Form Mv-141 - Surrender Of A Registration Plate
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1MV-141 (3-17)
SURRENDER OF A REGISTRATION PLATE
www dmv pa gov
For Department Use Only
Registration Plate Must be Attached
Bureau of Motor Vehicles • 1101 S. Front Street • Harrisburg, PA 17104
A Applicant and Vehicle Information
Name of Registrant
Vehicle Identification Number
Registration Plate Number
Expiration Date
Title Number
Mo.
Yr.
B The above registration plate is being returned to PennDOT for the following reason(s):
1.
Replacement of Registration Plate
5.
Moved Out-of-State
9.
Exchange Registration Plate Issued
2.
Vehicle Sold (no plate needed)
6.
Insurance Stop
10.
Termination or Lapse of Insurance
3.
Voluntary Surrender
7.
Vehicle Returned to Dealer Within 20 Days
11.
Registration Privileges Suspended
4.
Personalized Registration Plate - Issued _____
8.
Vehicle Deal Cancelled
12.
Other:____________________________
C Decentralized Service or Full Agent Information (If applicable)
The registration plate listed above was surrendered on _______________ to the authorized agent below:
DATE
Decentralized Service or Full Agent Name
City
State
Zip Code
Street Address
NOTE TO VEHICLE OWNER: You must retain a copy of this receipt in order to obtain a replacement registration plate from an authorized agent.
FOR DEPARTMENT USE ONLY
Date Received
Month
Day
Year
INSTRUCTIONS
1. Vehicle owner and registration information must be listed in Section A exactly as shown on the vehicle owner's registration card.
2. In Section B, check appropriate reason the registration plate is being returned to PennDOT. NOTE: The registration plate must
be attached.
3. If the surrendered registration plate is being surrendered to an authorized decentralized service agent or full agent, Section C
must be completed by the authorized decentralized service agent or full agent and forwarded to PennDOT along with the
registration card and registration plate. Decentralized service agents must forward through the Messenger Service Center.
Full agents must mail this form to PennDOT’s Bureau of Motor Vehicles, P.O. Box 68674, Harrisburg, PA 17106-8674. If
completed by an authorized decentralized service agent or full agent, a copy of this form must be retained by the
authorized agent for at least three years. A copy of this completed form must be provided to and retained by the vehicle owner
and will be necessary to obtain a replacement registration plate, if needed at a later date.
If this form is completed by the applicant, the form and registration plate must be mailed to the Bureau of Motor Vehicles, P.O.
Box 68597, Harrisburg, PA 17106-8597. A copy of this completed form must be retained by the vehicle owner and will be
necessary to obtain a replacement registration plate, if needed at a later date.
4. To obtain a replacement registration plate, applicants must provide a copy of this completed form to a decentralized agent or
PennDOT's counter service in Harrisburg for a replacement.
Visit us at or call us at:
In state: 1-800-932-4600
TDD: 1-800-228-0676
Out-of-State: 1-717-412-5300
TDD Out-of-State: 1-717-412-5380
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