Free LAO Veteran License Plate Application - Wisconsin

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LAO VETERAN LICENSE PLATE APPLICATION
Wisconsin Department of Transportation MV2919 5/2006 s.341.14(6r) Wis. Stats.

_____ I would like nonpersonalized Lao Veteran plates.

_____ I would like personalized Lao Veteran 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 _________________________

1st Choice 2nd Choice 3rd Choice
Current License Plate # Year - Make

Meaning Meaning Meaning 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

The social security number is used for identification purposes.

(Applicant Signature)

Release of Personalized Plates
Release of Nonexempt Information
The Wisconsin Department of Transportation uses the information on this form to issue personalized 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.

I authorize the reissuance of my personalized license plate number specified to applicant shown above. I allow the Department of Transportation to reissue my current personalized plate after it is replaced with a different plate. X
(Signature of Owner Releasing Plate)

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.

How To Apply
1. Contact the Lao Veterans of America Inc. for license plate decals and an Application for Hmong/Lao Veteran License Plate in WI and Service Certificate. For more information, contact: Lao Veterans of America, Inc., PO Box 331, Menomonie, WI 54751 Telephone: 715-235-7934 2. Complete this form when you receive your certificate and decals for the Lao Veteran license plate. Check options on application. If you want nonpersonalized plates, mark application and omit steps 3-6. If you want personalized plates choose 1-6 characters. 3. If you choose 6 characters, no spaces are allowed. 5. Give meaning of request, i.e., what does this represent? 6. If you have personalized plates that you would like to replace with the same message on Lao Veteran plates, you may do so if your message is 6 characters or less. (Other restrictions may apply; call if you have questions.) 7. If the vehicle that you wish to register with Lao Veteran plates is already titled in your name, send: * A copy of your Certificate of Registration OR complete the vehicle description on the application above; * $15.00 issuance or personalized plate fee, plus the annual registration fee if the current plates expire within the next 3 months. 8. 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. 9. Send this application with 2 items from Lao Veterans of America, * Signed Application for Hmong/Lao Veteran License Plate in WI, and; * A photocopy of Service Certificate (Not ID card). 10. Make check or money order payable to: Registration Fee Trust. 11. Mail all required items to: Wisconsin Department of Transportation Special Plates Unit PO Box 7911 Madison, WI 53707-7911 Print

L A O V E T
If you choose 5 characters or less, you may request up to 2 spaces between any of the characters. Indicate spaces with diagonal lines.

U S L A O

4. 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 the Number 1 Letter S and Number 5 Letter G and Number 6 Letter Z and Number 2 Letter B and Number 8 Letter U and Letter V

GENERAL INFORMATION
A $15.00 personalized plate fee is required EACH year in addition to the regular annual registration fee. A $15.00 issuance fee is required when nonpersonalized Lao Veteran plates are issued. Check which option you would like us to follow, if your request is not available. 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 incorrectly or unclearly completed. WDOT may refuse to issue OR may recall after issuance, a request that is misleading or may be offensive to good taste or decency. If you are requesting a plate which the current owner no longer wants, please have the former owner complete the "Release of Personalized Plates" inside this application. Personalized plates will be mailed 4-6 weeks after you receive your Certificate of Registration. 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 plate order is processed. An agent may charge a $3 plate fee and / or may charge a $5 service fee. If you have questions: * Call 608-266-3041; * E-mail: [email protected] The Lao Veteran license plates recognize the sacrifices of Hmong and Laotian veterans who served on behalf of the United States of America in the Vietnam War.

Lao Veterans of America License Plate Application
Applicants must contact the Lao Veterans of America, Inc., for a Veteran's Certificate and license plate decals before applying for license plates. Lao Veterans license plates are available for the following vehicles that are owned or leased by certified members of Lao Veterans of America, Inc.:

Automobiles Motor Homes (annual registration only) Motor Trucks
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
MV2919 Wisconsin Department of Transportation

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

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