Form Tr-103 - Application For Disabled Veterans License Plate
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1KANSAS
APPLICATION FOR DISABLED
DEPARTMENT OF REVENUE
DIVISION OF VEHICLES
VETERANS LICENSE PLATE
TOPEKA, KANSAS 66626-0001
Expiration Date
Present License Plate Number
Month
Year
Name of Veteran
Address
City
, KS
ZIP
Auto [ ]
*Truck [ ]
Truck Weight
Veterans Claim #
Vehicle Information:
Year
Make
Style
ID #
* The full registration fee will be charged for truck plates over 12M.
I certify to be the current registered owner of the above vehicle.
Owner's Hand Printed Name
Signature of Vehicle Owner
Date
VETERANS ADMINISTRATION CERTIFICATION
I, the undersigned, certify that the above named veteran making application for veteran's registration is:
(Check appropriate box)
Entitled to compensation for a 50% disability under laws administered by the Veterans
Administration of the Federal Government.
Having been granted a statutory award by the Veterans Administration of the Federal
Government is entitled to compensation for the loss or permanent loss of use of one or both
feet, one or both hands or permanent vision impairment of both eyes.
Regional Director Veterans Administration
Address
City
INSTRUCTIONS
• Application must be signed by the vehicle owner applying for disabled veteran status.
•
Application for Disabled Veteran license plate shall be made at the local county treasurer’s office.
• Owner will forward application (form TR-103) to the Regional Director of the Veterans Administration
for certification and appropriate signatures.
• Any person who owns a motor vehicle and is responsible for the transportation of such veteran may
apply for a Disabled Veteran license plate.
• There are no registration fees associated with either the initial Disabled Veteran license plate
application or registration renewal.
• More that one Disabled Veteran license plate may be issued. ONLY the initial Disabled Veteran
license plate will be free of registration fees, all additional Disabled Veteran license plates WILL HAVE
standard registration fees due and must be collected.
• If applying for a Handicapped Placard in addition to the Disabled Veteran license plate, a TR-159,
Handicap Placard and/or Plate Application must be completed.
TR-103 www (07-2009)
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