PennDOT MV-219 Application for Self-Insurance Certificate – Pennsylvania law requires all motor vehicle owners to maintain financial responsibility. For individuals, corporations, government agencies, and certain organizations that prefer to self-insure rather than purchase traditional liability insurance, the official pathway is the PennDOT Form MV-219 – Application for Certificate of Self-Insurance.
This comprehensive guide explains what Form MV-219 is, who can use it, the required supporting documents, collateral rules, the application process, and how to obtain the current version of the form. All information is drawn from official Commonwealth of Pennsylvania sources, including the Pennsylvania Department of Transportation (PennDOT) and the Pennsylvania Code.
What Is PennDOT Form MV-219?
Form MV-219 is the official application used to request or renew a Certificate of Self-Insurance under Pennsylvania’s Motor Vehicle Financial Responsibility Law (75 Pa.C.S. § 1787). Once approved, the certificate allows the applicant to act as a self-insurer for one or more vehicles registered in Pennsylvania instead of carrying a commercial auto liability policy.
The form is issued by the Bureau of Motor Vehicles and is currently designated MV-219 (5-25). It covers both initial applications and annual renewals.
Download the official Form MV-219 here:
Download PennDOT Form MV-219 (PDF)
Who Can Apply for a Certificate of Self-Insurance in Pennsylvania?
Any person or entity that can demonstrate sufficient financial ability to pay motor vehicle liability judgments may apply. Common applicants include:
- Private individuals
- Corporations and partnerships
- Government agencies and authorities
- Religious organizations
PennDOT provides specialized self-insurance packets tailored to each category:
- Pub 617 – Self-Insurance Packet for a Government Agency
- Pub 618 – Self-Insurance Packet for a Corporation
- Pub 619 – Self-Insurance Packet for a Religious Group
- Pub 620 – Self-Insurance Packet for an Individual
Required Documents for a Complete Self-Insurance Proposal
According to official PennDOT guidance and 67 Pa. Code Chapter 223, a complete proposal must include the following items:
- Completed Form MV-219 – Application for Certificate of Self-Insurance (initial or renewal).
- Master Self-Insurance and Security Agreement – A formal agreement between the applicant and PennDOT.
- Financial Statements – A balance sheet and income statement reflecting the applicant’s actual financial condition for the last completed calendar or fiscal year. Corporate or partnership statements must be certified by a CPA or responsible accounting officer.
- Collateral (Security) – Minimum amounts required by regulation (details below).
Government agencies and authorities are generally exempt from the collateral requirement.
Collateral Requirements for Self-Insurance
Pennsylvania sets clear minimum collateral amounts under 67 Pa. Code § 223.4:
- $50,000 for the first vehicle
- $10,000 for each additional vehicle
- Maximum total collateral: $1,000,000
Acceptable forms of collateral include:
- U.S. currency
- U.S. Treasury bills or notes
- Other negotiable obligations of the United States Government
- Escrow deposits held solely for self-insurance purposes in banks, credit unions, or savings and loan associations
- Bonds or other security approved by PennDOT after review
United States Savings Bonds are not accepted because they are non-negotiable.
How to Complete and Submit Form MV-219?
The form requests detailed information, including:
- Applicant name, address, nature of business, and self-insurance administrator contact details
- Whether the application is initial or a renewal
- Type of coverage desired (public liability, property damage, first-party benefits, etc.)
- Claims history for the past four years (accidents, claims paid, reserves)
- Number of vehicles owned in Pennsylvania
- Banking information, insurance on other assets, contingent liabilities, and officer/partner names
- A complete balance sheet
- Self-certification under penalty of perjury
Proper corporate execution requires signatures from the Self-Insurance Administrator plus a President or Vice-President and the Secretary or Treasurer. A corporate seal is typically required on supporting documents.
Mail the complete package to the address shown on the form or in the applicable self-insurance packet (generally the Bureau of Motor Vehicles, Financial Responsibility Section, Harrisburg, PA).
Processing typically takes eight to ten weeks once a complete package is received. Incomplete submissions are returned with a letter listing deficiencies.
Annual Renewal Requirements
Certificates of Self-Insurance must be renewed annually. Under 67 Pa. Code § 223.3, the renewal application (Form MV-219 marked as renewal), updated financial statements, and any required collateral adjustments must be filed with PennDOT on a calendar-year basis on or before March 1.
PennDOT reviews the renewal and may request additional information before issuing a new certificate.
Legal Basis and Benefits of Self-Insurance
Self-insurance is authorized by 75 Pa.C.S. § 1787. An approved self-insurer must still provide the minimum benefits required by the Motor Vehicle Financial Responsibility Law, including first-party benefits and the ability to satisfy judgments, as well as uninsured motorist coverage up to the statutory limits.
Self-insurers are not required to participate in the Assigned Risk Plan or contribute to the Assigned Claims Plan.
A valid Certificate of Self-Insurance (or the insurance identification card issued by the self-insurer) serves as acceptable proof of financial responsibility for registration, traffic stops, and other legal purposes in Pennsylvania.
Official Resources and Contact Information
For the most current forms, packets, and instructions, always use official Commonwealth sources:
- Apply for a Certificate of Vehicle Self-Insurance (official PennDOT page)
- Direct download of Form MV-219
- PennDOT Customer Service: 717-412-5300 (Monday–Friday, 8 a.m.–5 p.m. ET)
- Financial Responsibility Unit email: [email protected]
Additional statutory and regulatory references:
Final Tips for a Successful Application
Ensure all financial statements are current and accurate. Incomplete or outdated information is the most common reason for delay or rejection. Keep copies of everything submitted. Once the Certificate of Self-Insurance is issued, maintain the required collateral and file timely renewals to avoid gaps in coverage.
By following the official requirements and using the current version of Form MV-219, Pennsylvania vehicle owners and organizations can successfully establish and maintain self-insurance status in full compliance with state law.