Mv-1l - 2007 - Application For Lessee Information
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1MV-1L
(8-07))
APPLICATION FOR
Department of Transportation
LESSEE
Bureau of Motor Vehicles
1101 S. Front Street
INFORMATION
Harrisburg, PA 17104-2516
FOR DEPARTMENT USE ONLY
APPLICATION TO ADD, CHANGE OR DELETE LESSEE INFORMATION FOR A LEASED VEHICLE
CHECK
THE APPROPRIATE BLOCK:
Daily Rental Vehicle - Complete Sections A, B and E.
Leased Vehicle - Check the appropriate box below and complete sections indicated:
Add Lessee Information - Complete Sections A through E.
Change Lessee Information - Complete Sections A and C (if changed), D (if changed) and E.
Delete Lessee Information - Complete Sections A and E.
NOTE:
Any changes in this information provided at time of the original application will require a new MV-1L to
be completed and returned to the Department (i.e., daily rental to long term lease, long term to daily rental).
A
VEHICLE INFORMATION
VEHICLE IDENTIFICATION NUMBER
TITLE NUMBER
REGISTRATION PLATE NUMBER
B
VEHICLE OWNER INFORMATION -
NOTE: The title will always be in the name of the owner and mailed to the owner or encumbrance holder.
MIDDLE NAME
LAST NAME OR FULL BUSINESS NAME
FIRST NAME
STREET ADDRESS
ZIP CODE
CITY
STATE
C
LESSEE INFORMATION - Person/Company leasing the vehicle from the vehicle owner.
PA DL OR PHOTO ID #
DATE OF BIRTH
APPLICANT LAST NAME OR FULL BUSINESS NAME
MIDDLE NAME
FIRST NAME
OR BUS. ID #
CO-APPLICANT LAST NAME
MIDDLE NAME
DATE OF BIRTH
FIRST NAME
PA DL OR PHOTO ID #
CURRENT STREET ADDRESS
CITY
STATE
ZIP CODE
D
MAILING INFORMATION - Please read each column heading.
Check the appropriate
Registration owner - who keeps
Registration document recipient - who will
Application to renew recipient - who
block to indicate
the registration plate when the
receive the registration plate, card, sticker,
will receive the registration renewal
the proper combination
lease expires.
weight class decal, and VIN plate.
application.
VEHICLE OWNER
VEHICLE OWNER
VEHICLE OWNER
0
1
VEHICLE OWNER
LESSEE
VEHICLE OWNER
5
VEHICLE OWNER
VEHICLE OWNER
LESSEE
6
LESSEE
LESSEE
VEHICLE OWNER
LESSEE
VEHICLE OWNER
LESSEE
7
2
LESSEE
LESSEE
LESSEE
E
CERTIFICATION
I certify all information listed above is true and correct.
Signature of Vehicle Owner or Authorized Person
Date
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