Free Endangered Resources Plate Application - Wisconsin

ENDANGERED RESOURCES LICENSE PLATE APPLICATION
MV2858 6/2007 s.341.14(6r) Wis. Stats.

Wisconsin Department of Transportation

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

Clear Form

Endangered Resources 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

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 END 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 Endangered Resources 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.

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

HOW TO APPLY
1. To order an Endangered Resources (END) plate, mark application and omit steps 2-4. 2. To order a personalized END plate, choose 1-6 characters. If you choose 6 characters, no spaces are allowed.

General Information
When you request an Endangered Resources (END) plate, you pay: A $25.00 donation to the Endangered Resources Fund. 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.

WO L V E S
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.

S A V E M
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 END 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; * $25.00 END 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; * $25.00 END 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 Endangered Resources (END) Plate A $15.00 personalized pate fee is required every year in addition to the $25.00 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.

Endangered Resources License Plate Application
Wisconsin's Endangered Resources Program works to identify, protect and manage native plants, animals and Wisconsin's natural communities from the common to the critically endangered. Your annual donation works to: * Enhance the quality of life in Wisconsin by bringing back Endangered and Threatened species: * Prevent rare species from becoming endangered; * Preserve and manage the best examples of native ecosystems in our State Natural Areas for public use, education and research; * Promote knowledge and stewardship of our state's precious natural heritage for our children and grandchildren, since healthy ecosystems are good for wildlife and people.
MV2858 Wisconsin Department of Transportation

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 Endangered Resources 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.