MV-190-SIDE A (9-15) COMMERCIAL IMPLEMENT OF HUSBANDRY OR IMPLEMENT OF HUSBANDRY SUPPLEMENTAL APPLICATION For Department Use Only Bureau of Motor Vehicles • Commercial Registration Section 1101 South Front Street • Harrisburg, PA 17104 NOTE: This application must be used with Form MV-1 or Form MV-4ST. q Implement of Husbandry q Commercial Implement of Husbandry q New - Complete Sections A, B, C, and E. q Transfer of IMPH - Complete Sections A, B, and E. q New - Complete Sections A, B, C, D, and E. q Transfer of CIMPH - Complete Sections A, D, and E. NOTE: Implement of Husbandry and Commercial Implement of Husbandry registration plates may be personalized. Should you choose to personalize your Implement of Husbandry or Commercial Implement of Husbandry registration plate, please complete and attach Form MV-904C, "Application for Personalized Commercial Registration Plate," to this application. NOTE: There is an additional $100 fee required with each personalization request. A B Title Number Vehicle Identification Number Applicant Name If vehicle is part of a Pennsylvania Fleet, please provide the following: Fleet Number Fleet Account Number Equipment Number q Describe in detail how and where this equipment is used. q Do you charge fees when this equipment is used? q List the individual or business name and identification number under which you last filed your Pennsylvania Income Tax Return (PA40), including Schedule F. C Individual or Business Name Identification Number Year Last Filed q Two clear photographs are needed (one rear view and one side view). q The actual maximum weight of the vehicle ready for service is needed. Either have the vehicle weighed at a weigh station with all fluids and driver in the vehicle, and submit the weigh slip from the scales or list the unladen weight or shipping weight, or gross vehicle weight rating. If no weight slip is attached, specify which weight you are listing. q Do you own or lease all of the farm(s) on which the vehicle will be used?.............................. r YES q Identify the primary agricultural commodity produced by your farm or agriculture enterprise: D r NO q List the nutrients, soil amendments or chemicals applied commercially by this vehicle for production agriculture: q List the total number of days per year this vehicle is operated over the highway: E I/We hereby certify under penalty of law that all information herein is TRUE and CORRECT and that I/we understand that any misstatement of fact is a misdemeanor of the third degree punishable by a fine up to $2,500 and/or imprisonment up to 1 year (18 Pa.C.S. Section 4904[b]). Signature q q q q FOR DEPARTMENT USE ONLY Date This vehicle qualifies as an implement of husbandry. This vehicle qualifies as a commercial implement of husbandry with a TK body type. This vehicle qualifies as a commercial implement of husbandry with a IMPH body type. This vehicle does not qualify as an Implement of Husbandry or Commercial Implement of Husbandry; therefore, this vehicle should be registered as a truck. MV-190-SIDE B (9-15) SPECIAL MOBILE EQUIPMENT SUPPLEMENTAL APPLICATION A NOTE: This application must be used with Form MV-1 or Form MV-4ST. Title Number Vehicle Identification Number Applicant Name If vehicle is part of a Pennsylvania Fleet, please provide the following: Fleet Account Number B For Department Use Only Bureau of Motor Vehicles • Commercial Registration Section 1101 South Front Street • Harrisburg, PA 17104 Fleet Number Equipment Number Determination of status - Any motor vehicle originally designed to be used for the transportation of property, to which machinery has been attached, may be considered special mobile equipment if the following conditions apply: • Is the attachment permanently affixed to the machinery?............................................................. q YES q NO • Is this vehicle designed to preclude the use of the vehicle for the transportation of freight, merchandise, sand, gravel, chemicals, fertilizer or other loads, except tools incidental to the specialized use of the vehicle or trailer with a gross weight of 3,000 lbs or less? .......................................................................................q YES q NO • What is the average number of days per week the vehicle will be operated over the road? ________________ • What is the average number of miles per year the vehicle will be operated over the road? ________________ Describe in detail how and where this equipment is used: ___________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ • List D.E.R. Drillers License Number for water well drilling rigs: _______________________________________ • The actual maximum weight of the vehicle ready for service is needed. Either have the vehicle weighed at a weigh station with all fluids and driver in the vehicle and submit the weight slip from scales, or list the unladen weight or shipping weight, or gross vehicle weight rating below. If no weight slip is attached, specify which weight you are listing. _________________________ Unladen Weight _________________________ Shipping Weight _________________________ Gross Vehicle Weight Rating I have attached two clear photographs (one rear view and one side view).......................................q YES C If you answered no to any of the questions above, the vehicle does not qualify as special mobile equipment, therefore, this vehicle should be registered as a truck. Personalized Special Mobile Equipment registration plate choices may contain up to FOUR letters or numbers in combination. Only one hyphen or space is permitted as part of the available spaces for personalization. No other special characters are available. Please print clearly. NOTE: The shaded boxes with a pre-printed letter configuration of "SME" are specific to this registration plate and cannot be changed. These letters will appear on your personalized registration plate. FIRST CHOICE D q NO SECOND CHOICE S M E S M E THIRD CHOICE S M E I/We hereby certify under penalty of law that all information herein is TRUE and CORRECT and that I/we understand that any misstatement of fact is a misdemeanor of the third degree punishable by a fine up to $2,500 and/or imprisonment up to 1 year (18 Pa.C.S. Section 4904[b]). Signature Date IF PERSONALIZING YOUR REGISTRATION PLATE • Personalized Special Mobile Equipment registration plates may contain up to FOUR letters and numbers in combination. NOTE: A preprinted letter configuration of “SME” will precede your personalized configuration on your registration plate and cannot be changed. NOTE: For personalized Implements of Husbandry or Commercial Implements of Husbandry registration plates, complete and attach Form MV-904C, “Application for Personalized Commercial Registration Plate.” • If a hyphen or space is used as part of the registration configuration, it counts as one of the available spaces for personalization. Only one hyphen or space is permitted, but not both. NOTE: No additional special characters are available. • When requesting a numeric character of zero, please list as "Ø" instead of the alpha character of "O". • PennDOT reserves the right to limit or reject certain requests. • The fee to personalize your Special Mobile Equipment registration plate is an additional $100, and the registration on your vehicle must be current in order for PennDOT to process your request. The additional $100 fee covers the cost of your personalized registration plate order only and will not renew your vehicle's registration. If your registration has expired or expires in the next three months, please include your completed renewal application, Form MV-105, "Pennsylvania Registration Renewal Application," or Form MV-140, “Request for Registration,” and a separate check or money order in the amount of your registration renewal fee. Payment is to be made by check or money order payable to the Commonwealth of Pennsylvania. PLEASE DO NOT SEND CASH. • To check personalized registration plate availability, visit PennDOT’s Driver and Vehicle Services website, www.dmv.pa.gov, and select Plate Availability from the list of services under the Vehicle Services heading. Personalized registration plates will not be reserved until PennDOT receives payment and a completed application, and approves your requested registration plate configuration [number(s) and/or letter(s)]. Please note that registration plate requests are processed on a first-come, first-served basis; although a requested registration plate configuration may show as being available on the website, it is possible that a request for the same registration plate configuration may have already been submitted by another customer and may not be available when making application. • Personalized registration plates will be manufactured on the basis of this application. NO REFUND of the fee will be issued when an applicant cancels a request after the order is placed with the manufacturer. • Allow eight to 10 weeks for delivery. Visit us at www.dmv.pa.gov or call us at: In state: 1-800-932-4600 u TDD: 1-800-228-0676 u Out-of-State: 1-717-412-5300 u TDD Out-of-State: 1-717-412-5380
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