Free University License Plates Application - Wisconsin

UNIVERSITY LICENSE PLATE APPLICATION
MV2724 4/2007 s.341.14(6r) Wis. Stats.

Clear Form

Wisconsin Department of Transportation

Check Options ____ I would like nonpersonalized HEG/HEM plates. ____ I would like personalized HEG/HEM plates. Note: If all personalized choices have been used: ____ I would like standard HEG/HEM plates. ____ Call me at the telephone number below. ____ E-mail me at ___________________________

Circle Campus to be shown on plate Madison Eau Claire Milwaukee Platteville Stout Green Bay Oshkosh River Falls Superior LaCrosse Parkside Stevens Point Whitewater

Meaning

1st Choice
Meaning

2nd Choice
Meaning

3rd Choice
The social security number is used for purposes authorized by law. Give information for the vehicle that you wish to register with HEG/HEM plates.
Current License Plate # Year - Make Body Type Vehicle Identification #

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

(Applicant Signature)

Release of Personalized Plates Release of Nonexempt Information
I authorize the reissuance of my personalized license plate number specified above to applicant shown above. I allow the Department of Transportation to reissue my current personalized plate after it is replaced with a different plate. The Wisconsin Department of Transportation uses the information on this form to issue HEG/HEM 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.
(Signature of Owner Releasing Plate)

X 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.

This will remove your name from marketing lists.

No.

Print

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

HOW TO APPLY
1. To order a nonpersonalized Higher Education (HEG/HEM) plate, mark application and omit steps 2-4. 2. To order a personalized HEG/HEM plate, choose 1-6 characters. If you choose 6 characters, no spaces are allowed.

General Information
When you request a University plate, Higher Education - Madison (HEM) Higher Education Group (HEG) you pay: A $20.00 donation to the designated UW Campus. The donation may be tax deductible if you itemize your income tax returns. An annual $15.00 fee for personalized plates OR a $15.00 original issuance fee; Your regular registration fee, if your current plates expire within 3 months.

2 E D U K 8
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 O 4 U W
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 HEG/HEM plates is already titled in your name, send: * A copy of your Certificate of Registration OR complete the vehicle description on the application; * $15.00 issuance or personalized plate fee, plus the annual registration fee if the current plates expire within the next 3 months; * $20.00 HEG/HEM donation. 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; * $20.00 HEG/HEM donation. 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.

Personalized University (HEG/HEM) Plate A $15.00 personalized pate fee is required every year in addition to the $20.00 donation and regular registration fee. If your personalized request is not available, on the form, check which option you would like us to follow. WisDOT may refuse to issue or 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. Plates will be mailed 4-6 weeks after you receive a new Certificate of Registration. Plates Required in 2 Days 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 University plate order is processed. An agent may charge a $3 plate fee and / or may also charge a $5 service fee. If you have questions: * Call: 608-266-3041 * E-mail: [email protected] * FAX: 608-267-5106 * Write to the address given.

University License Plate Application
Who is eligible? Any Wisconsin resident University 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
MV2724 Wisconsin Department of Transportation