Form Mv-904sp - Application For Special Organization Registration Plate Page 2

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GENERAT.
INFORMATION REGARDTNG
A
SPECIAL ORGANIZATION PLATE
.
PLEASE
ALLOW 4.6 WEEKS FOR
DELIVERY.
'
This
app
Sections
A'
D
(if
nd
in
full,
turned
to the
orgernization
official for
submissi
or'
No
application
to
the
orga
mber wilr
be processed. The organization
must
com
s
B
and
C.
All
app
be
DOT
by
ation.
'
t
listed
in
section
A must
b
d
owner
of the vehicle
a$
inrdicated
on
the
verhicle,:;
registration
the vehicle is
a
leased
vehicle,
"Application
for Lessee Information," must be completed and
attached.
MV.1L is
available
on our
webs
v.srate.pa.us.)
'
PennDor
charges
an issuance fee of
$25'
Participating organizations may charge an
add
tional fee
above
the $25
l)ennDoT
fee.
The organization fee is
$__.
Therefore, the
totil
fu-"
Oue
with this application is
$__..
Fees must
be
made payabte
to
the organization name
of _
.
organization
I
duplicated.
I
n
registration
this
applicat
replacement
and
submit
Plate,
Renewal
Sticker
or Weight
Class
Sticker,',
nt
special organization registration
plate can
b
.pa.us.)
'
Requests for special organization registration
plates-
are restricted
to
passenger vehicles,
tru,cks
with
a
registered gross weight of not
more
than
14'000
lbs.,
trailers
and motor homes'
Motorcycles
co
not qualify for special
,rrganlation
registration
plates.
'
No
REFUND
oF
FEE
will
be issued
when
an
applicant
cancels
a
request
afier the
order is placed.
'
when
the applicant
ceatses
to be a
member
in the
organization
as
listed
in
Section B, thr: registration
plate
must be returned
to
PennDoT
Complete
Form
MV-44
and
submit a
fee of
$tt
for.
the
issuance of
a
regular series
,Jgiitration
plate.
'
Special organization registration
plates are
issued
in
number sequence unless requesting porsonalization
in section
D.
'
To
avoid possible problerns with citations
with
your old registration plate, return it to: Bureau of Motor Vehicles,
Fleturn
.lag
Unit,
p.o.
Box 68597,
Harrisburg'
PA 17106-s597
after you
have
reieived
your
special
organization
registration
ptate.
'
lf applying for a Fraternal
order
of
Police plate, the
PA
State Lodge seal and the
pA
State
Loclge
Recording
secrr:tary
signature must
be affixed to this application.
IF PERSONALIZING YOUR
SPECIAL ORGANIZATION REGIS;TRATION PLATE
'
Personalized Special
Organization
registration plates
may
contain up
to
FIVE letters
and
nurnbers in cr)mbination.
'
A
hyphen or space
is
not recognized as part of the registration plate configuration and does not count as one
of
the
letterr;
or numbers.
An extra box
is
provided
if
you wish to include
a
hyphen or space as part
6f
your configuration.
only
one hyphen or
spac€, is
permitted,
but not both.
lf
you do not wish to include a hyphen or space,
do
not
use the
extra box.
Nol'E:
No adclitional special
craracters
are
available.
'
When requesting a
numeric
character of
zero,
please list as
"g
" instead of the
alpha
characl:er
of
,,O".
.
PennDOT reserves
the
right
tcl
limit or
reject
certain
requests.
'
Ira
r
requt:st.
The fee to
personalize
your
special
lon
the
cost
of your personalized iegistration
er
ration, please include.your completed renewal
n'
pplication,"
or
Form MV-140, "Request
for
Flegistration,"
and
a
separate check or money
order
in
the amount
of
your registration
renewal fee.
Payment
is
to be
mrade
by check or money order
payable
to
the Commonwealth
of Pennsylvania. pLEASE
DO
N
OT
SEND CASH.
'
To
check personalized registration plate availability, visit PennDOT's Driver and Vehicle Servir:es website, ,
and
select
the
Personalized Registration
Plate
Availability link from
the
list
of
services under
the
Online Driver
and
Vehicle
Services
heading.
Personalized
registration plates will not be reserved until
PennDOT
receives paynrent and
er
completed
apprlication, ano
approves your requested registration
plate
configuration [number(s) and/or
lette(s)].
Please note
that
registratiol
plate requests are
processed on a first-come,
first-served
basis.
Although a
requested registration
plate configuration
mal'ihow
as
being
available
on
the website, it is possible that a request for the same
registration
plate configuration may
herve alreadlT
been submittirJ by
another
customer
ancl
may not be available
when
making application.
'
Personal registration plates
will be
manufactured on
the
basis
of this
application.
No refurrd
of the
fee will be
issued when
an
applicant cancels
a
request
afler the order
is placed with
the
manufacturer.
Visit
us
at
or call us
at:
ln
state:
1-800-932-4600
o
TDD:
1-800-228-0676
t
Out-of-State: 1-7'17-412-5300
aTDD
Out-of-State:
1-117-412-Sg8O

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