Fill Out a Valid Mv 427 Penndot Form

Fill Out a Valid Mv 427 Penndot Form

The MV-427 PennDOT form serves as a crucial application for establishing a new safety inspection station in Pennsylvania or making significant changes to an existing one. It stipulates a comprehensive checklist that ensures applicants submit all necessary information accurately and completely. Failure to comply with these requirements leads to the rejection of the application, underscoring the form's importance in maintaining high standards for vehicle safety inspections.

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The MV-427 PennDOT form is essential for various business operations related to vehicle inspection stations in Pennsylvania. This comprehensive form serves as an application for new inspection stations and for existing stations undergoing changes such as relocation, ownership transfer, or reappointment following suspension. Detailing the process meticulously, the form necessitates the inclusion of several critical pieces of information and documents, such as the MV-427A for stations applying for both safety and emission inspections, a list of certified safety inspectors with their numbers, a Certificate of Liability Insurance or bond with specific requirements, and a valid Employer Identification Number (EIN) or Social Security Number (SSN), among others. The packet must also contain proof of a valid insurance policy with PennDOT as the certificate holder, adding layers of verification to safeguard both the station and its clientele. Moreover, an instruction sheet provides step-by-step guidance on accurately completing the form, ensuring all submitted information is clear and precise to facilitate smooth and efficient processing. This meticulous approach ensures the highest standards of safety and compliance are upheld, reflecting the state's commitment to maintaining road safety and vehicle integrity.

Document Example

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)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

 

 

 

 

County

 

 

 

 

 

 

 

 

State

 

 

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

 

(Title)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

 

 

 

 

NAME

TITLE

PA DL/PHOTO ID#

DATE OF BIRTH

 

 

 

 

STREET ADDRESS

CITY

STATE

ZIP

 

 

 

 

NAME

TITLE

PA DL/PHOTO ID#

DATE OF BIRTH

 

 

 

 

STREET ADDRESS

CITY

STATE

ZIP

 

 

 

 

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?

Yes _____ No _____

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?

Yes _____ No _____

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?

Yes _____ No _____

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?

Yes _____ No _____

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?

Yes _____ No _____

If yes, explain

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

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?

Yes _____ No _____

If yes, explain

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

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?

Yes _____ No _____

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

 

NAME

LICENSE

CERTIFICATION

CLASS

 

 

 

EXPIRATION

EXPIRATION

 

 

DATE

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

Vehicle Inspection Division

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.

_____________________________

1.

_____________________________

1.

_____________________________

2.

_____________________________

2.

_____________________________

2.

_____________________________

3.

_____________________________

3.

_____________________________

3.

_____________________________

4.

_____________________________

4.

_____________________________

4.

_____________________________

5.

_____________________________

5.

_____________________________

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.

(Title)

______________________________________________________________

____________________

(Print Name As It Appears Above)

 

 

(Date)

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.

Form Breakdown

Fact Number Fact Detail
1 The MV-427 form is used for applying for a new inspection station or making changes to an existing one.
2 When applying for both safety and emission inspection stations, separate forms MV-427 for safety and MV-427A for emission must be completed.
3 A list of certified safety inspectors, including their inspector numbers, must be submitted with the form MV-443.
4 Proof of a minimum $10,000 liability insurance or bond is required, ensuring coverage for vehicle damage during inspections.
5 The insurance or bond must list the station's name, physical location, coverage amount, and period.
6 Applicants must include a valid Employer Identification Number (EIN) or Social Security Number (SSN) and a State Sales Tax Number in the application packet.
7 Photos of the inspection area, sticker security area, and office area, along with copies of the most recent utility bills, are required.
8 The application process is governed by the Vehicle Code, 75 Pa.C.S. Sections 4721, 4723 or 3368, and regulations established by the Pennsylvania Department of Transportation (PennDOT).

Mv 427 Penndot - Usage Guide

Completing the MV-427 form is an essential step for individuals or businesses looking to establish a new inspection station or update the details of an existing one. Careful completion ensures that all relevant information is accurately communicated to the Pennsylvania Department of Transportation (PennDOT). Here is a structured guide to assist with filling out this form.

  1. Start by reading the instruction sheet included in your station information packet to understand the form's purpose and requirements.
  2. Section A: Check the box that correctly describes your reasoning for submitting the form. Choose among options like new inspection station setup, reappointment, change of location, or ownership, among others.
  3. Section B: Provide business information such as the name and address of the business, telephone number, and the owner's name and driver's license number. Remember, if the owner's driver's license is from outside Pennsylvania, include the state abbreviation and driver's license number.
  4. Section C: Indicate the business structure (sole proprietorship, partnership, corporation), Federal ID and State Sales Tax numbers, the size of the inspection area, and the types of inspections your station will perform. If you're still waiting for any ID number, write "APPLIED FOR" in the respective box and submit the numbers to the Department once received.
  5. Section D: If applicable, provide details of any other inspection station(s) you own, or information regarding a station you wish to cancel due to changes in location, ownership, or type.
  6. Section E: Only fill this if a person other than the owner or a corporate officer will be responsible for operating the station. Print all parts except for the signature, which must be done by the owner or corporate officer directly.
  7. Leave Section F blank as it's for official use only.
  8. Section G: The form must be signed by either the owner or a corporate officer. If someone else is authorized to run the station, as noted in Section E, that individual must also sign the form.
  9. Double-check all sections to ensure completeness and accuracy. Providing false or inaccurate information can invalidate the application.
  10. Attach all required documents as listed in the Safety Station Application Checklist, including proof of insurance or bond, a list of certified safety inspectors, copies of lease or deed, recent utility bills, photos of the inspection and office areas, and any additional documents required based on your specific application.
  11. Once all parts of the form and attachments are ready, mail or email the complete packet to the address provided in the instructions, directed to the attention of Troy Roadcap, Manager, or the stationappointments@pa.gov email.

Completing the MV-427 form attentively is crucial for a successful application process. Each step ensures the Department of Transportation has the necessary information to process your application efficiently. Remember, any inaccuracies or omissions may lead to delays or rejection of your application. Therefore, take your time, follow the instructions carefully, and ensure everything is in order before submission.

More About Mv 427 Penndot

What is the purpose of the MV-427 form?

The MV-427 form is intended for use by businesses applying to become a new inspection station, or for existing inspection stations that need to report changes such as a change of location, ownership, reappointment after a suspension, and other significant modifications. It serves as the application for either initiating or altering the status of an inspection station's certification.

Can the same MV-427 form be used for both safety and emission inspections?

No, if applying for both safety and emission inspection certifications, two separate MV-427 forms must be filled out. One form should exclusively detail safety inspections, while the other should be solely for emissions. Checking both options on a single form is not permitted.

What additional documents are required alongside the MV-427 form?

Along with the MV-427 form, applicants must include form MV-427A (if applicable for both safety and emission inspection applications), a list of certified safety inspectors with their inspector number on form MV-443, a letter of authority included in section E if applicable, proof of insurance or bond, a copy of a valid insurance policy with PennDOT listed as the Certificate Holder, a copy of the lease or deed, recent utility bills, photos of the inspection and related areas, a valid Employer Identification Number (EIN) or Social Security Number (SSN), and a valid State Sales Tax Number.

How is the form MV-427 submitted?

The completed MV-427 form, along with all the required documentation, should be mailed or emailed to the Pennsylvania Department of Transportation Vehicle Inspection Division, at the address specified on the form directions. Attention should be given to Troy Roadcap, Manager or the relevant contact detailed in the form's instructions.

What happens if any information is missing from the application packet?

If the application packet is incomplete or lacks any required documents, it will be rejected. The applicant will receive a letter from PennDOT notifying them of the deficiencies and possibly providing instructions on how to complete the submission correctly.

Is proof of insurance required for the application?

Yes, proof of insurance or a bond in the amount of at least $10,000.00 is mandatory. This document must include the station's name, physical location, coverage amount, and period of coverage. Acceptable insurance is a “Garage Keeper’s Legal Liability Policy” which ensures compensation for any damages to vehicles during an inspection.

Are photos of the inspection station necessary for the application?

Yes, photos are required to show the interior and exterior of the inspection area, sticker security area, and the office area. These photos help verify the suitability of the location for conducting vehicle inspections according to PennDOT's standards.

What should be done if an applicant has not received their Federal ID or State Sales Tax Number yet?

If the Federal ID or State Sales Tax Number has been applied for but not yet received, the applicant may write "APPLIED FOR" in the appropriate fields on the form. However, the numbers should be forwarded to the Department as soon as they are received.

If there’s a change in station type, what should be done?

For changes in the type of inspection station (e.g., from general to motorcycle, fleet to general, or vice versa), the applicant must indicate this change in the appropriate section of the MV-427 form. A separate application may be required if adding an entirely new station type, such as emissions inspection if previously not authorized.

Common mistakes

When filling out the MV-427 PennDOT form for Safety Station Application, applicants often stumble over a handful of common but critical errors. These mistakes can delay the processing of the application, leading to unnecessary setbacks and frustrations. As someone embarking on this process, being aware and cautious of these pitfalls can ensure a smoother application journey.

First and foremost, a frequent mistake is the mishandling of the requirement to submit separate forms for safety and emissions inspections. The instructions clearly stipulate that if an applicant is seeking appointments for both safety and emission inspections, two distinct forms must be completed — one specifying SAFETY and the other EMISSIONS. However, applicants often check both boxes on a single form or submit only one form for both inspections, leading to the application's rejection.

Another common error involves the Section E – Letter of Authority on form MV-427, which mandates specific documentation when the figure listed is neither the owner nor listed as an owner/corporate officer on form MV-427A. Often, applicants overlook the necessity to provide a separate document detailing this individual's name and driver's license number. This omission can invalidate a crucial part of the application, as it fails to properly identify the person responsible for the operation of the inspection station.

Additionally, the requirement for attaching proof of insurance or a bond often trips up applicants. The proof must include the station name, physical location, amount of coverage, and period of coverage clearly detailed. Failure to attach this proof or providing incomplete information regarding the insurance policy or bond amounts to an incomplete application, thereby stalling the approval process. Given that insurance is a critical component for the operation's legality and safety, this oversight can have significant ramifications.

Lastly, the confusion surrounding the completion of the MV-427A form, particularly in the case of applying for both safety and emission inspection stations, results in errors. The form requires applicants to list all owners, partners, or corporate officers, including specific details such as driver's license numbers and dates of birth. Applicants sometimes omit critical details or incorrectly fill in the business information, leading to processing delays. Particularly, failing to distinguish between the requirements for safety versus emissions inspections in the documentation can cause the entire packet to be returned for correction.

Documents used along the form

When dealing with the process of applying for or making changes to an inspection station through PennDOT, the MV-427 form is just the tip of the iceberg. There are several additional forms and documents that might need to be prepared and submitted along with this form to ensure that the application process is smooth and complete. Each document serves a unique purpose, contributing to the comprehensive evaluation of the inspection station’s qualifications and readiness to provide services. Let’s dive into some of these essential forms and documents.

  • MV-427A: This supplemental form is required for each inspection station and is crucial for providing additional information that complements the MV-427. It covers details about owners, partners, or corporate officers, and acknowledges the need for a bond or insurance. This form helps PennDOT assess the legal and financial readiness of the station to operate within the state's regulatory framework.
  • MV-443: This form lists certified safety inspectors, including their inspector numbers. It is essential to ensure that all individuals performing safety inspections at the station are appropriately certified and their credentials are up to date. It provides PennDOT with the assurance that inspections will be carried out to the required standards.
  • Certificate of Liability Insurance or Bond: Proof of insurance or a bond, with a minimum coverage of $10,000, must be attached to the application. This document protects vehicle owners by ensuring compensation for any damages during an inspection. It must include the station name, location, coverage amount, and period of coverage.
  • Copy of Lease or Deed: Providing a copy of the lease or deed for the property where the inspection station operates verifies the legality of the business location. It helps PennDOT ensure that the station has a legitimate, physical presence in the state.
  • Copies of utility bills (most recent electric and phone bill): These documents serve as additional proof of the operational status and physical location of the inspection station. Ensuring that the station has active utilities helps confirm its readiness to provide services to the public.

While the MV-427 form is the cornerstone of the application or modification process for an inspection station, it’s clear that each accompanying document plays a critical role. From confirming the qualifications and certifications of inspectors with the MV-443, to ensuring financial responsibility through the Certificate of Liability Insurance or Bond, each piece of documentation collectively supports a seamless and regulated inspection process. Applicants need to prepare diligently, ensuring each requirement is met to facilitate their journey through PennDOT’s application process, ultimately achieving or maintaining their status as a certified inspection station.

Similar forms

The MV-427A form, which complements the MV-427 in the application process for an inspection station, is similar to the MV-427 form in its necessity for accuracy and completion to avoid application rejection. Like the MV-427, the MV-427A requires detailed business information, including insurance acknowledgments and owner details, making both forms critical in the vetting process for new or modifying inspection stations. This similarity ensures that applicants provide a comprehensive backdrop of their operational and ownership framework, aligning with regulatory requirements for transparency and accountability in business operations.

The MV-443 list of certified safety inspectors form shares resemblances with the MV-427, primarily in its role in ensuring compliance with safety and regulatory standards for inspection stations. By listing certified safety inspectors, the MV-443 form facilitates the verification process akin to how the MV-427 ensures stations meet setup and operational standards. Both documents function as integral parts of a larger framework designed to uphold safety, reliability, and competence within the vehicle inspection ecosystem, promoting a standardized approach to vehicle safety inspections.

The Certificate of Liability Insurance or Bond document required alongside the MV-427 form is similar in its function to safeguard against potential liabilities. Just as the MV-427 form stipulates the need for strict adherence to inspection standards, the certificate acts as a financial assurance, preparing inspection stations for accountability in case of damage or mishap during vehicle inspections. This confluence of precautions and standards across both documents emphasizes the commitment to protective measures, ensuring that all operational aspects of an inspection station are covered under regulatory safeguards.

The requirement for a valid Employer Identification Number (EIN) or Social Security Number (SSN) as part of the MV-427 form submission process mirrors similar regulatory practices seen in other business-related applications, making it akin to forms used in tax registration and employment regulation. This similarity underscores the importance of formal business identification and tracking, associating the business with federal and state regulatory bodies for accountability and tax-related processes. It meshes the operational aspects of vehicle inspection stations with broader business practice responsibilities, emphasizing regulatory compliance and the formalization of business identities.

Dos and Don'ts

Filling out the MV-427 Penndot form is a crucial step for those applying for a safety inspection station authorization or making changes to an existing station. Ensuring that the form is filled out correctly helps prevent delays or rejection of the application. Here are seven things you should and shouldn't do when completing the form:

  • Do use black ink and print clearly or type. This helps ensure that all information is legible and can be processed efficiently.
  • Do complete a separate form for safety and emissions if you are applying to be a safety and emission inspection station. Checking both boxes on the same form is a common mistake that leads to application rejection.
  • Do include all required attachments such as the MV-443 list of certified safety inspectors, proof of insurance or bond, a copy of the lease or deed, and photos of the inspection, sticker security, and office areas.
  • Do ensure that the person listed in Section E (Letter of Authority) is also listed as an owner or corporate officer on the MV-427 or MV-427A form, or provide a separate document with their name and driver's license number.
  • Don’t leave any sections incomplete. Incomplete information will result in the packet being rejected, and a notification of deficiency will be sent to the applicant.
  • Don’t provide false, inaccurate, or incomplete information. Doing so will automatically invalidate the certificate once it is discovered, potentially leading to significant delays or legal trouble.
  • Don’t forget to sign the application in Section G if you are the owner or corporate officer. In cases where Section E is completed, the authorized individual must also sign the application.

Following these guidelines closely will ensure that the application process is as smooth as possible. Attention to detail and thoroughness in providing all necessary information and attachments are key to a successful MV-427 form submission.

Misconceptions

There are several misconceptions about the MV-427 PennDOT form, which is crucial for the application and maintenance of vehicle inspection stations in Pennsylvania. Understanding these misconceptions can help streamline the application process and ensure compliance with state regulations. Below are ten common misunderstandings:

  • Only one MV-427 form is necessary for both safety and emission inspections: This is incorrect. If applying for a safety and emission inspection station, one form for safety and a separate form for emission must be completed. Checking both safety and emissions on the same form is a mistake.
  • The MV-427A form is optional: In fact, if applying for both safety and emission inspection capabilities, completing two separate MV-427A forms is mandatory. It's not optional but a requirement.
  • Certified inspector information can be omitted if unavailable at the time of application: The MV-443 list of certified safety inspectors, including inspector numbers, must be included in the packet. Omission can lead to rejection of the packet.
  • Any type of insurance or bond is acceptable: The application packet must include proof of insurance or a bond in the amount of at least $10,000.00, specifically for compensation for any damage to a vehicle during an inspection. Not all insurance types are acceptable.
  • A valid employer identification number (EIN) or social security number (SSN) isn't necessary for the application: A valid EIN or SSN is required and must be presented in the application packet.
  • Photos of the facility are not crucial for the initial application: Photos of the interior and exterior of the inspection area, sticker security area, and office area are required components of the station information packet.
  • The application process is complete upon submission of the MV-427 form: Completing and submitting the MV-427 form is just one step in the process. The entire station information packet must be submitted, and additional documentation is required for a complete application.
  • Personal driver’s license information of non-owner operators is irrelevant: If someone other than the owner or a corporate officer is listed in Section E of the MV-427 form, a separate document providing that person's name and driver's license number must be included.
  • Out-of-state driver’s license numbers do not require additional information: If providing an out-of-state driver's license number, the date of birth must also be provided with the information.
  • Submitting incorrect or incomplete information may delay the process but won't invalidate the application: Providing false, inaccurate, or incomplete information within the application automatically invalidates the certificate, contrary to some beliefs that it only causes delays.

Correcting these misconceptions is key to a smooth application process for becoming a certified inspection station in Pennsylvania. Complying with the specific requirements and understanding the significance of each document and piece of information requested can greatly expedite the process.

Key takeaways

When applying to become a designated inspection station in Pennsylvania or updating station details, it's crucial to follow the guidance provided by the Pennsylvania Department of Transportation (PennDOT) and accurately complete the MV-427 form. Here are the key takeaways to remember:

  • Ensure that the MV-427 form is filled out completely. For applicants seeking both safety and emission inspection designations, separate forms for each must be filled out — combining both on a single form is incorrect.
  • If the MV-427A form is part of your submission, accurately completing two separate forms is necessary when applying for both safety and emission inspection station status.
  • A list of certified safety inspectors, including their inspector number, is mandatory. This list verifies the qualifications of personnel conducting the inspections.
  • For the section on authority (Section E of the MV-427), if the individual listed is not the owner or a corporate officer, a supplementary document is required. This document must provide the name and driver’s license number, and if an out-of-state license, the date of birth must also be included.
  • Attach proof of a liability insurance policy or bond with at least $10,000 coverage. This serves as a safeguard, providing compensation for any damage occurring to a vehicle during its inspection. The documentation must clearly state the station name, physical address, coverage amount, and the coverage period.
  • Include a copy of the lease or deed to affirm the station's location along with the most recent utility bills as evidence of operational premises.
  • Photographs highlighting the interior and exterior of the inspection, sticker security area, and office area are required. These photos offer visual proof of the station's readiness and compliance with requirements.
  • The application packet must contain valid identification numbers, including an Employer Identification Number (EIN) or Social Security Number (SSN) and a State Sales Tax Number, to confirm the business's legitimacy.

Once all the documents are prepared following these guidelines, they should be mailed or emailed to the specified address or email provided by PennDOT. Adhering to the detailed instructions ensures a smoother approval process for the inspection station application.

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