MV-951 (10-18)

APPLICATION FOR CERTIFICATE OF

www.dmv.pa.gov

AUTHORIZATION AS A SALVOR
For Department Use Only
Bureau of Motor Vehicles • P.O. Box 68584 • Harrisburg, PA 17106-9584

Application for authorization as a salvor may be made in conjunction with application for registration as a Miscellaneous Motor Vehicle
Business (MMVB) in the vehicle salvage class or repair or towing business. If you currently hold this classification, please indicate name
and identification number of business.

____________________________________________________________________________________________________
Name I.D. Name

A NAME AND ADDRESS OF BUSINESS - Exactly as registration is to be issued.

Business Name Business ID#

Street Address (Principal Place of Business)

City County State Zip Code

Business Phone Number Home Phone Number of

President or Controlling Partner

B TYPE OF BUSINESS - Check ( 4 ) One THIS LOCATION IS - Check ( 4 ) One)

r Sole Proprietorship r Partnership r Corporation r Owned r Leased

C LIST ALL OWNER(S), PARTNERS OR CORPORATE OFFICERS OF BUSINESS

1. Full Name Title PA DL/Photo ID# Date of Birth

Street Address City State Zip Code

2. Full Name Title PA DL/Photo ID# Date of Birth

Street Address City State Zip Code

3. Full Name Title PA DL/Photo ID# Date of Birth

Street Address City State Zip Code

4. Full Name Title PA DL/Photo ID# Date of Birth

Street Address City State Zip Code

D BUSINESS DESCRIPTION - Indicate the nature of your business that qualifies your business for the type of registration
for which you are making application.

E ADDITIONAL INFORMATION

1. Have all owners, partners and officers read and understood Chapter 253 (Salvors)? . . . . . . . . . . . . . . . . . . . . . .r YES r NO
2. Do you own or rent adequate storage facilities (minimum 5,000 square feet) for storing abandoned vehicles? . .r YES r NO
3. Does this storage facility meet all local land use and zoning requirements? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .r YES r NO
4. Do you own or rent suitable equipment for towing abandoned vehicles? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .r YES r NO
List: ___________________________________________________________________________________________________
F NOTARIZATION
I (We) certify under penalty of law that the information contained
herein is true and correct.
SUBSCRIBED AND SWORN
TO BEFORE ME: MO. DAY YEAR

t
_______________________________________________________ SIGNATURE OF PERSON ADMINISTERING OATH
Authorized Signature Date
S
_______________________________________________________
Printed Name of Authorized Signer Title
T
DO NOT NOTARIZE UNLESS
_______________________________________________________ A SIGNED IN PRESENCE
Authorized Signature Date
OF NOTARY
M
_______________________________________________________
Printed Name of Authorized Signer Title
P
_______________________________________________________
Authorized Signature Date

_______________________________________________________
Printed Name of Authorized Signer Title

WARNING: Misstatement of fact is a misdemeanor of the third degree punishable by a fine of up to $2,500 and/or imprisonment up
to 1 year [18 Pa.C.S. Section 4904(b)] in addition to any sanction imposed by this department.

NOTE: When business is discontinued, your salvor registration must be returned to the department within 5 days. If the business is
moved to another location, the department must be notified within 10 days of the change.

INSTRUCTIONS FOR COMPLETING FORM MV-951

1. All information must be typed or printed in full. List name of business exactly as Salvor Authorization is to be issued.
Address must have physical street address. Post Office Box may be used in addition to street address. Include
business phone and home phone numbers. The license issued will be valid only at the business listed on this
application.
2. Check appropriate box for type of business and if location is owned or leased and attach copy of the deed or lease.
3. List all owners, partners or corporate officers and do not forget to include their titles. Individuals should list their PA
Driver’s License number in the space provided. Additional sheets may be used if necessary.
4. Answer each question and provide all information requested.
5. Sign, date and have notarized in Section F.

DOCUMENTS THAT MUST ACCOMPANY THIS FORM

1. The bond prescribed by Title 75, Section 7303, on the form of the department (Form MV-375).
2. At least three photographs which clearly show the possession of towing equipment and the 5,000 square feet of
required space for the storage of abandoned vehicles.

Mail all completed forms to: Commonwealth of Pennsylvania, Department of Transportation, Bureau of Motor Vehicles,
P.O. Box 68594, Harrisburg, PA 17106-8594.

Visit us at www.dmv.pa.gov or call us at 717-412-5300. TTY callers — please dial 711 to reach us.