Form MVD-403 "Application for Extension of the Use of a Loaner Plate" - Maine

What Is Form MVD-403?

This is a legal form that was released by the Maine Department of the Secretary of State - a government authority operating within Maine. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2016;
  • The latest edition provided by the Maine Department of the Secretary of State;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form MVD-403 by clicking the link below or browse more documents and templates provided by the Maine Department of the Secretary of State.

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Download Form MVD-403 "Application for Extension of the Use of a Loaner Plate" - Maine

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Department of
the Secretary of State
Bureau of Motor Vehicles
Patty A. Morneault
Matthew Dunlap
Deputy Secretary of State
Secretary of State
David W. Guilmette
Director, Office of Investigation
& Dealer Licensing
Application for Extension of the Use
of a Loaner Plate
This application is to extend the use of a loaner dealer plate to the customer listed below:
*PLEASE PRINT CLEARLY*
Legal Dealership Name: _____________________________________________________________
DBA (if applicable): ________________________________________________________________
Dealer Phone Number: _____________________________ Fax: ___________________________
Dealer Contact Person: ______________________________________________________________
Dealer Loaner License/Plate Number: __________________________________________________
Customer Name: ______________________________________________________________________________
Customer Complete Address: ____________________________________________________________________
Vehicle being loaned (year, make, and model): _______________________________________________________
Loaner Vehicle Identification Number (VIN): ________________________________________________________
Loaner Plate Number: __________________________________________________________________________
Customer’s Vehicle (year, make, and model): _______________________________________________________
Customer’s Vehicle Identification Number (VIN): ____________________________________________________
Customer’s Plate Number: _______________________________________________________________________
Original Start Date: ________________________________ Original End Date: ____________________________
It is the understanding of this office that the loaner plate has presently been in use for seven (7)
consecutive days, and the customer’s vehicle is currently in the above mentioned repair facility awaiting
parts.
Application may be faxed to: (207) 624-9126
MVD-403 Rev 04/2016
101 Hospital Street, #29 State House Station, Augusta, Me 04333-0029 Tel. (207) 624-9000 Ext. 52143 Fax: (207) 624-9126 TTY Users call Maine relay 711
Department of
the Secretary of State
Bureau of Motor Vehicles
Patty A. Morneault
Matthew Dunlap
Deputy Secretary of State
Secretary of State
David W. Guilmette
Director, Office of Investigation
& Dealer Licensing
Application for Extension of the Use
of a Loaner Plate
This application is to extend the use of a loaner dealer plate to the customer listed below:
*PLEASE PRINT CLEARLY*
Legal Dealership Name: _____________________________________________________________
DBA (if applicable): ________________________________________________________________
Dealer Phone Number: _____________________________ Fax: ___________________________
Dealer Contact Person: ______________________________________________________________
Dealer Loaner License/Plate Number: __________________________________________________
Customer Name: ______________________________________________________________________________
Customer Complete Address: ____________________________________________________________________
Vehicle being loaned (year, make, and model): _______________________________________________________
Loaner Vehicle Identification Number (VIN): ________________________________________________________
Loaner Plate Number: __________________________________________________________________________
Customer’s Vehicle (year, make, and model): _______________________________________________________
Customer’s Vehicle Identification Number (VIN): ____________________________________________________
Customer’s Plate Number: _______________________________________________________________________
Original Start Date: ________________________________ Original End Date: ____________________________
It is the understanding of this office that the loaner plate has presently been in use for seven (7)
consecutive days, and the customer’s vehicle is currently in the above mentioned repair facility awaiting
parts.
Application may be faxed to: (207) 624-9126
MVD-403 Rev 04/2016
101 Hospital Street, #29 State House Station, Augusta, Me 04333-0029 Tel. (207) 624-9000 Ext. 52143 Fax: (207) 624-9126 TTY Users call Maine relay 711