MV-221 is the Statement of Non-Operation of Vehicle(s) that the Pennsylvania Department of Transportation (PennDOT) Bureau of Motor Vehicles publishes for vehicle owners. In it, the owner certifies that the listed vehicle or vehicles were not operated, and that operation was not permitted, between an insurance cancellation date and an insurance replacement date. On FillingPDF you can fill out the form online and download or print the completed PDF. The form and its mailing, fax and email details are published by PennDOT, so you send the finished statement through those channels.
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What is MV-221?
Form MV-221, Statement of Non-Operation of Vehicle(s), is a certification issued by the PennDOT Bureau of Motor Vehicles in which a vehicle owner states that a motor vehicle was neither operated nor allowed to be operated during a period when its insurance coverage had lapsed.
The statement is built around two dates: the insurance cancellation date and the insurance replacement date. The owner certifies that the vehicle or vehicles listed on the form were not operated between those dates because of the lapse in coverage.
The form has four lettered sections:
- A, the certification, with the owner's printed name and the two dates.
- B, application information for the owner and any co-owner: name or full business name, PA driver's license/photo ID number or business ID number, date of birth and telephone number.
- C, vehicle information, with room for five vehicles: title number, registration plate number, vehicle identification number and make.
- D, the applicant signature block.
The form states two conditions at the top: the statement is unacceptable if the insurance lapse is greater than 30 days, and all information must be completed by the vehicle owner only. It also carries a warning that a misstatement of fact is a misdemeanor of the third degree under 18 Pa.C.S. Section 4904[b]. The form has a "For Department Use Only" area that the owner leaves blank.
Who needs to file MV-221?
The vehicle owner uses Form MV-221. The form says that all information must be completed by the vehicle owner only, so it is the owner who prints the name in Section A and fills in Sections B and C.
Who may use it, and when:
- Owners whose insurance on a vehicle was cancelled and later replaced, and who did not operate or permit operation of the vehicle between those two dates.
- Co-owners: Section B has a separate line for a co-owner, and Section D has a signature line for the co-owner.
- Businesses: Section B accepts a full business name and a business ID number, and Section D refers to a title of an authorized signer, so an authorized signer may sign for the owner.
Do not use the form if the insurance lapse was greater than 30 days: the form states that the statement is unacceptable in that case. It also cannot be used to certify anything other than non-operation of the listed vehicles during the lapse, and the certification must be true, since a misstatement of fact is a misdemeanor of the third degree.
When to file MV-221
Complete Form MV-221 after your insurance has been replaced, because Section A asks for both the insurance cancellation date and the insurance replacement date. The form is acceptable only if the lapse between those two dates is 30 days or less; a lapse greater than 30 days makes the statement unacceptable. No separate due date is printed on the form, so check with PennDOT at 717-412-5300 (TTY callers dial 711) if you were asked to return it by a certain date.
How to fill out MV-221
Print your name in Section A
In the certification, print your name on the line after "I,". Only the vehicle owner completes the form.
Enter the lapse dates
Write the Insurance Cancellation Date and the Insurance Replacement Date in the two date spaces. The lapse between them must not be greater than 30 days.
Complete owner details in Section B
Enter your last name (or full business name), first name, middle name, PA DL/Photo ID# or Bus. ID#, date of birth and telephone number.
Add a co-owner if there is one
Use the Co-Owner line in Section B for the co-owner's last name, first name, middle name, PA DL/Photo ID# or Bus. ID#, date of birth and telephone number.
List each vehicle in Section C
For every vehicle covered by the statement, enter the title number, registration plate number, vehicle identification number and make on its own line. The form has five lines.
Read the warning in Section D
Section D warns that a misstatement of fact is a misdemeanor of the third degree under 18 Pa.C.S. Section 4904[b]. Confirm every entry is true before signing.
Sign and date the statement
The owner or authorized signer signs and dates the first line. A co-owner signs and dates the second line; an authorized signer writes a title there.
Review and download the completed PDF
Check names, dates, identification numbers and vehicle details. Download or print the completed PDF from FillingPDF and send it through one of the channels described under How to submit.
How to submit MV-221
You can send the completed MV-221 to PennDOT by mail, by fax or by email.
- Mail: Bureau of Motor Vehicles, PO Box 68674, Harrisburg, PA 17106-8674.
- Fax: (717) 772-1550.
- Email: [email protected].
Before you send it, make sure the owner has signed and dated Section D, and the co-owner has signed if one is listed. For questions, visit www.pa.gov/dmv or call 717-412-5300; TTY callers dial 711. The form names no other channel, and it gives no fee or attachment. FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Submitting the statement when the insurance lapse was greater than 30 days; the form says it is unacceptable in that case.
- Having someone other than the vehicle owner complete the information; the form says all information must be completed by the vehicle owner only.
- Leaving the insurance cancellation date or the insurance replacement date blank in Section A.
- Listing a vehicle that was operated, or whose operation was permitted, during the lapse; a misstatement of fact is a misdemeanor of the third degree.
- Sending the form without the owner's signature and date in Section D, or without the co-owner's signature when a co-owner is listed.
- Entering a vehicle's title number, registration plate number, vehicle identification number or make in the wrong column in Section C.
- Mailing the statement to an address other than Bureau of Motor Vehicles, PO Box 68674, Harrisburg, PA 17106-8674, or to a fax number or email that is not the ones printed on the form.
- Writing in the "For Department Use Only" area at the top of the form.
Frequently asked questions
What is Form MV-221?
MV-221 is the Statement of Non-Operation of Vehicle(s) from PennDOT's Bureau of Motor Vehicles. The owner uses it to state that a vehicle was not operated, and that operation was not permitted, between an insurance cancellation date and an insurance replacement date.
Who can complete the MV-221 form?
Only the vehicle owner. The form states that all information must be completed by the vehicle owner only. Section B has a line for a co-owner, and Section D has a line for a co-owner or the title of an authorized signer.
What if my insurance lapse was longer than 30 days?
The statement is not acceptable. The form says the certification is unacceptable if the insurance lapse is greater than 30 days. Contact PennDOT at 717-412-5300 (TTY callers dial 711) if you need to know what applies to your situation.
Where do I send Form MV-221?
Send it to the Bureau of Motor Vehicles, PO Box 68674, Harrisburg, PA 17106-8674, by fax to (717) 772-1550, or by email to [email protected]. These are the three channels printed on the form.
Can I fill out MV-221 online?
Yes. You can fill out the PDF online on FillingPDF and download or print it. FillingPDF does not send the form to PennDOT; you submit it by mail, fax or email using the details on the form.
Can more than one vehicle be listed on MV-221?
Yes. Section C has five lines, each for a title number, registration plate number, vehicle identification number and make. The statement in Section A refers to "vehicle(s)" and one set of cancellation and replacement dates.
What happens if I give false information on MV-221?
The form warns that a misstatement of fact is a misdemeanor of the third degree, punishable by a fine and/or imprisonment, under 18 Pa.C.S. Section 4904[b]. Check every entry before you sign Section D.
Does MV-221 need to be signed by a co-owner?
If a co-owner is listed in Section B, Section D has a line for the co-owner's signature and date. For a business, that line also asks for the title of the authorized signer.
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