Penndot Form Mv-402
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2MV-402 (2-08)
APPLICATION FOR
Commonwealth of Pennsylvania
SUN SCREENING
Department of Transportation
CERTIFICATE OF
Vehicle Inspection Division
P.O. Box 68697
EXEMPTION
Harrisburg, PA 17106-8697
FOR DEPARTMENT USE ONLY
THE FOLLOWING QUESTIONS ARE TO BE ANSWERED BY THE APPLICANT
1. Full Name
Daytime Telephone #
NOTE: Individuals should list their PA Driver’s
PA DL/Photo ID # or Bus. ID#
License (PA DL) or Photo ID # in the space provided.
Businesses should list their Business ID# (Bus. ID)
Date of Birth
where indicated (i.e. E.I.N).
2. Street Address __________________________________________________________________________
City
State
Zip Code
3. Vehicle for which application is being made. Make
Year
VIN
Registration Plate
Title Number
4. Windows with after market sun screening for which a certificate of exemption is requested:
“PLACE X WHERE NEEDED”
Windshield
Driver Side: Left Front ______________
Left Rear ______________
Passenger Side: Right Front _____________
Right Rear _____________
On vans, station wagons and buses list the number of additional rear side windows:
Number of additional passenger side right-rear windows: __________________
Number of additional driver side left-rear windows: _______________________
5. When did you purchase this vehicle?
Date _______________/________/____________
Month
Day
Year
6. When was the sun screening installed?
Date _______________/________/____________
NOTE: To be approved for window darkening
Month
Day
Year
products, installation must have been prior to
September 8, 1984.
6a.If unknown, was sun screening installed prior to
your ownership of the vehicle?
Yes _____________ No _______________
7. When was this vehicle first registered by you
in Pennsylvania?
Date _______________/________/____________
Month
Day
Year
8. What is the serial number of the current inspection
sticker displayed on this vehicle?
Number __________________________________
I certify under penalty of law that the above facts are true and correct to the best of my knowledge and that the
vehicle is equipped with the after market sun screening as indicated.
Vehicle Owner’s Signature ________________________________________________ Date _______________
(When vehicle is registered in more than one name, all signatures must appear above.)
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