Form Mv-11 - Application For Permanent Antique, Classic Or Collectible Registration Plate - Pennsylvania Department Of Transportation

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MV-11 (1-17)

APPlicAtiOn fOr PermAnent

Antique, clAssic Or cOllectible

registrAtiOn PlAte

For Department Use Only

Bureau of Motor Vehicles • Special Tag Unit • P.O. Box 68293 • Harrisburg, PA 17106-8293

The fee for any of the above registration plates is $75, plus a certificate of title fee of $51 and a $5 fee for local use, if applicable. Refer to the

Fee For Local Use Fact Sheet on our web site at The use of antique, classic and collectible registration plates is governed

by Section 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 one day a week.

nOte: 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. nOte: Collectible vehicles are not eligible to display a

vintage registration plate.

Although buses and trucks are eligible for antique and classic registration plates, buses mAY nOt be used to transport passengers and

trucks mAY nOt haul cargo.

Antique and classic plates are not available for motorized pedalcycles or motor homes.

If your title is being held by a lienholder and it is an Electronic Lien Title (ELT), check here.

(No Paper Title Will Be Attached)

A APPlicAnt(s) infOrmAtiOn

PA DL/Photo ID#

Date of Birth

Last Name (or Full Business Name)

First Name

Middle Name

or Bus. ID#

Middle Name

Date of Birth

PA DL/Photo ID#

Co-Owner Last Name

First Name

Street Address

Daytime Telephone Number

(

)

City

State

Zip Code

VeHicle DescriPtiOn AnD generAl infOrmAtiOn

Title Number

Vehicle Identification Number

Odometer Reading

Body Type

Policy Number

Insurance Company Name - (Copy of valid Proof of Insurance must be attached.)

Policy Effective Date

Policy Expiration Date

cOllectible VeHicle infOrmAtiOn

Describe in detail how the vehicle has been modified to qualify as a collectible vehicle as defined on the reverse side of this form. All engine and

exhaust system modifications must be described in detail and two additional color photographs are required. One photo of the engine compartment

that shows the qualifying engine modifications and the other of the exhaust system that shows the modified changes or the new exhaust system that

was installed must be included. nOte: If the change is not engine related, i.e., low slung “1950’s” type vehicles, an additional color photograph of the

vehicle must be included. Please use additional pages if more space is required:

OPtiOnAl PersOnAliZAtiOn request (nOte: Additional $100 Fee Required.)

The number of allotted letters or numbers in combination varies depending on the selected registration plate type. Pre-printed letter

configurations or designated letter(s) appear on personalized registration plates based on the type of plate requested. Please see the

reverse side of this application for additional information. Only one hyphen or space is permitted as part of the available spaces for

personalization. No other special characters are available. Please print clearly.

THIRD CHOICE

FIRST CHOICE

SECOND CHOICE

self-certificAtiOn AnD signAture

The 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 would

have been in at the time it was originally manufactured and both interior and exterior are in good condition including paint, chrome, wheels and body.

I understand that this vehicle must be maintained in compliance with Pennsylvania Equipment Regulations.

The signature below hereby certifies under penalty of law that the information contained herein is true and correct. WArning: Unsworn falsification to

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 Pa.C.S. Section 4904[b]).

Signature

Signature of Co-Owner/Title of Authorized Signer

Date