Application For Massachusetts Law Enforcement Support License Plates Form
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1Application for Massachusetts Law Enforcement Support License Plates
Customer Information:
Name:_________________________________ License #:____________________
Address:_____________________________________ Daytime Telephone:___________
City/State/zip_______________________________________________
Current Plate # (If applicable)_____________________ Ship plate to:_______________
(Registry of Motor Vehicles branch location; visit
to find out nearest branch)
For official use only:
Reg# assigned:________
Check received:_________ Amt:_______ check number:_______
INSTRUCTIONS:
1. Fill out the information requested above.
2. Send this application with a $40.00 check for the special plate fee. Please note: Your check will not be
cashed until 1,500 pre orders are received.
3. Once your check is processed the $40.00 fee is non refundable.
Make your check payable to Mass DOT (checks are good for one year).
(Note: There is a $20.00 plate swap fee plus any applicable registrations fees due at the time of plate
pick-up. These fees will depend on your current plate number and expiration year. For instance, your
current plate may expire in March of 2012. If your new plate expires in January 2013, the registration
system will charge you for the extra amount of time you receive on your registration.)
4. Do not send this application and check to the RMV. Send to
Victoria Le Blanc- MassLEOplates
P.O. Box 890296
E. Weymouth, MA 02189-0005
5. You will be notified by mail that your plates have been shipped to the requested Registry of Motor
Vehicles branch. Bring your registration and current plates (if applicable) to the branch at that time. Before
manufacturing of the plate begins, 1,500 pre orders must be collected. Once that number is achieved, it will
take approximately 6 months to manufacture the plates and for them to reach the branches.
6. Registration must be renewed every two years.
7. If you are putting your plate on a newly acquired vehicle, you must pay applicable sales tax, title and
registration fees at time of registration.
8. These special plates are available to Massachusetts residents using this form only; there is no online
ordering process at this time. License plates will use randomly assigned numbers only.
Registry use only
RMV Batch No._______________________Approved:__________________
For more information, contact: Victoria Le Blanc,
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