Application Form For Volunteer Fire Department License Plates
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MV 40-12-250D
LABAMA
EPARTMENT OF
EVENUE
12/13
M
V
D
OTOR
EHICLE
IVISION
P.O. Box 327630 • Montgomery, AL 36132-7630 • (334) 242-9006
Application For Volunteer Fire Department License Plates
INSTRUCTIONS ON REVERSE SIDE
REGISTRANT INFORMATION
DEPARTMENT NAME
DEPARTMENT FEIN
STREET ADDRESS
TELEPHONE NUMBER (Include Area Code)
FAX
(
)
(
)
CITY
STATE
ZIP
EMAIL
ADDITIONS
OFFICE USE
BODY
TAG FOR
MAKE
MODEL
YEAR
COLOR
VEHICLE IDENTIFICATION NUMBER*
TYPE
TRANSFER
ONLY
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DELETIONS
BODY
CURRENT
MAKE
MODEL
YEAR
COLOR
VEHICLE IDENTIFICATION NUMBER*
TYPE
TAG NUMBER
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Total new license plates requested . . . . . _________ X $24.25 = $_________________
Total license plates to be transferred . . . . _________ X $ 1.25 = $_________________
Total amount due . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $_________________
I understand that the Volunteer Fire Department tag(s) issued or reassigned to the motor vehicle(s) identified above cannot be used on any other vehicle. I also understand that
this (these) vehicle(s) will not be used for any purpose that is not related to the tasks/functions applicable to the volunteer fire department to which it (they) is (are) registered.
The Volunteer Fire Department tag must be removed from the vehicle when it is sold or otherwise permanently taken out of service by the agency to which the tag is assigned.
Alabama law requires that a valid registration receipt be carried within the vehicle.
I certify that the information contained hereon is true and correct and that the vehicle(s) described above is (are) insured as required by Alabama law.
Signed by: __________________________________________ Title: ______________________________ Date: _______________________
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Parent category: Business