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The MV-427 PennDOT form is a critical component for businesses aiming to operate as safety inspection stations within Pennsylvania, underscoring the importance of meticulous documentation and compliance with state regulations. Upon deciding to apply for a new inspection station designation or to announce changes such as a shift in location, ownership, or post-suspension reappointment, the MV-427 form serves as the foundational document required for submission. Alongside, the application process mandates the inclusion of a comprehensive station information packet, which must encompass a duly filled MV-427 form (with distinct forms for safety and emissions inspections), an MV-427A form for each inspection type, a list of certified safety inspectors via the MV-443 form, documented proof of a valid insurance policy or bond of at least $10,000 to cover potential vehicle damage during inspections, and concrete evidence of a viable business location and operations such as a lease or deed and recent utility bills. Failure to include any stipulated items results in the immediate rejection of the application, highlighted by a notification letter outlining the deficiencies. Importantly, the process also emphasizes the need for a valid Employer Identification Number (EIN), State Sales Tax Number, and the accurate completion of various sections covering business information and operational specifics to ensure compliance and facilitate the approval process. This rigorous submission prerequisite underscores the state’s commitment to maintaining high safety and emission standards, ensuring that only qualified and compliant stations attain the coveted status of being PennDOT-certified inspection centers.

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Safety Station Application Check List

Upon submission of the station information packet, all items below must be included. If information is incomplete, the packet will be rejected. A letter will be sent to the applicant, notifying them of the deficiency. Additionally, included in the packet is an instruction sheet detailing how to complete form MV-427.

MV-427 (If applying for a safety and emission inspection, station must complete one form for safety and a separate form for emission. (Do NOT check both safety and emissions on the same form. One form should only specify SAFETY and the other form, if necessary, should only specify EMISSIONS).

MV-427A (must complete two separate forms if applying for a safety and emission inspection station).

MV-443 list of certified safety inspectors (include inspector number).

If you have completed section E Letter of Authority on form MV-427 and the person listed in section E is not listed on the form MV-427 as owner or is not listed as an owner/corporate officer on form MV-427A, you must include a separate document to provide that person’s name and driver’s license number with the packet. (If you are providing an out-of-state driver’s license number, you must also provide date-of-birth with the information.)

MV-500

Certificate of liability insurance or bond: Attach proof of insurance or a bond, in the amount

of at least $10,000.00, providing compensation for any damage to a vehicle during an inspection. A

“ Garage Keeper’s Legal Liability Policy” is acceptable. This proof of insurance or bond MUST include station name, physical location, and amount of coverage and period of coverage.

Must have a valid insurance policy with PennDOT listed as the Certificate Holder, using the address below

Copy of lease or deed

Copies of utility bills (most recent electric and phone bill)

Photos of the interior and exterior of the inspection area, sticker security area, and office area.

Must have a valid Employer Identification Number (EIN) or Social Security Number (SSN)

Must have a valid State Sales Tax Number

The completed packet should be mailed/emailed to:

Pennsylvania Department of Transportation

Vehicle Inspection Division

P O Box 68696

Harrisburg, PA 17106-9003

ATTN: Troy Roadcap, Manager

EMAIL: stationappointments@pa.gov

MV- 4 2 7

I NSPECTI ON STATI ON APPLI CATI ON

I NSTRUCTI ONS

USE: This application should be completed when applying for a new inspection station, and when any changes occur to an existing station, such as; change of location, change of ownership, and reappointment after a suspension, etc.

COMPLETI ON OF FORM: When properly completed and approved, this application will serve as your appointment certificate. Please use black ink and print clearly or type. PROVI DI NG FALSE, I NACCURATE, OR I NCOMPLETE I NFORMATI ON WI THI N THE APPLI CATI ON AUTOMATI CALLY I NVALI DATES THI S CERTI FI CATE.

Section A: I ndicate the reason for this application.

New inspection station: A business which is not currently an inspection station.

Reappoint After Cancel: A previously cancelled station reopens. (WRI TE THI S REASON I N THE BLOCK MARKED “ OTHER” ) NOT APPLI CABLE FOR PREVI OUS ENHANCED EMI SSI ON STATI ONS.

Reappointment after Suspension: A business that had its inspection privileges suspended and wishes to reopen as an inspection station after the suspension has been served.

Change of Location: An existing inspection station that is moving to a new location or is remodeling the existing location to provide additional space.

Change of Ownership: When a new owner(s) takes over an existing inspection station or when a corporation changes President and the person was never listed as a Corporate Officer in the past. (WRI TE THI S REASON I N THE BLOCK MARKED “ OTHER” )

Change of Authority: When a person in charge of an inspection station changes, but the ownership of the company remains the same. ( Section E should be completed at this time.)

Change of Mailing Address: When a business wants to update an existing mailing address that is different than the physical location.

Add Mailing Address: When a business wants its mail to be delivered to an address other than the physical location of the garage. (WRI TE THI S REASON I N THE BLOCK MARKED “ OTHER” ) .

Delete Mailing Address: when a business wants to delete an existing mailing address other than its physical location. (WRI TE THI S REASON I N THE BLOCK MARKED “ OTHER” ) .

Change of address by Post Office: When the business address of the station is being changed by the United States Post Office, or other agency.

Company to Corporation: A sole proprietorship or partnership incorporates. (WRI TE THI S REASON I N THE BLOCK MARKED “ OTHER” ) .

Change of Trade Name: An existing inspection station making a name change only. (See Company to Corporation above it the station is incorporating) .

Adding or changing a station type: When a general station adds motorcycle, a fleet station changes to a general station and vice versa. (WRI TE THI S REASON I N THE BLOCK MARKED “ OTHER” ) .

Add or Drop Partner: When a business adds or drops a partner(s) . (WRI TE THI S REASON I N THE BLOCK MARKED “ OTHER” ) .

Section B: Complete this section with the following information.

Business name: I ndicate the name under which you will operate. (list both names is you trade under a

different name; ie. Smith’s Garage, inc. T/ A Mike Smith Automotive.

Business address: I ndicate the actual location of the business. Must be a street address, no post office boxes in this space. I f you want to use a PO Box, complete the mailing address box in this section.

Telephone number: Provide the business telephone number including area code.

• Ow ner’s name: List the owner of the business. I f business is a partnership list on partner. I f the business is a corporation, list a corporate officer. A regional or district manager is also acceptable.

Driver License# : Provide the owner’s driver’s license number. I f license is issued from a state other than

Pennsylvania, please list the correct state abbreviation after the operator number: e.g., 123038483949 NJ (for operator number from New Jersey) .

Mailing address ( if different from the business address) : May be indicated in the space provided. I f you wish to receive mail from the Department at your business address, the mailing address segment of Section B should remain blank.

Section C: This section provides additional information about your business.

I ndicate if you are the sole proprietor, a partnership, or a corporation. (Commonwealth stations should check corporation) .

I ndicate your Federal I D number and Sate Sales Tax number in the appropriate boxes. I f you have submitted applications to these agencies and have not received your identification numbers, you may write “ APPLI ED FOR” in the appropriate boxes, and then submit your number(s) to the Department when they are received.

I ndicate the size of the I nspection area where inspection are performed (ie. 22ft x 28 ft or if more than one bay, e.g., Bay 1 22ft x 28 ft Bay 2 22ft X 62 ft, etc.)

I ndicate the one category most appropriate for your business.

I ndicate the type(s) of station you wish to operate which should coincide with the type(s) of vehicles you will be inspecting. I f applying for a safety station and an emission station you must complete a separate application for each type. (Do not mark safety and emission on the same application) .

I ndicate the type(s) of station you wish to operate and check the appropriate box(es) for any type(s) of vehicles you will be inspecting at your business.

Section D: First section should be completed when you own another inspection station. Second section should be completed when you need to cancel a previous inspection station.

First Section – Provide the station number(s) of other station(s) you own.

Second Section – Provide the current station number and/ or name of station being cancelled due to change of location, change of ownership or change of station type, ie. Fleet to General.

Section E: This section should be completed by the owner or a corporate officer ONLY when a person OTHER THAN an owner or a corporate officer is responsible for operating the business in the owner/ corporate officer’s behalf.

I MPORTANT: PRI NT ALL PARTS OF SECTI ON E, EXCEPT for the signature of the owner/ corporate officer.

Section F: DO NOT WRI TE I N THI S SPACE.

Section G: The application must be signed by the owner/ corporate officer at the time of application submission. I N THOSE CASES WHERE SECTI ON E HAS BEEN COMPLETED, THE PERSON AUTHORI ZED BY THE OWNER/ CORPORATE OFFI CER MUST SI GN THE APPLI CATI ON.

 

MV-427 (2-08)

 

 

 

 

 

 

 

INSPECTION STATION

 

 

FORDEPARTMENTUSEONLY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PLEASE TYPE OR PRINT CLEARLY.

 

 

 

CERTIFICATE OF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INCIDENT# ____________________________

 

THIS APPLICATION WILL SERVE AS

 

 

 

 

APPOINTMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YOUR CERTIFICATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A

CHECK THE PROPER BLOCK:

 

 

New Inspection Station

 

 

Re-appointment after suspension

 

Change of Location

 

Change ofAuthority within a Company or a Corporation

 

Change of MailingAddress

Change ofAddress by Post Office

 

Change of Trade Name

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B

NAME AND ADDRESS OF BUSINESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Business

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Business StreetAddress

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

 

 

 

 

County

 

 

 

 

 

 

 

 

State

 

 

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Telephone #

 

Owner’s Name

 

 

 

 

 

 

 

 

Driver’s License #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MailingAddress (if different than above)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

 

 

 

 

County

 

 

 

 

 

 

 

 

State

 

 

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C

BUSINESS INFORMATION

CHECK ✔ OWNERSHIP CLASS:

Sole Proprietorship (A)

Partnership (B) Corporation (C)

 

Federal ID #

 

 

 

 

State Sales Tax #

 

 

 

 

 

Size of InspectionArea

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Category ✔ Check One:

Garage (A)

 

Manufacturer (E)

 

Gas Station (B)

 

New Dealer (C)

 

Used Dealer (D)

 

Station Type: Motorcycle (A)

 

 

 

 

Fleet (C)

 

 

 

 

General (E)

 

Enhanced Safety

 

Commonwealth (F)

 

 

 

 

Emission (X)

 

Trailer (D)

 

 

Inspection (J)

 

Type of vehicles you will be inspecting:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Passenger Cars

 

 

Light Trucks

 

Trailers 10,000 lbs or less

 

 

Trucks over 17,000 lbs.

 

Buses

 

 

Motorcycles

 

Trailers over 10,000 lbs.

 

 

Trucks 17,000 lbs. or less

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D

Station number of other Station(s) presently owned:

 

 

 

Station number and/or name of current Inspection Station:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

E

LETTER OF AUTHORITY

 

 

 

F

 

 

 

CERTIFICATION

 

Thisletterauthorizes_______________________________________

 

 

Certificate ofAppointment as an Official Inspection Station

 

 

(Print Name of person signing the application)

 

 

 

 

Pursuant to the provisions of the Vehicle Code, 75 Pa.C.S. Sections 4721,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4723 or 3368,Act of June 17, 1976, No. 81, as amended.

 

________________________________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Title)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

residing at _______________________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(home street address)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

________________________________________________________

 

 

 

(NOT VALID WITHOUT SEAL)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(city/town)

 

(county)

 

 

 

(state)

(zip)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

to be responsible for all inspection operations performed at the above

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

station.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

_______________________________________ _______________

 

 

This certificate may be suspended or cancelled at any time if the provisions

 

 

 

of the Vehicle Code or the inspection regulations are not being complied

 

(Signature of owner or officer)

 

 

 

 

 

 

 

 

(Date)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

with or if the business is being improperly conducted.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

_______________________________________

 

 

 

 

 

Any change at a designated Official Inspection Station automatically

 

(Title)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

invalidates this Certificate.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

G

Application Date:

 

 

 

 

 

 

 

Appointment Date:

 

 

 

 

Inspection

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Station #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Iverifythatthefactssetforthonthisapplicationwerecheckedafterthecompletionoftheformandaretrueandcorrect.Thisverificationismadesubject

 

to the penalties of Section 4904 of the Crimes Code (18 Pa.C.S. § 4904) relating to Unsworn falsification to authorities.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Applicant Signature:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Department Investigator:

 

 

 

 

 

 

 

 

 

 

Troop/Station

 

 

 

 

 

 

Badge #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WHITE - Business Copy

YELLOW - Bureau of Motor Vehicles Copy

PINK - Investigator Copy

MV-427A (4-12)

Station Application

Supplemental Information

For Department Use Only

ATTACHMENT 1

PLEASE TYPE OR PRINT CLEARLY

A.STATION NAME: _____________________________________________________________________________________

B.INSURANCE ACKNOWLEDGEMENT:

I understand that a bond or certificate of insurance in the amount of $10,000 is required for each inspection station. I also understand that failure to maintain this bond or insurance will result in cancellation of my inspection station.

Yes ______ No ______

C.ADDITIONAL INFORMATION:

1.LIST ALL OWNERS, PARTNERS OR CORPORATE OFFICERS (NOTE: Individuals should list thier PA Driverʼs License (PA DL) or Photo ID# in the space provided. Business should list their Business ID# (Bus.ID) where indicated (i.e. E.I.N.)

NAME

TITLE

PA DL/PHOTO ID#

DATE OF BIRTH

 

 

 

 

STREET ADDRESS

CITY

STATE

ZIP

 

 

 

 

NAME

TITLE

PA DL/PHOTO ID#

DATE OF BIRTH

 

 

 

 

STREET ADDRESS

CITY

STATE

ZIP

 

 

 

 

NAME

TITLE

PA DL/PHOTO ID#

DATE OF BIRTH

 

 

 

 

STREET ADDRESS

CITY

STATE

ZIP

 

 

 

 

NAME

TITLE

PA DL/PHOTO ID#

DATE OF BIRTH

 

 

 

 

STREET ADDRESS

CITY

STATE

ZIP

 

 

 

 

2.Has this business or the owners, partners or officers thereof ever been a dealer, miscellaneous motor vehicles business, messenger service, inspection station or issuing agent in this or any other state?

Yes _____ No _____

If yes, list name(s), location(s), and identification number(s).

_________________________________________________________________________________________________

_________________________________________________________________________________________________

3.Is this application for a change of ownership or was this location previously an inspection station?

Yes _____ No _____

If yes, list previous station name(s), address(s) and identification number(s).

_________________________________________________________________________________________________

_________________________________________________________________________________________________

4.Is this inspection station being sold, transferred or leased while the station is suspended or restored pending appeal?

Yes _____ No _____

If yes, were you ever affiliated with this station or are you related in any way to the owner(s)? Yes _____ No _____

5.Have any owners, partners or corporate officers of this business been affiliated with a dealership, miscellaneous motor vehicle business, messenger service, inspection station or issuing agent whose privilege to conduct business as such was suspended, cancelled or revoked or is currently under investigation or received notice to attend a Departmental or court hearing or is awaiting a decision by a hearing officer or a Court?

Yes _____ No _____

If yes, list name, location, and identification number and explain situation.

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

6.Does any owner, partner, corporate officer or any business with which they were previously affiliated, have any outstanding liabilities which are due and owing to the Commonwealth, including but not limited to, taxes, fees, monetary penalties or outstanding paperwork?

Yes _____ No _____

If yes, explain

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

7.Have any owners, partners or corporate officers of this business ever been convicted or administratively sanctioned for violations of Department regulations Chapter 175 or 177 or Chapter 47 of the Vehicle Code?

Yes _____ No _____

If yes, explain

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

8.Have any owners, partners or corporate officers of this business ever remitted uncollectible checks payable to the Department of Transportation or the Commonwealth of Pennsylvania?

Yes _____ No _____

If yes, explain

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

9.Are all owners, partners, officers and management/supervisory employees aware of their responsibilities and obligations relating to the operation of an official inspection station, including but not limited to, record keeping, supervision of employees and customer relations?

Yes _____ No _____

If no, explain

_________________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________

I hereby verify that the information set forth above is true and correct to the best of my knowledge, information and belief. This verification is made subject to the penalties of 18 PA. C.C.§4904, relating to unsworn falsification of authorities.

Signature: _________________________________________________________________________________________

Print Name as it Appears Above: _______________________________________________________________________

Title: ________________________________________________________________________________________________

Date: _______________________________________________________________________________________________

MV-443 (3-06)

Commonwealth of Pennsylvania

DEPARTMENT OF TRANSPORTATION

OFFICIAL INSPECTION STATION NUMBER _____________________________

CURRENT LIST OF CERTIFIED

SAFETY INSPECTION MECHANICS

 

OPERATOR’S

MECHANIC

 

NAME

LICENSE

CERTIFICATION

CLASS

 

 

 

EXPIRATION

EXPIRATION

 

 

DATE

DATE

 

1.____________________________________________________________________________________

2.____________________________________________________________________________________

3.____________________________________________________________________________________

4.____________________________________________________________________________________

5.____________________________________________________________________________________

6.____________________________________________________________________________________

7.____________________________________________________________________________________

8.____________________________________________________________________________________

9.____________________________________________________________________________________

10.___________________________________________________________________________________

11.___________________________________________________________________________________

12.___________________________________________________________________________________

13.___________________________________________________________________________________

14.___________________________________________________________________________________

15.___________________________________________________________________________________

16.___________________________________________________________________________________

17.___________________________________________________________________________________

MV-500 (11-10)

www.dot.state.pa.us

Bureau of Motor Vehicles

Vehicle Inspection Division

P.O. 68697 • Harrisburg, PA 17106-8697

Pennsylvania Department of Transportation Authorized Agents for Purchasing Stickers

r NEW

r REVISED (PLEASE CHECK ONE)

 

PRINT NAME AS LISTED ON ID

 

OPERATOR NUMBER

 

SOCIAL SECURITY#

 

OR DRIVER’S LICENSE

 

 

 

(IF NON-PA DRIVER’S LICENSE)

 

 

 

 

 

1.

_____________________________

1.

_____________________________

1.

_____________________________

2.

_____________________________

2.

_____________________________

2.

_____________________________

3.

_____________________________

3.

_____________________________

3.

_____________________________

4.

_____________________________

4.

_____________________________

4.

_____________________________

5.

_____________________________

5.

_____________________________

5.

_____________________________

I hereby authorize the above listed person(s) to sign sticker requisitions and receive Certificates of Inspection for the following Official Inspection Station:

__________________

__________________________________

________________________

(Station Number)

(Station Name)

 

(Telephone #)

______________________________________________________________

____________________

(Signature of Station Owner or Authority) - Station Owner or Authority must be listed in one of the five lines above.

(Title)

______________________________________________________________

____________________

(Print Name As It Appears Above)

 

 

(Date)

REVIEW INSTRUCTIONS ON REVERSE SIDE BEFORE COMPLETING.

THIS FORM MAY NOT BE COPIED OR FAXED

Official Inspection Stations must use this form to authorize purchaser(s) to sign Form MV-436A, "Inspection Sticker and Insert Order Form."

You may submit up to five names to be placed in a computerized signature file for your station. (NO MORE THAN FIVE (5) NAMES ARE PERMITTED). Each name submitted must include, driver’s license number (or government issued photo identification card number) and Social Security number (if non-PA driver’s license).

If the station owner or authority (as listed in sections B or E of the certificate of appointment Form MV-427) or corporate officer, partner, etc. (listed on Form MV-427A) intends to sign Form MV-436A to purchase inspection stickers, his/her name, operator number, and Social Security Number

(if applicable) must also be listed on one of the five (5) designated spaces.

If the REVISED box is checked, you will need to list all persons whom you have previously authorized and wish to remain authorized. Any names that are not on this form will be deleted from the computerized signature file.

Stations which are appointed to perform both safety and emission inspections may submit only one (1) authorization form. The authorized purchasers for these stations will be able to sign Form MV-436A for both safety and emission stickers.

Bonded messengers and members of the Legislature cannot be listed on this form as authorized purchasers.

Return this form to: Bureau of Motor Vehicles, Vehicle Inspection Division, P.O. Box 68697, Harrisburg, PA 17106-8697. If you have questions please call (717) 787-2895.

File Attributes

Fact Number Description
1 The MV-427 form is for applying to become a new inspection station or update details of an existing one within Pennsylvania.
2 Applicants must indicate specific reasons for the application, such as a change of ownership or location, or reappointment after a suspension.
3 Sections on the form include business information, type of station desired, additional ownership details, and certification.
4 Two separate MV-427 forms must be completed if applying for both safety and emission inspection stations.
5 A Certificate of Liability Insurance or bond of at least $10,000 must be attached with the application for compensation in case of damage during an inspection.
6 The application must include copies of lease or deed, recent utility bills, and photos of the inspection, sticker security, and office areas.
7 Valid Employer Identification Number (EIN) or Social Security Number (SSN) and State Sales Tax Number are required for the application.
8 Providing false, inaccurate, or incomplete information within the application automatically invalidates the certificate.
9 The completed packet, including the MV-427 form and other requisite documents, should be mailed or emailed to the specified address of the Pennsylvania Department of Transportation Vehicle Inspection Division.
10 Governing law(s) for the MV-427 form include the Vehicle Code, 75 Pa.C.S. Sections 4721, 4723, or 3368, Act of June 17, 1976, No. 81, as amended.

How to Fill Out Mv 427 Penndot

Filling out the MV-427 PennDOT form is an essential step for businesses looking to become certified safety inspection stations in Pennsylvania. If you're aiming to apply for new inspection station certification or update your existing certification due to changes like ownership or location, following these steps will ensure your application is completed accurately. Remember, providing all the required information correctly the first time can save you from delays.

  1. Start by deciding the reason for your application. Check the appropriate box in Section A based on whether you are applying for a new inspection station, reappointment after a suspension, change of location, ownership, or any other reason mentioned in the instructions.
  2. In Section B, provide your business name as it is known or will be known. Make sure to list any trade names if applicable. Enter the street address of your business location, avoiding P.O. boxes for this particular entry, along with your business phone number, owner's name, and driver's license number including the state abbreviation if it's not a Pennsylvania license.
  3. For Section C, check whether your business is a sole proprietorship, partnership, or corporation. Fill in your Federal ID and State Sales Tax numbers. If you're waiting on these numbers, write "APPLIED FOR" and update PennDOT when you receive them. Describe the size of your inspection area and select the category that best describes your business. Also, indicate the type(s) of inspections your station will perform.
  4. Section D should be filled out if you own other inspection stations or if you're canceling a current station due to changes. Provide all relevant station numbers or names.
  5. In Section E, the "Letter of Authority," complete this only if someone other than the business owner or corporate officer will be responsible for the operation of the inspection station. Include the representative’s name, home address, and signature.
  6. Do not write anything in Section F, as it is for department use only.
  7. Section G requires the signature of the owner or corporate officer. This signature certifies the application’s accuracy and compliance with the legal requirements.

After completing these steps, make sure to collect all required documents listed in the checklist provided, such as liability insurance or bond and the MV-443 list of certified safety inspectors. Once everything is prepared, mail or email your packet to the specified address or email provided in the instructions. This thorough approach will facilitate a smoother application process, bringing you a step closer to becoming a certified safety inspection station in Pennsylvania.

Frequently Asked Questions

What is the MV-427 form used for?

The MV-427 form is an application utilized by businesses in Pennsylvania that wish to become an official vehicle safety inspection station. It is also used when an existing station undergoes changes like a change of location, ownership, or when it needs to reapply following a suspension.

How many MV-427 forms need to be completed if applying for both safety and emission inspection stations?

If a station is applying to conduct both safety and emission inspections, two separate MV-427 forms must be filled out. One form should be completed for safety inspections only, and a separate form should be used exclusively for emission inspections. Marking both on the same form is not allowed.

What additional documentation is required along with the MV-427 form?

Along with the MV-427 form, the station information packet must include:

  • MV-427A form.
  • MV-443 list of certified safety inspectors, including inspector numbers.
  • Letter of Authority, if applicable, with specific additional documentation.
  • Proof of a bond or liability insurance in the amount of at least $10,000.
  • Copy of lease or deed for the property.
  • Recent utility bills (electric and phone).
  • Photos of the inspection, sticker security, and office areas.
  • A valid Employer Identification Number (EIN) or Social Security Number (SSN).
  • A valid State Sales Tax Number.
If any of these items are missing, the application will be rejected.

Where should the completed MV-427 packet be sent?

The completed station information packet, including the MV-427 form and all necessary documentation, should be mailed or emailed to the Pennsylvania Department of Transportation Vehicle Inspection Division at the address or email provided in the form instructions.

What happens if information is missing from the packet?

If information is missing from the packet, it will be rejected. A letter will be sent to the applicant detailing the deficiencies that need to be addressed for the application to proceed.

Can digital copies of supporting documents be submitted with the MV-427 form?

The instructions do not specify whether digital copies are acceptable, so it is advised to submit physical copies of all required documents unless the instructions or PennDOT directly states otherwise. Contacting PennDOT for clarification is recommended if this question arises.

What type of insurance is needed to fulfill the application requirements?

An insurance bond or a certificate of liability insurance verifying coverage of at least $10,000 is required. This ensures compensation for any damage to vehicles during inspections. The insurance must specifically list the station's name, physical location, coverage amount, and the period of coverage. A Garage Keeper's Legal Liability Policy is deemed acceptable for this purpose.

What should be done if changes occur to the inspection station after the application is submitted?

If any changes occur to the inspection station after the application is submitted — such as changes in ownership, location, or operational details — PennDOT must be notified promptly. Depending on the nature of the change, a new MV-427 form, or other documentation, may need to be submitted.

Is there a fee to submit the MV-427 application?

The documentation does not specify a fee associated with the MV-427 form application; however, it's common for state applications to include processing fees. Applicants should verify directly with PennDOT for the most current fee information.

Common mistakes

One common mistake people make when completing the MV-427 PennDOT form is not thoroughly reading the instruction sheet included in the station information packet. This results in incomplete or incorrectly filled sections. Specifically, applicants often fail to understand that they need to complete separate forms for safety and emission inspections. The instruction clearly states that the safety and emissions sections should not be checked off on the same form, yet this detail is frequently overlooked, leading to packet rejection.

Another error involves the submission of the MV-427A form. The requirement to submit two separate MV-427A forms if applying for both a safety and emission inspection station is frequently missed. This oversight stems from not carefully reviewing the checklist or misunderstanding the instructions, resulting in an incomplete application packet and subsequent delays in processing.

Not including a list of certified safety inspectors with their inspector numbers, as required under the MV-443 section, is another mistake. Applicants sometimes neglect to gather and include this critical piece of information, which verifies the qualifications of individuals performing inspections at the station. This omission can lead to the PennDOT dismissing the entire application for being incomplete.

Many applicants mistakenly believe providing their personal or business information is sufficient without attaching additional evidence like a Letter of Authority for a person operating the business on behalf of the owner/corporate officer, if applicable. Where section E of the MV-427 form is completed, and the designated operator is different from the owner or corporate officer, a separate document detailing the operator's name and driver's license number must be included, a step often forgotten.

Last but not least, overlooking the requirement to attach proof of insurance or bond is a significant error. Applicants must attach proof of a garage keeper’s legal liability policy or equivalent, with at least $10,000.00 coverage for damages during vehicle inspections. This documentation must detail the station’s name, location, coverage amount, and period. Failing to include this proof can result in the immediate rejection of the application, as it raises concerns about the station’s financial responsibility and capability to cover damages resulting from inspection activities.

Documents used along the form

When applying for vehicle inspection station accreditation through the MV-427 form for the Pennsylvania Department of Transportation, it is important to be aware of additional documents that are often required. These additional documents facilitate the application process, ensuring a comprehensive review and validation of the applicant's credentials and the inspection station’s readiness.

  • MV-427A: This form supplements the MV-427 form for applicants applying to become a safety and emissions inspection station. It requires detailed information about all owners, partners, or corporate officers, enhancing the verification process for the legitimacy and suitability of the inspection station.
  • MV-443: A crucial list that includes the names and inspector numbers of all certified safety inspectors at the station. This document ensures that all personnel performing inspections have the current, required qualifications and certifications.
  • Certificate of Liability Insurance or Bond: This provides proof of financial responsibility, guaranteeing coverage for any damages to vehicles while in the care of the inspection station. A minimum of $10,000 coverage is required, specifying the station’s name, location, coverage amount, and period.
  • Lease or Deed: A copy of the property's lease or deed where the inspection station operates is required to prove the station's physical location. It assists in verifying that the business operates from a legitimate and stable facility.
  • Copies of Utility Bills: Recent electric and phone bills are needed to further confirm the operational and physical location of the inspection station. This information helps in the logistics of communication and facility verification.

Together with the MV-427 form, these documents form a comprehensive packet that ensures the Pennsylvania Department of Transportation has all necessary information to process an application for becoming an authorized vehicle inspection station. It is crucial for applicants to thoroughly complete and include all required documents to avoid delays or rejections of their application.

Similar forms

The MV-427 form for PennDOT, detailing application instructions for inspection stations, shares similar characteristics with several other forms and documents used in various regulatory or compliance contexts. Each one of these documents serves a distinct purpose but operates within a framework that requires accurate and complete information to ensure compliance with specific regulatory standards or requirements.

One such document is the IRS Form W-9, Request for Taxpayer Identification Number and Certification. Like the MV-427, the W-9 is essential for compliance with federal regulations, specifically for tax reporting purposes. Both forms require the provision of accurate identification and business-related information to avoid penalties and ensure proper documentation is maintained.

The Business License Application forms that local governments require for operating a business within their jurisdiction also bear resemblance to the MV-427. These forms typically demand detailed information about the business, including owners' names, business location, and the nature of the business, to ensure it meets local zoning and business operation laws.

OSHA Form 300, the Log of Work-Related Injuries and Illnesses, although serving a different purpose, shares the objective of compliance through accurate record-keeping. Where the MV-427 aims at ensuring inspection stations meet safety standards, Form 300 ensures workplaces record and report injuries to maintain a safe working environment.

The FCC Form 605, Quick-Form Application for Authorization in the Ship, Aircraft, Amateur, Restricted and Commercial Operator, and General Mobile Radio Services, like the MV-427, is used to obtain or modify licenses for specific operations. Both documents are critical for regulatory approval and necessitate precise and comprehensive submission of information.

The Alcohol and Tobacco Tax and Trade Bureau (TTB) requires various forms for businesses involved in the production, distribution, and sale of alcohol and tobacco products. Similar to the MV-427, these forms are crucial for compliance with federal laws, tax obligations, and licensing requirements.

The Environmental Protection Agency's (EPA) Notification of Hazardous Waste Activity form is another example. This form, which companies must complete to report hazardous waste activities, emphasizes the importance of environmental safety and compliance, mirroring the safety and emissions focus of the MV-427.

Another akin document is the USDA APHIS Veterinary Services Form 16-4, Application for Import or in Transit Permit (Animals, Animal Semen, and Animal Embryos). It is paralleled with MV-427 in terms of its specificity for a niche operational permission, focusing on the importation of animals rather than vehicle safety inspections.

The U.S. Fish and Wildlife Service’s Application for Import/Export Permit (Form 3-200) also shares similarities with the MV-427. Both forms are essential for operational compliance in specific sectors, with the Form 3-200 focusing on the import and export of wildlife and wildlife products.

Similarly, the Federal Motor Carrier Safety Administration’s (FMCSA) Motor Carrier Identification Report, Form MCS-150, is necessary for commercial motor vehicle operators to obtain a USDOT Number. Like the MV-427, this form ensures that operators meet safety regulations.

Lastly, the Department of Health and Human Services’ (HHS) Health Insurance Portability and Accountability Act (HIPAA) compliance documents, though primarily focused on the protection of patient information, emphasize the necessity of adhering to federal guidelines and safeguarding sensitive information, reflecting the compliance aspect of the MV-427.

In summary, while each of these documents serves a unique purpose, ranging from tax compliance to environmental safety, they all require thorough, accurate information and adherence to specific regulatory standards. The common thread among them and the MV-427 is the need for detailed and precise documentation to meet compliance and operational standards.

Dos and Don'ts

When filling out the MV-427 PennDOT form for Safety Station Application, there are certain practices you should follow to ensure your application is complete and processed without delay. Below is a list of dos and don'ts to guide you through the process:

Dos:

  1. Complete separate MV-427 forms for safety and emission inspections, specifying "SAFETY" on one form and "EMISSIONS" on the other, if applying for both.
  2. Include the MV-443 list of certified safety inspectors with their inspector numbers.
  3. Attach a copy of your Certificate of Liability Insurance or bond, ensuring it reflects the correct station name, physical location, coverage amount, and coverage period.
  4. Ensure that all sections are filled out clearly and accurately in black ink or typed.
  5. Provide a valid Employer Identification Number (EIN) or Social Security Number (SSN) and State Sales Tax Number as required.
  6. Sign the application in section G, by the owner or corporate officer. If section E has been completed, the person authorized there must also sign it.

Don'ts:

  • Do not check both the safety and emissions boxes on a single MV-427 form when applying for inspection station certification.
  • Avoid submitting incomplete or inaccurately filled-out forms, as this will lead to rejection.
  • Do not forget to include the MV-427A form if you are applying for both safety and emission inspection stations.
  • Do not omit the Letter of Authority in Section E if the person responsible for the operation is not listed as an owner or corporate officer on the MV-427 or MV-427A forms.
  • Avoid using anything but black ink or typing when completing the form to ensure readability.
  • Do not leave out photos of the interior and exterior of the inspection area, sticker security area, and office area as these are mandatory requirements.

Misconceptions

  • One common misconception is that the MV-427 form can be used for both safety and emissions inspections on the same form. However, if applying for a safety and emission inspection station, the station must complete a separate MV-427 form for safety and a separate form for emissions. It is not acceptable to check both safety and emissions on the same form.

  • Another misconception is that if the person responsible for the operation of the business, as listed in Section E of form MV-427, is not an owner or corporate officer, no additional information is needed. In reality, a separate document must be included to provide that person's name and driver's license number, along with their date of birth if providing an out-of-state driver's license number.

  • Some people believe a generic insurance policy is sufficient for the application packet. However, the certificate of liability insurance or bond must be specifically in the amount of at least $10,000, clearly state the station's name, physical location, amount of coverage, and period of coverage. A generic policy without these specifics will not be accepted.

  • There's a false notion that only the MV-427 form is necessary when applying to become a safety inspection station. In fact, the complete station information packet must include several items: the MV-427 form, MV-427A form, MV-443 list of certified safety inspectors, proof of insurance or bond, a valid insurance policy with PennDOT listed as the certificate holder, and several other supporting documents.

  • Lastly, a misconception exists that once completed, the MV-427 form guarantees immediate approval and operational status. The truth is that providing false, inaccurate, or incomplete information within the application automatically invalidates the certificate. The form serves as an appointment certificate only when properly completed and approved, and all requirements are met.

Key takeaways

When applying for a safety and emission inspection station designation, understanding the nuances of the MV-427 PennDOT form is critical to ensure accuracy, compliance, and successful processing. Following are eight key takeaways designed to guide applicants through this process efficiently:

  • Applicants must not select both safety and emissions inspections on the same MV-427 form. A separate form is required for each type of inspection authorization sought.
  • Complete submission of the station information packet requires inclusion of form MV-427A, emphasizing the need for attention to detail and ensuring that two separate forms are completed if the station is applying for both safety and emission inspection certifications.
  • The inclusion of a valid certificate of liability insurance or bond, with a minimum amount of $10,000, is non-negotiable. This document must accurately reflect the station’s name, physical location, coverage amount, and the coverage period to guarantee compensation for any vehicle damage during inspections.
  • Applicants are obligated to include a MV-443 list that enumerates certified safety inspectors, complete with their inspector numbers, ensuring that personnel are qualified and officially recognized.
  • In cases where the individual listed in section E of form MV-427—representing authority over the station—is not the owner or a corporate officer as described on form MV-427A, a separate document detailing their name and driver’s license number must be attached.
  • Ensuring the presence of a valid Employer Identification Number (EIN) or Social Security Number (SSN) is imperative for the validation of the application, along with a valid State Sales Tax Number, underscoring the legal and financial readiness of the station.
  • Applicants must furnish proof of a valid insurance policy with PennDOT acknowledged as the Certificate Holder, using a designated address. This requirement highlights the importance of establishing a formal relationship with PennDOT and ensuring liability coverage is recognized.
  • Photos capturing the interior and exterior of the inspection area, sticker security area, and office area are mandatory. These visual evidences serve to validate the suitability and preparedness of the physical location for conducting inspections.

By adhering to the specified requirements and ensuring that all documentation is complete and accurate, applicants can navigate the application process more seamlessly. Remember, incomplete or inaccurate information can lead to the outright rejection of the packet, so careful attention to the guidelines outlined in the MV-427 PennDOT form instructions is crucial.

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