PA DOT Form DL-9106. Insurance Company / Agency Affidavit of Intended Use

Form DL-9106 is an affidavit form used by insurance companies or agencies to declare the intended use of a motor vehicle. This form is typically required when obtaining or renewing a driver's license or vehicle registration and serves as a declaration of the vehicle's primary use.

The form includes sections where the insurance company or agency can provide their information, policy details, and the intended use of the vehicle. This may include options such as personal use, business use, commercial use, or other specific purposes.

It is important to accurately complete this form to ensure that the driver's license or vehicle registration accurately reflects the vehicle's intended use. Providing false or misleading information on this form may result in penalties or legal consequences.

Application Example: Insurance companies or agencies can use this form to declare the intended use of a motor vehicle for their policyholders. The form should be completed with accurate and truthful information about the vehicle's primary use. This form is essential for ensuring that the driver's license or vehicle registration aligns with the vehicle's intended purpose.

Related Forms: There may not be direct alternatives to Form DL-9106, as it specifically addresses the intended use of a motor vehicle by insurance companies or agencies. However, other forms related to driver's licenses, vehicle registrations, or insurance policies may be required depending on the specific transaction or purpose.