Fillable Form Lt-430 - 30 Day Temporary Tag Order Form printable pdf download

Form Lt-430 - 30 Day Temporary Tag Order Form

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NORTH CAROLINA DIVISION OF MOTOR VEHICLES

LICENSE AND THEFT BUREAU

3129 MAIL SERVICE CENTER

RALEIGH, N.C. 27699-3129

919-861-3182

30 DAY TEMPORARY TAG ORDER FORM

Dealer License Number ____________

Dealer Name _______________________________

Address _______________________________________________________________________

(Markers can only be shipped via UPS to the physical address on record with the Dealer Unit - unless picked up)

(We do not accept prepaid shipping labels)

Phone Number (____)

________________________________________

Helpful tips:

Temporary tags cannot be ordered by telephone or online. They must be ordered by mail at the

address above, or picked up in person at NC DMV, 1100 New Bern Avenue, Dealer Unit Room 109,

Raleigh, NC 27697 Monday through Friday between 8am – 5pm.

* Forms of payment: Mail in orders - check, cashier’s check or money order. Walk in orders must use a

dealership check. Walk in cash or credit/debit cards payments are accepted only by the dealer owner.

* You must submit completed ledger pages from the back of each book once completed to avoid order

rejection due to excessive ACTIVE plates on record. Only three prior issue dates are permitted to be

ACTIVE at one time. Only send the white original ledger sheets. You must retain the book at your

dealership for at least one full year from the last tag issue date.

* Completed ledger sheets can be mailed with or without an additional order to NC DMV Dealer Unit,

3129 MSC, Raleigh, NC 27699. You may also fax the completed ledger sheets to 919-861-3805.

FEES: $25.00 PER SET OF 25 TEMPORARY TAG AND BOOK SET

(checks to: NC DMV)

I would like to order_____set(s) of 25 Temp. tags for automobiles/trailers @ $25.00 each = $_________

I would like to order_____set(s) of 25 Temp. tags for motorcycles

@ $25.00 each = $_________

Printed Name ________________________________ Title _____________________ Date __________

Signature ____________________________________

LT-430 (11/13)

Form Lt-430 - 30 Day Temporary Tag Order Form

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