Free Military license plates application - Wisconsin

MILITARY LICENSE PLATE APPLICATION
MV2653
License Plate #

Wisconsin Department of Transportation

11/2006

s.341.14(6r) Wis. Stats.
Year - Make Body Type

Clear Form
Vehicle Identification #

Give information for the vehicle that you wish to register with MLG plates.

Print Applicant Full Name - Last, First, M.I.

Meaning of First Choice

First Choice
Street Address

Second Choice Third Choice

Meaning of Second Choice

City, State, ZIP Code

Meaning of Third Choice

Area Code - Telephone Number Where You May be Reached 7 a.m. - 4:30 p.m.

Check Options:

Social Security Number - For Identification Purposes

Circle ONE choice below, to be shown on plate:
U.S. Air Force Air Force Academy Air Force Reserve Air Force Retired Air Force Veteran U.S. Army Army Reserve Army Retired Army Veteran Military Academy U.S. Coast Guard Coast Guard Academy Coast Guard Reserve Coast Guard Retired Coast Guard Veteran U.S. Marine Corps Marine Corps Reserve Marine Corps Retired Marine Corps Veteran Merchant Marine Academy U.S. Navy Naval Academy Navy Reserve Navy Retired Navy Veteran Afghanistan War Veteran Air Force Cross Medal Air Force Distinguished Service Medal Airman's Medal Army Distinguished Service Medal Bronze Star Medal Coast Guard Distinguished Service Medal Coast Guard Medal Distinguished Flying Cross Distinguished Service Cross Iraq War Veteran Legion of Merit Medal Navy and Marine Corps Medal Navy Cross Medal Navy Distinguished Service Medal Noble Eagle Veteran Purple Heart Medal Silver Star Medal Soldier's Medal Persian Gulf War Veteran Korean War Veteran Somalia War Veteran Vietnam War Veteran World War I Veteran World War II Veteran

_____ I would like nonpersonalized Military plates. _____ I would like personalized Military plates Note: If all personalized choices have been used: _____ I would like nonpersonalized plates _____ Call me at the number given _____ E-mail me at _________________________

(Applicant Signature)

HOW TO APPLY
1. To order nonpersonalized Military plates, mark application and omit steps 2-4. 2. To order personalized Military plates, choose 1-6 characters. If you choose 6 characters, no spaces are allowed.

D F E N D R

If you choose 5 characters, you may request up to 2 spaces between any of the characters. Indicate this request with diagonal lines as shown here.

G I J O E
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? 5. If the vehicle that you wish to register with Military group plates is already titled in your name, send: * A copy of your Certificate of Registration OR complete the vehicle description on the application above; * $15.00 issuance or personalized plate fee, plus the annual registration fee if the current plates expire within the next 3 months. 6. If the vehicle is NOT titled in your name, send: * A completed title application (MV1 or MV11); * All required fees, including annual registration fee; * Additional $15.00 issuance or personalized plate fee. 7. Send this application with signed "Proof of Eligibility" or photocopy of eligibility documentation. 8. Make check or money order payable to: Registration Fee Trust. 9. Mail all required items to: Wisconsin Department of Transportation Special Plates Unit PO Box 7911 Madison, WI 53707-7911.

Pearl Harbor Veteran Survivor stationed in Hawaii on 12/7/41

Proof for Academy
If applying for plates as a student or alumni of a Military Academy, submit a photocopy of your student ID card, Orders to the Academy, or a copy of your diploma.

Proof of Eligibility
(All documentation is subject to verification by WIDOT.)

Submit a photocopy of your form: DD214, "Discharge Certificate," or equivalent. If you are currently serving and have not been issued a DD214 or equivalent, showing eligibility, submit: A dated letter on official letterhead, signed by your unit commander; OR The following Verification Statement, signed by your unit commander: I verify that the applicant is a member of:

(Unit Name)

(Commander Signature)

(Date)

(Print or Type Commander Name)

GENERAL INFORMATION
When you request a Military license plate (MLG), you pay: A $15.00 issuance fee. WI DOT will transfer funds to the WI Department of Veterans Affairs, Veterans Trust Fund. This fee may be tax deductible for certain tax filers; consult your tax advisor. OR An annual $15.00 fee for personalized plates; An annual registration fee, if your current plates expire within 3 months. Personalized Military (MLG) Plates A $15.00 personalized plate fee is required every year in addition to the regular registration fee. If your personalized request is not available, check on the form which option you would like us to follow. WDOT may refuse to issue OR may recall after issuance, a request that is misleading or may be offensive to good taste or decency. 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. If you are requesting a plate which the current owner no longer wants, please have the former owner complete the "Release of Personalized Plates" on this application. Plates will be mailed 4-6 weeks after you receive the new Certificate of Registration. Plates Required in 2 Days To legally operate your vehicle, you must display license plates within 2 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 order is processed. An agent may also charge a $3 plate fee and / or may charge a $5 service fee. If you have questions: Call: 608-266-3041 FAX: 608-267-5106 E-mail: [email protected] Write to the address given.

RELEASE OF NONEXEMPT INFORMATION
The Wisconsin Department of Transportation uses the information on this form to issue Military group plates. Under open records laws, the Department must make nonexempt information available upon request. Do you want your name withheld from mailing lists of 10 or more individuals? Yes. No. This will remove your name from marketing lists.

RELEASE OF PERSONALIZED PLATES

I authorize the re-issuance of my personalized license plate number specified above. I allow the Department of Transportation to reissue my current personalized plate after it is replaced with a different plate.

Military License Plate Application
Who is eligible?
The qualified individual must be an owner, lessee, or trust beneficiary. Military Plates are available for:
Automobile Motor Home (Annual registration only) Truck 4,500, 6,000 or 8,000 pound gross weight including dual purpose farm and dual purpose motor home 12,000 pound gross weight farm truck.

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, personalized plate fee, or any other fee from former owner is allowed.
Print

NO special parking privileges are provided with military plates.
MV2653 Wisconsin Department of Transportation

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