Free MV2505 Temporary License Plate Application - Wisconsin


File Size: 17.0 kB
Pages: 1
File Format: PDF
State: Wisconsin
Category: Government
Author: WisDOT
Word Count: 206 Words, 1,304 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.dot.wisconsin.gov/drivers/forms/mv2505.pdf

Download MV2505 Temporary License Plate Application ( 17.0 kB)


Preview MV2505 Temporary License Plate Application
Section A - Vehicle Owner Information

DO NOT WRITE ABOVE THIS LINE.

TEMPORARY LICENSE PLATE APPLICATION 30 Day Operating Permit
MV2505 11/2004 s.341.09 Wis. Stats.

Mail To: Wisconsin Department of Transportation Research and Information PO Box 8070 Madison WI 53708-8070 Make Check Payable To: Registration Fee Trust

Complete form using BLUE or BLACK ink.

Application Type
In-person Fee: $3.00 plus $5.00 counter service fee Temporary license plates may be received immediately at any DMV Service Center which provides registration service.
Mail
Fee: $3.00 Temporary license plates are
usually mailed within three (3) working days
of receipt of the application.


License Plate Number

Vehicle Identification Number

Vehicle Year, Make

Print Owner Name - Last, First, Middle Initial

Area Code - Telephone Number Between 7:30 a.m. and 4 p.m.

Street Address

City

State

ZIP Code

I request a temporary plate for the vehicle listed above because:
The vehicle failed the emission test and is being repaired. Other - Explain

X

(Owner Signature) (Date)

The Wisconsin Department of Transportation complies with the Americans with Disabilities Act. The Area Below Is For Office Use ONLY Plate Number Issued Effective Date Expiration Date

Total Amount Collected

Financial Number

Badge Number