Form Mv-6d - Application For Transporter License Plates - Georgia

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Permanent (12) Digit Customer ID No.:

Master Tag No.:

MV-6D (Revised 5-2017)

CLEAR

DOR USE ONLY

Web and MV Manual

Georgia Department of Revenue - Motor Vehicle Division

Application for Transporter License Plates

ANY CORRECTION OR ALTERATION WILL VOID THIS FORM

Purpose of this Form: This form is to be used by a business owner or executive officer to request the manufacture of Transporter license plates.

How to submit this Form: This form must be completed in its entirety, legibly printed or typed, and submitted along with all required documents and fees to the

Business Registration Unit of the Motor Vehicle Division. Please mail this completed form to ATTN: Business Registration Unit, Department of Revenue/Motor

Vehicle Division, P.O. Box 740381, Atlanta, GA 30374-0381.

Required Document(s): You are required to submit documents supporting State and Federal identification numbers and licenses; a Certificate of Motor Carrier

Insurance Policy; photos of business and signage; copy of land line telephone bill; list of current employees and contractors; and copies of current employees and

contractors driver’s license.

BUSINESS INFORMATION

Company, Business, Firm, Corporation, LLC

Telephone No.:

Business Name:

Publicly listed, no cell phone number.

Business Owner’s

Last Name

First Name

Middle Initial

Suffix

Full Legal Name:

Street No.

Street Name

Apt/Suite No.

City

State

ZIP Code

Business Address:

Georgia Tax

Federal Employee

Identification No.:

Identification No. (FEIN):

Georgia Business or

USDOT No.:

Occupational License No.:

Contact information for the person responsible for maintaining records will be used by the Department of Revenue Office of Special Investigations

as contact for review of records.

Contact Person’s Name:

Telephone No.:

LICENSE PLATE REQUEST

Transporter License Plate Limited Uses:

1. To facilitate the delivery of new or used motor vehicles, trucks, trailers, or buses between manufacturers, distributors, dealers, sellers, or purchasers;

2. To move a mobile office, a mobile classroom, a mobile or manufactured home, or house trailer;

3. To drive a motor vehicle or pull a trailer that is part of the inventory of a dealer to and from a motor vehicle or trailer trade show or exhibition or to, during,

and from a parade in which the motor vehicle or trailer is used; or

4. To drive special mobile equipment from the manufacturer of the equipment to a facility of a dealer; or from one facility of a dealer to another facility of a

dealer.

5. To transport vehicles from or to the State of Georgia.

By completing this form, the business is certifying its understanding of the limited uses for a Transporter license plate and its intention to report as

requested to the department a vehicle movement log which contains at least the following information:

1. Vehicle type and description to include year, make, model and vehicle

3. The location the vehicle was first operated;

identification number (VIN);

4. The destination of the vehicle;

2. Full name of vehicle operator to include their driver’s license number and

5. The authorized purpose listed under code section 40-2-38.1.

residence address;

CALCULATE TOTAL DUE:

MAILING FEE

MASTER PLATE

ADDITIONAL PLATES

TOTAL DUE

(See instructions for mailing fee)

# of 1lates

X $62.00

# of Plates

X $12.00

# of Plates

62.00

= $__________

$___________

CERTIFICATION

I do solemnly swear, affirm or certify under criminal penalty of a felony for fraudulent use of a false or fictitious name or address or making a material false

statement punishable by a fine of up to $5,000 or by imprisonment of up to five (5) years, or both, that statements contained on documents submitted by me

are true and accurate. I also swear, affirm or certify that I am the authorized agent to sign for the company listed above, and shall comply with all state laws,

rules and regulations pertaining to these tags.

Business Owner or

Signature:

Date:

Executive Officer Name:

Witness Name and Title:

Signature:

Date:

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