Form Mv-3 - Motor Vehicle Verification Of Fair Market Value By The Issuing Agent

Download a blank fillable Form Mv-3 - Motor Vehicle Verification Of Fair Market Value By The Issuing Agent in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form Mv-3 - Motor Vehicle Verification Of Fair Market Value By The Issuing Agent with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

MV-3 (3-17)

MOTOR VEHICLE VERIFICATION OF FAIR

www dmv pa gov

MARKET VALUE BY THE ISSUING AGENT

For Department Use Only

Bureau of Motor Vehicles • 1101 S. Front St. • Harrisburg, PA 17104-2516

TYPE OR PRINT ALL INFORMATION AS REQUESTED

VEHICLE DESCRIPTION

Model Year

Make of Vehicle

Model

Body Type

Purchase Price

Vehicle Identification Number (VIN)

Odometer Reading

(No Tenths)

______ ______ ______ , ______ ______ ______

AGENT VERIFICATION OF FAIR MARKET VALUE - Check (

) the appropriate block:

r I certify that the average Fair Market Value for the vehicle described above is $ ________________________________________

as verified by the current edition of a PennDOT approved publication.

Name of Publication: ______________________________________________________________________________________

r This vehicle or the fair market value for this vehicle was not listed in a current edition of a PennDOT approved publication in my

possession.

Signature of Authorized Agent

Agent Number

Date

PURCHASER INFORMATION

Last Name (or Full Business Name)

First Name

Middle Name

PA DL/Photo ID#

Date of Birth

or Bus. ID#

Co-Purchaser Last Name

First Name

Middle Name

PA DL/Photo ID#

Date of Birth

PURCHASER/SELLER EXPLANATION

Explain in detail why the purchase price listed on Form MV-1, MV-4ST, MV-217 or Applicant Summary Statement is less than 80% of the average Fair Market Value, or if

the vehicle is over 15 years old and the purchase price is less than $500, explain how the purchase price was determined, or if the vehicle is not listed in a PennDOT

approved publication, explain how the purchase price as listed in Section A was determined. Please use additional paper if more space is required. NOTE TO PURCHASER:

An additional audit of this vehicle sale by the Department of Revenue may occur. Please retain copies of this form, your cancelled check or original cash

receipt, and your receipt from the seller of this vehicle, along with either your copy of the Application for Certificate of Title (Form MV-1), the Vehicle Sales and

Use Tax Return/Application for Registration (Form MV-4ST) or the Application by Financial Institutions for Certificate of Title After Default by Owner (Form MV-

217A). If you fail to reply to the Department of Revenue, you will be assessed for the estimated amount of tax due.

SEAL AND SIGNATURE OF SELLER - NOT REQUIRED FOR VEHICLES PURCHASED OUT-OF-STATE

I/We state that I/we have read and signed this form after its completion, and I/we swear or

SUBSCRIBED AND SWORN

TO BEFORE ME:

MONTH

DAY

YEAR

affirm that the statements made herein are true and correct, and that any statement made on

or pursuant to this form is subject to the penalties of 18 Pa.C.S. Section 4903(a)(2) (relating to

false swearing), which shall include punishment of a fine not exceeding $5,000, or to a term or

SIGNATURE OF PERSON ADMINISTERING OATH