Form Mv-1l - Application For Lessee Information
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1MV-1L (4-13)
APPLICATION FOR LESSEE INFORMATION
APPLICATION TO ADD, CHANGE OR DELETE LESSEE
INFORMATION FOR A LEASED VEHICLE
For Department Use Only
Bureau of Motor Vehicles • 1101 South Front Street • Harrisburg, PA 17104-2516
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.
Last Name or Full Business Name
First Name
Middle Name
Street Address
City
County
State
Zip Code
C LESSEE INFORMATION
- Person/Company leasing the vehicle from the vehicle owner.
Applicant Last Name or Full Business Name
First Name
Middle Name
PA DL or Photo ID# Date of Birth
or Bus ID#
Co-Applicant Last Name
First Name
Middle Name
PA DL or Photo ID# Date of Birth
Current Street Address
City
County
State
Zip Code
D MAILING INFORMATION
- Please read each column heading.
Registration document recipient -
Application to renew recipient -
Check the appropriate
Registration owner - who keeps
who will receive the registration
the registration plate when the
who will receive the registration plate, card,
block to indicate
renewal application.
the proper combination
lease expires.
sticker, weight class decal, and VIN plate.
0
Vehicle Owner
Vehicle Owner
Vehicle Owner
1
Vehicle Owner
Lessee
Vehicle Owner
5
Vehicle Owner
Vehicle Owner
Lessee
6
Lessee
Lessee
Vehicle Owner
7
Lessee
Vehicle Owner
Lessee
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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