Limited Power Of Attorney Only For Purchase Of A Hope For Kids With Diabetes License Plate Page 2
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3In order to purchase the Hope for Kids with Diabetes license plate, you will need to complete a
Commitment to Purchase Form by visiting your local Alabama County Motor Vehicle Office. The other
option that is available to you is to complete the Limited Power of Attorney Form, so that a Children’s of
Alabama representative would have the authority to complete the form on your behalf.
Below you will find important information that should address any questions you have about the Limited
Power of Attorney Form:
Completing the Limited Power of Attorney Form:
•
o
The person whose name is on the car title must be the person to complete the form. If the
person owns more than one vehicle, the same form may be used. If there are several
family members who own cars, each person must complete an individual form.
o
The form must be notarized. If you do not know a notary, most banks have access to a
notary who could assist you.
o
The regular price of the license plate is $50.00, but generous donors have offered to pay
for the first 1,000 tags for the first year. THEY ARE FREE! Therefor, you may not need to
include any form of payment – simply return the form.
o
If you would like to make a donation to the Hope for Kids with Diabetes fund, you may
include your check payable to Children’s of Alabama.
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The SIGNED ORIGINAL Limited Power of Attorney Form must be sent to the address below.
Unfortunately, we cannot accept a scanned or copied version of the form.
Next Steps:
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The Children’s of Alabama representative will take your signed original form to the Motor
Vehicle Office. Once the Commitment to Purchase Form is completed on your behalf, a
receipt will be generated. This receipt will be mailed to the address provided on the form.
o
YOU MUST RETAIN THE ORIGINAL RECEIPT, as this will be what you will take to the Motor
Vehicle Office to receive your license plate. The Department of Motor Vehicles will not
release your license plate to you without the original receipt.
o
Until we have sold 1,000 Hope for Kids with Diabetes license plates, you will keep your
current license plate. You will be notified when the Hope for Kids with Diabetes plates are
available for pick-up.
In order to complete the process:
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o
Please return the signed original form to
Hope for Kids with Diabetes License Plate
Children’s of Alabama
th
1600 7
Avenue South
Birmingham, AL 35233
Together we can provide Hope for Kids with Diabetes, by having a specialty license plate on over 1,000
cars in Alabama! The sooner we receive 1,000 commitments, the sooner we will have them on our
vehicles.
If you have any questions, please contact Emily Hornak with Children’s of Alabama at
. If you would prefer not to complete the Limited Power of Attorney Form,
you may visit your local County Motor Vehicle Office to complete the Commitment to Purchase Form. Just
be sure to tell them that you want to purchase the Hope for Kids with Diabetes license plate. You will not
be able to take advantage of the free offer by visiting the Motor Vehicle Office; you will have to pay the
$50.00 fee. Thank you for your support!
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