Form Mv-903 - Request For Carnival Registration Plate

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MV-903 (12-14)

REQUEST FOR CARNIVAL

www dmv state pa us

REGISTRATION PLATE

(Truck and Truck Tractors Only)

For Department Use Only

Bureau of Motor Vehicles • PO Box 68269 • Harrisburg, PA 17106-8269

Original Application - If this application accompanies Forms MV-1 or MV-4ST, the registration fee is one-half of the regular truck

or truck tractor registration fee.

Replacement Application - If this application is used to replace a standard truck or truck tractor registration plate, an $11

replacement registration plate fee is required. NOTE: No refund for registration fees paid previously will be given.

APPLICANT INFORMATION

Last Name(s) or Company Name

First Name

Co-Owner Last Name

First Name

Street Address

City

State

Zip Code

VEHICLE DESCRIPTION

Title Number

Vehicle Identification Number

Registration Plate Number

Make of Vehicle

Body Type

Registered Gross Weight

Registered Comb. Weight

INSURANCE INFORMATION

Insurance Company Name

Policy Number

Policy Effective Date

Policy Expiration Date

APPLICANT(S) SIGNATURE

I/We acknowledge that I/we may lose my/our operating privilege or vehicle registrations for failure to maintain financial responsibility on the currently

registered vehicle for the period of registration and that the vehicle listed above is used exclusively for the purpose of transportation of circus or carnival

personnel, equipment or machinery and may only be used from April 1st through September 30 of any year.

Owner Sign Here

Co-Owner Sign Here

Telephone Number

For a complete listing of fees, refer to Form MV-70S, "Bureau of Motor Vehicle Schedule of Fees," found on

our website at

NOTE: Carnival registration plates are not yet available for personalization.

Mail completed application and fees to:

Department of Transportation

Bureau of Motor Vehicles

P.O. Box 68269

Harrisburg, PA 17106-8269