Free Green Bay Packer License Plate Application - Wisconsin

GREEN BAY PACKER LICENSE PLATES APPLICATION
MV2917 1/2008 s.341.14(6r) Wis. Stats.

Wisconsin Department of Transportation
Clear Form

The social security number is used for identification purposes. Give information for the vehicle that you wish to register with Packer plates.
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

City

State

ZIP Code

Check Options
I would like personalized Packer plates Note: If all personalized choices have been used I would like nonpersonalized plates Call me at ________________________ between 7 a.m. and 4:30 p.m. E-mail me at _____________________ I would like nonpersonalized Packer plates.

(Applicant Signature)

Personalized Message Request
First Choice
Meaning of First Choice

Personalized Plates Release

I authorize the re-issuance of my personalized license plate number specified above. I allow the DOT to reissue my current personalized plate after it is replaced with a different plate.

Second Choice
Meaning of Second Choice

(Signature of Owner Releasing Plate)

Third Choice
Meaning of Third Choice

New Owner - please check one: Have plates in good condition in my possession Need new plates issued Note: No credit of any fees from former owner is allowed.

How to Apply
1. To order nonpersonalized Packer (PAK) plates, mark application and omit steps 2-5. 2. To order personalized Packer plates, choose 1-6 characters. If you choose 6 characters, no spaces are allowed. 5. If the vehicle that you wish to register with Packer plates is already titled in your name, send: * A copy of your Certificate of Registration OR the complete vehicle description on the application below; * $15.00 issuance or personalized plate fee, $25.00 Packer donation, plus the annual registration fee if the current plates expire within the next 3 months. 6. If the vehicle is NOT titled in your name, send: * A completed title application (MV1 or MV11) and fees, including annual registration fee; * Additional $15.00 issuance or personalized plate fee, and $25.00 Packer 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

P A C K E R
If you choose 5 characters, you may request up to 2 spaces between any of the characters. Indicate spaces with diagonal lines.

G O P A K
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?

Plate Donation Benefits Lambeau Field When you request a Packers plate you pay: A $15 original issuance fee, or an annual $15 fee for personalized plates; A $25 donation to Lambeau Field; Your regular registration fee, if your current plates expire within 3 months. Thereafter, you will pay the $25 donation and the regular registration fee for standard Packers plates. The $25 donation may be deductible if you itemize your income tax returns. Personalized Packers Plates Available A $15 personalized plate fee is required every year in addition to the $25 donation and regular registration fee. If your personalized request is not available, check which option on the form you would like us to follow. DOT may refuse to issue OR may 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 the new Certificate of Registration. Plates Required in 2 days To legally operate your vehicle, you must display license plates within 2 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 order is processed. An agent may also charge a $3 plate fee and/or may charge a $5 service fee. If you have questions: Call: 608-266-3041; FAX: 608-267-5106; E-mail: [email protected];
ADA - The Wisconsin Department of Transportation complies with the Americans with Disabilities Act.

Proceeds from the sale of Green Bay Packer license plates will go towards Lambeau Field maintenance and operating costs.

Green Bay Packer

License Plate Application
Packer Plates are available for: Automobiles Motor Homes (annual registration only) Motor Trucks 4,500, 6,000 or 8,000 pounds gross weight including dual purpose farm and dual purpose motor home 12,000 pound gross weight farm truck
Wisconsin Department of Transportation MV2917

RELEASE OF NONEXEMPT INFORMATION The Wisconsin Department of Transportation uses the information on this form to issue Packer license 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 No

This will remove your name from marketing lists.

Write to the address given inside.