Free Personalized License Plates Application - Wisconsin


File Size: 83.3 kB
Pages: 2
File Format: PDF
State: Wisconsin
Category: Government
Author: WisDOT - DMV
Word Count: 926 Words, 5,770 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.dot.wisconsin.gov/drivers/forms/mv2428.pdf

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Preview Personalized License Plates Application
PERSONALIZED LICENSE PLATES APPLICATION
MV2428 6/2008 s.341.145 Wis. Stats.
Circle type of plate wanted (Abbreviations identified on other side of brochure)

Wisconsin Department of Transportation

Clear Form

AUT 1st Choice

MTM

CYC

LTK

FRM
Meaning Meaning Meaning

> Motorcycle Only <

2nd Choice 3rd Choice
Current License Plate # Year - Make

Body Type

Vehicle Identification # Reserve Only

Owner(s)/Lessee Name (Last, First, M.I.) - Print

Social Security # or Driver License # or (If company owned) FEIN #

Street Address

Telephone # where you may be reached 7 a.m. to 4:30 p.m.

City

State

ZIP Code

The social security number is used for identification purposes.

(Applicant Signature)

Release of Personalized Plates
Release of Nonexempt Information
I authorize the reissuance of my personalized license plate number specified to applicant shown above. The Wisconsin Department of Transportation uses the information on this form to issue personalized license plates. Under open records laws, the Department must make nonex empt information available upon request. Do you want your name withheld from mailing lists of 10 or more individuals? Yes. This will remove your name from marketing lists. No.

X
(Signature of Owner Releasing Plate)

New Owner - please check one: Have plates in good condition in my possession
Need new plates issued


Note: No credit of registration fees or personalized plate fee from former owner is allowed.

How to Apply
1. Choose 1-7 characters (except for a motorcycle plate choose 1-5 characters). 2. If you choose 7 characters, you may request up to 2 spaces between any of the characters. Indicate this request with diagonal lines as shown here. (This does not apply to a motorcycle plate.) 5. If the vehicle that you wish to register with personalized plates is already titled in your name, send: * A copy of your Certificate of Registration OR the
complete vehicle description on the application;
* $15.00 personalized plate fee plus annual registration fee if plates expire within the next 3 months for AUT, LTK and MTM plates. * $30.00 biennial personalized plate fee plus biennial registration fee if plates expire within the next 3 months for CYC and FRM plates. 6. If the vehicle is NOT titled in your name, send:
* A completed title application (MV1 or MV11) and fees, including annual registration fee; * $15.00 personalized plate fee for AUT, LTK and MTM plates. * $30.00 biennial personalized plate fee for CYC and FRM plates. 7. Make check or money order payable to: Registration Fee Trust 8. Mail all required items to: Wisconsin Department of Transportation Special Plates Unit PO Box 7911 Madison, WI 53707-7911

A P P L Y 4 7
Motorcycle Only - If you choose 5 characters,
no spaces are allowed.

G O W I S
3. Use capital letters or numbers. The letter O and the number zero are the same. The following are not acceptable: small letters, symbols, signs, hyphens, apostrophes, etc. Carefully distinguish between: Letters L or I and Number 1 Letter Z and Number 2 Letter S and Number 5 Letter B and Number 8 Letter G and Number 6 Letter U and Letter V. 4. Provide meaning of request, i.e., what does this represent?

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General Information



Type of Plate Abbreviations
AUT MTM CYC LTK FRM Auto Motor Home Motorcycle Truck Farm Truck

A $15.00 personalized plate fee is required EACH year in addition to the regular annual registration fee. Biennial license plates for motorcycles or farm trucks require $15.00 personalized plate fee for EACH year of registration. If your request has already been issued to someone else, it will be denied. No refund or adjustment will be made for a change of choice or spacing after the plate has been ordered, or if the application is unclear or incorrectly completed. The department may refuse to issue a request which may be offensive to good taste or decency, misleading or conflict with the issuance of any other license plates. The department is authorized to recall, after issuance, a plate that is discovered to be obscene or otherwise offensive. If you are requesting a plate which the current owner no longer wants, "Release of Personalized Plates" must be completed and signed. Allow approximately 4-6 weeks for the manufacturing process, after Certificate of Registration is received. If you wish to just reserve the plates at this time, omit the vehicle information and check box: "Reserve Only." If you have questions, call 608-266-3041; e-mail: [email protected] or write to the address given on other side.

Personalized
License Plates Application
Personalized Plates are available for: Automobile Motor Home (annual registration only) Motorcycle Truck

Social Security Number
If you are applying as an individual, you are required to provide your Social Security Number, pursuant to 1997 Act 191, for the purposes of s.49.22 Wis. Stats. Under the Social Security Act, 42 USC s.405(c)(2)(C)(i), the department and other state and federal agencies may use the Social Security Number for purposes authorized by law.





Legal Operation
To legally operate your vehicle, you must display license plates within two business days of purchase. If you do not have current plates, apply to a DMV Customer Service Center or an agent authorized by DMV to obtain a temporary plate while your personalized plate order is processed. An agent may charge a $3 plate fee and / or may also charge a $5 service fee.







4,500, 6,000 or 8,000 pound gross weight including dual purpose farm, dual purpose motor home, and "for hire" 12,000 pound gross weight farm truck

ADA - The Wisconsin Department of Transportation complies with the Americans with Disabilities Act.

MV2428

Wisconsin Department of Transportation

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