DEALER ASSIGNMENT COVERING A VEHICLE ACQUIRED AND HELD FOR ...

MV-27 (7-23)

DEALER ASSIGNMENT COVERING A VEHICLE

ACQUIRED AND HELD FOR RESALE

Bureau of Motor Vehicles ? Harrisburg, PA 17122

dmv.

A VEHICLE INFORMATION

Title Holder¡¯s DIN/Bus. Partner ID# (If applicable)

Name of Original Title Holder

Model Year

Vehicle Identification Number

PA Title Number

Body Type

Make

WARNING: Federal and State Laws require

I/We, certify to the best or my/our knowledge that the odometer reading is ___ ___ ___, ___ ___ ___

that you state the mileage in connection

miles and reflects the actual mileage of the vehicle unless one of the following boxes is checked:

with the transfer of ownership. Failure to

complete or providing a false statement may

o Reflects the amount of mileage in excess of its mechanical limits; or,

result in fines and/or imprisonment.

o is not the actual mileage. WARNING: Odometer discrepancy.

I/We further certify that the vehicle is free of any encumbrance; and, that ownership is hereby transferred to the following Pennsylvania registered dealer.

TENTHS

Name of Acquiring Dealer:_________________________________________ Acquiring Dealer DIN/Bus. Partner ID#:_____________________

Street Address:______________________________________________ City:____________________________ State:_____ Zip:___________

FIRST ASSIGNMENT

SELF-CERTIFICATION

I/We declare under penalty of perjury under the law of the Commonwealth of Pennsylvania, that the foregoing is true and correct, and that

application was made for the above product.

Furthermore, I/we state that I/we have read and signed this application after its completion, and I/we swear or affirm that the statements made

herein are true and correct, and that any statement made on or pursuant to this application is subject to the penalties of 18 Pa.C.S. Section 4904

(relating to unsworn falsification), which include criminal prosecution and a term of imprisonment, the maximum of which may be one year

[18 Pa.C.S. 4904(b)], or up to two years [18 Pa.C.S. 4904(a)]. In addition to any other penalty, a person convicted under this section shall be

sentenced to pay a fine of at least $1,000 [18 Pa.C.S. 4904(d)].

Signed on the _____ day of _____________, _______________ at ____________________________________, ________________________.

(county or other location, and state)

(country)

Printed Name of Original Title Holder/Authorized Person

Signature of Original Title Holder/Authorized Person

Printed Name of Co-Seller/Printed Name of Firm

Signature of Co-Seller/Printed Name of Firm

I, a registered Pennsylvania Dealer, hereby certify that I have acquired and hold for resale, the above described vehicle.

Signature of Acquiring Dealer

Date of Acquisition (MM/DD/YY)

WARNING: Federal and State Laws require

I/We, certify to the best or my/our knowledge that the odometer reading is ___ ___ ___, ___ ___ ___

that you state the mileage in connection

miles and reflects the actual mileage of the vehicle unless one of the following boxes is checked:

with the transfer of ownership. Failure to

complete or providing a false statement may

o Reflects the amount of mileage in excess of its mechanical limits; or,

result in fines and/or imprisonment.

o is not the actual mileage. WARNING: Odometer discrepancy.

I/We further certify that the vehicle is free of any encumbrance; and, that ownership is hereby transferred to the following Pennsylvania registered dealer.

TENTHS

Name of Acquiring Dealer:_________________________________________ Acquiring Dealer DIN/Bus. Partner ID#:_____________________

SECOND ASSIGNMENT

Street Address:______________________________________________ City:____________________________ State:_____ Zip:___________

SELF-CERTIFICATION

I/We declare under penalty of perjury under the law of the Commonwealth of Pennsylvania, that the foregoing is true and correct, and that

application was made for the above product.

Furthermore, I/we state that I/we have read and signed this application after its completion, and I/we swear or affirm that the statements made

herein are true and correct, and that any statement made on or pursuant to this application is subject to the penalties of 18 Pa.C.S. Section 4904

(relating to unsworn falsification), which include criminal prosecution and a term of imprisonment, the maximum of which may be one year

[18 Pa.C.S. 4904(b)], or up to two years [18 Pa.C.S. 4904(a)]. In addition to any other penalty, a person convicted under this section shall be

sentenced to pay a fine of at least $1,000 [18 Pa.C.S. 4904(d)].

Signed on the _____ day of _____________, _______________ at ____________________________________, ________________________.

(county or other location, and state)

(country)

Printed Name of Original Title Holder/Authorized Person

Signature of Original Title Holder/Authorized Person

Printed Name of Co-Seller/Printed Name of Firm

Signature of Co-Seller/Printed Name of Firm

I, a registered Pennsylvania Dealer, hereby certify that I have acquired and hold for resale, the above described vehicle.

Signature of Acquiring Dealer

Date of Acquisition (MM/DD/YY)

WARNING: Federal and State Laws require

I/We, certify to the best or my/our knowledge that the odometer reading is ___ ___ ___, ___ ___ ___

that you state the mileage in connection

miles and reflects the actual mileage of the vehicle unless one of the following boxes is checked:

with the transfer of ownership. Failure to

complete or providing a false statement may

o Reflects the amount of mileage in excess of its mechanical limits; or,

result in fines and/or imprisonment.

o is not the actual mileage. WARNING: Odometer discrepancy.

I/We further certify that the vehicle is free of any encumbrance; and, that ownership is hereby transferred to the following Pennsylvania registered dealer.

TENTHS

Name of Acquiring Dealer:_________________________________________ Acquiring Dealer DIN/Bus. Partner ID#:_____________________

Street Address:______________________________________________ City:____________________________ State:_____ Zip:___________

THIRD ASSIGNMENT

SELF-CERTIFICATION

I/We declare under penalty of perjury under the law of the Commonwealth of Pennsylvania, that the foregoing is true and correct, and that

application was made for the above product.

Furthermore, I/we state that I/we have read and signed this application after its completion, and I/we swear or affirm that the statements made

herein are true and correct, and that any statement made on or pursuant to this application is subject to the penalties of 18 Pa.C.S. Section 4904

(relating to unsworn falsification), which include criminal prosecution and a term of imprisonment, the maximum of which may be one year

[18 Pa.C.S. 4904(b)], or up to two years [18 Pa.C.S. 4904(a)]. In addition to any other penalty, a person convicted under this section shall be

sentenced to pay a fine of at least $1,000 [18 Pa.C.S. 4904(d)].

Signed on the _____ day of _____________, _______________ at ____________________________________, ________________________.

(county or other location, and state)

(country)

Printed Name of Original Title Holder/Authorized Person

Signature of Original Title Holder/Authorized Person

Printed Name of Co-Seller/Printed Name of Firm

Signature of Co-Seller/Printed Name of Firm

I, a registered Pennsylvania Dealer, hereby certify that I have acquired and hold for resale, the above described vehicle.

Signature of Acquiring Dealer

Date of Acquisition (MM/DD/YY)

INSTRUCTIONS

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Type or Print all information in full.

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This form is to be used only with Pennsylvania Certificates of Title with revision dates prior to 11/89.

NOTE: Pennsylvania Certificate of Title must be attached.

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Do not complete this form unless you have the assigned Pennsylvania Certificate of Title in your

possession.

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No more than three dealer assignments are permitted (one Form MV-27) per title assignment. This form may

not be used for out-of-state assignments.

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Form MV-27 should remain attached to the assigned Pennsylvania Certificate of Title, and must accompany

application for transfer of title to the purchaser (or fourth dealer) when submitted to PennDOT.

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Assignment on Form MV-27 to a person or firm registered in the Miscellaneous Motor Vehicle Business class

is NOT permitted.

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Do not use this form if the vehicle has been repossessed.

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Seller's signature for each assignment on Form MV-27 must be self-certified.

NOTE: The acquiring dealer is responsible for reporting its acquisition of the vehicle to PennDOT within seven

days of the acquisition date on Form MV-27A, ¡°Weekly Notification of Dealer Acquisition Covering Vehicles

Acquired For Resale From Another Dealer of Manufacturer,¡± or Form MV-27B, ¡°Weekly Notification of Dealer

Acquisition Covering Vehicles Acquired For Resale From An Individual (Non-Dealer).¡±

Visit us at dmv. or call us at 717-412-5300. TTY callers ¡ª please dial 711 to reach us.

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