Form Mv53 - Application For Military Registration

APPLICATION FOR MILITARY REGISTRATION

STATE OF MONTANA - MOTOR VEHICLE DIVISION - TITLE AND REGISTRATION BUREAU

This application allows a Montana resident on active military duty WHO ENTERED THE SERVICE FROM MONTANA and is stationed outside of Montana to

purchase license plates and register a motor vehicle that he/she owns and operates for the cost of registration alone (exempting Montana taxes and fees).

RECERTIFICATION REQUIRED EACH YEAR FOR RENEWAL. If the vehicle is registered to more than one applicant, co-owners must pay a proportionate

share of taxes and fees otherwise due, unlesss the co-owner also qualifies and applies for military registration.

I HEREBY DECLARE THAT THE STATE OF MONTANA IS MY DOMICILE, THAT I WAS A MONTANA RESIDENT AT THE TIME OF ENTERING

MILITARY SERVICE, AND THAT MY MONTANA RESIDENCE IS:

Street address

City

THAT I AM THE REGISTERED OWNER AND OPERATOR OF THE FOLLOWING VEHICLE:

Year

Make

Model

Lic. Plate #

Vehicle ID#

Title #

GVW

THAT I AM ON ACTIVE MILITARY DUTY AS STATED BELOW -- please print:

Name, rank, serial number:

Organization Unit:

Immediate Commanding Officer:

Duty address:

I CERTIFY UNDER PENALTY OF LAW that the statements made herein, as recorded in the personnel and finance records of my military service, are true and

correct to the best of my knowledge, information and belief. SIGNATURE:

Subscribed and sworn to before me this ______ day of ___________________________________, 19 ____.

AFFIX

Officer Administering Oath

SEAL

Residing at

HERE

NOTICE CONCERNING RELEASE OF PERSONAL INFORMATION

Motor vehicle records are released to individuals and businesses for a variety of uses, BUT you may have your name and address withheld from release for certain uses by INITIALING the appropriate box(es) below.

Your selection(s) will not affect release for motor vehicle recall, warranty, anti-theft, safety or emission purposes. Selection applies to personal information of any co-owner for this vehicle record. To cover other

vehicle records, you must obtain a separate form at your county treasurer's office.

No release for DIRECT MAIL/PRODUCT

No release for OTHER USES, EXCLUDING governmental, business or employment verification, legal proceedings,

MARKETING uses

licensed investigations, insurance, towing or other statistical reporting purposes.

Upon request, this form can be made available in an alternative format.

MV53 (Internet) Rev. 09/97