establish or modify a vehicle inspection station in Pennsylvania. This form is part of a comprehensive application process that ensures all safety and emission inspection stations meet the necessary regulatory requirements. When submitting the MV-427, applicants must include a detailed checklist of supporting documents to avoid rejection. Essential components of the application include separate forms for safety and emissions inspections, proof of liability insurance or a bond, and a list of certified safety inspectors. Additionally, the form requires information about the business, including ownership details, inspection area specifications, and any changes in station authority or location. Completing the MV-427 accurately is vital, as any discrepancies can lead to the invalidation of the application. The application process is designed to maintain high standards of vehicle safety and environmental compliance, ultimately benefiting the community and the state. Proper preparation and adherence to the outlined requirements are essential for a successful application.
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)
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
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
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?
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?
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?
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?
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?
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?
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?
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
LICENSE
CLASS
EXPIRATION
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
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.
_____________________________
2.
3.
4.
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.
(Print Name As It Appears Above)
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.
The MV-427 form is a crucial document for those applying to become an official vehicle inspection station in Pennsylvania. However, several other forms and documents are often required to accompany this application. Each of these documents serves a specific purpose and helps ensure that the application is complete and compliant with state regulations. Below is a list of these important forms and documents.
Gathering these documents is essential for a smooth application process. Each form and piece of information plays a vital role in establishing compliance with Pennsylvania's regulations for vehicle inspection stations. Ensuring that all required documentation is complete and accurate will help avoid delays or rejections in the application process.
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When filling out the MV-427 form for PennDOT, it’s essential to follow the guidelines carefully to ensure a smooth application process. Here are seven key takeaways:
The MV-427 form is an application for individuals or businesses wishing to establish a new vehicle inspection station or make changes to an existing station. Changes may include alterations in ownership, location, or type of inspection services offered. Proper completion of this form is crucial, as it serves as the appointment certificate once approved.
To ensure a complete application, the following documents must be included:
Failure to include any of these items may result in rejection of the application.
The MV-427 form should be completed using black ink, with clear and legible printing or typing. It is essential to provide accurate and complete information, as any false or misleading details can invalidate the application. Each section must be filled out according to the instructions provided, ensuring that the purpose of the application is correctly indicated.
If the submitted application packet is found to be incomplete, the applicant will receive a letter detailing the deficiencies. It is important to address these issues promptly to avoid delays in the approval process.
No, you cannot apply for both safety and emissions inspections on the same MV-427 form. Each type of inspection requires a separate application. Be sure to complete one form specifically for safety inspections and another for emissions inspections, as indicated in the application instructions.
The required amount for liability insurance or bond is at least $10,000. This coverage must compensate for any damage to a vehicle during an inspection. The proof of insurance or bond should clearly indicate the station name, physical location, coverage amount, and period of coverage.
The completed MV-427 application packet should be mailed or emailed to the following address:
Pennsylvania Department of Transportation Vehicle Inspection Division P O Box 68696 Harrisburg, PA 17106-9003 ATTN: Troy Roadcap, Manager EMAIL: stationappointments@pa.gov
Ensuring that the packet is sent to the correct address is crucial for timely processing.
This is incorrect. Applicants must complete separate forms for safety and emissions inspections. You cannot check both on the same form.
In fact, if applying for both safety and emissions inspections, two distinct forms must be submitted: one for safety and another for emissions.
This is false. All items listed in the checklist must be included. Incomplete packets will be rejected, and a letter will notify the applicant of any deficiencies.
This is not true. A copy of the lease or deed is a required document that must be included with the application packet.
This is misleading. The proof of insurance or bond must be at least $10,000, specifically providing coverage for damages during inspections.
This is incorrect. The application requires the most recent electric and phone bills as proof of business operations.
This is false. A valid EIN or SSN is mandatory for completing the application process.