LEAVE REQUEST FORM/AUTHORIZATION - United States Navy
SURRENDER OF A REGISTRATION PLATE Registration Plate Must be Attached For Department Use Only Bureau of Motor Vehicles • 1101 S. Front Street • Harrisburg, PA 17104 MV-141 (4-18) www.dmv.pa.gov q q q q q q q q D Law Enforcement/PennDOT Locations The registration plate listed above was surrendered on _____ to the authorized agent below: ................
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