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Click ‘Get Form’ to open it in the editor.
Begin by filling out Section I with your name, residential address, city, state, license plate number, and expiration details. Ensure all information is accurate for a smooth process.
In Section II, select the reason for your application by checking the appropriate box. If applicable, provide additional details such as the date of vehicle sale or other reasons.
Proceed to Section III to indicate what you wish to replace—be it a decal, plate, or registration. Remember to attest that you have not received any refunds related to this license plate.
Complete the insurance certification if replacing a decal or plate by entering your insurance company’s name.
If necessary, fill out Section IV regarding the removal of any authorized disabled individuals from your registration.
In Section V, provide details of any authorized individual making the report if different from the registered owner.
Finally, certify that all information is true in Section VI by providing your printed name, signature, and date.
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