Virginia Department of Motor Vehicles LICENSE PLATE APPLICATION

Purpose: Use this form to request souvenir, standard, personalized, or special license plates. Special license plate fees can be $10, $15, or $25 annually or a one-time $10, $25 or $50 fee based on the plate design, in addition to the registration fees. Personalization is an additional $10 annually.

Instructions: Return this form, with the appropriate fees, to any DMV customer service center or DMV Select Center. You may also mail the application and fees to Special Plates at the address above or apply online at www.dmvNOW.com. For more information, review the Additional Information Section on the back of this form. All other inquiries can be answered by calling our customer contact center at 1-866-DMV-Line (1-866-368-5463) or
1-800-435-5137.

APPLICANT INFORMATION

OWNER'S NAME

last*

first*

DAYTIME TELEPHONE NUMBER*

CO OWNER'S NAME

last

first

DAYTIME TELEPHONE NUMBER

ADDRESS

CURRENT MAILING ADDRESS (Including APT OR SUITE #)*

CITY*

STATE*

ZIP CODE*

CURRENT PLATE

CURRENT PLATE NUMBER

PLATE TYPE

PLATE EXPIRATION DATE

VEHICLE

VEHICLE TITLE NUMBER*

VEHICLE IDENTIFICATION NUMBER*

CERTIFICATION/SIGNATURES

This vehicle is insured with liability coverage by a company licensed to do business in Virginia. Coverage must be in effect at the time of application and must remain in effect as long as the vehicle is registered; even if the vehicle is not driven or is inoperable. This vehicle is not insured; therefore. I am remitting the applicable uninsured motor vehicle fee. This fee provides NO insurance coverage.

Your email*

Sponsor Gift Message

* Required Fields