Form Tc-840 - Relinquished Personalized Plates And Reassignment

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Utah State Tax Commission
TC-840
Rev. 6/01
Relinquished Personalized Plates and Reassignment
Division of Motor Vehicle, 210 North 1950 West, Salt Lake City, Utah 84134, (801) 297-7783, 800-DMV-UTAH, TDD 297-2021
Date _________________________
I _________________________________________ hereby relinquish all rights to
personalized plate number _____ _____ _____ _____ _____ _____ _____
Signed ________________________
Registered owner only
NEW OWNER APPLICATION
Date _________________________
Name ___________________________________________________
Address __________________________________________________
City ____________________________ State _______ Zip ____________
Telephone Number ______________________________
Vehicle information where plate will be reassigned (must have current registration)
Current plate
Expiration date
Year
Make
VIN
IMPORTANT: All plates must be manufactured and all fees paid.
As the registered owner of the vehicle on which they are to be displayed, I hereby make application for the
personalized plate combination designated above.
Failure of any vehicle owner to comply with the provisions of Utah Code §41-1a-413 concerning surrender of
personalized license plates upon transfer, sale, or disposal of a vehicle; or failure of any owner to register or renew
registration of a vehicle using the personalized license plates issued for that purpose, shall constitute release by that
owner of any priority for those personalized license plates; and the Motor Vehicle Division shall make that combination
of letters and/or numbers available to the public.
Checks should be made payable to the Utah State Tax Commission.
Signed ________________________
Registered owner only
FORM TX840

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