Form Vco/tr-102 - Military Veteran License Plate Application
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1MILITARY VETERAN
Kansas
LICENSE PLATE APPLICATION
D
R
EPARTMENT OF
EVENUE
D
V
A
D
& H
D
V
V
V
IVISION OF
EHICLES
CTIVE
UTY
ONORABLY
ISCHARGED
ETERAN
IETNAM
ETERAN
Central Office Operation
A
D
V
L
P
TR-103
PPLICATION FOR
ISABLED
ETERAN
ICENSE
LATE USE FORM
INSTRUCTIONS
be a Kansas resident. The Kansas Division of Vehicles issues Veteran license plates for three different groups of veterans
Applicant
MUST
or service members who served or are serving in the Armed Forces of the United States. There are only two (2) different license plates
directly associated with veteran status, Veteran License Plate and Vietnam Veteran License Plate;
Veteran plates may be issued to a Kansas resident currently serving in the Armed Forces of the United States* or, an individual who had
at least 180 days of active service and was honorable discharged from the Armed Forces of the United States.
Vietnam Veteran plate may be issued to a Kansas resident who served in the Armed Forces of the United States in Vietnam during the
Vietnam War.
Complete this form, attach proof of eligibility and submitted to county’s motor vehicle office when making application. Proof of
eligibility will be:
: General Orders; or Current Military ID Card -
*
Active Duty Military Member
ID C
CANNOT BE COPIED**
ARD
Discharged Former Military Member: Certificate of Release or Discharge from Active Duty, form DD-214 showing at least 180
days of active service and honorable discharge;
Vietnam Veteran: Certificate of Release or Discharge from Active Duty, form DD-214 showing one of the following medals
awarded:
Armed Forces Expeditionary Medal if applicant served in Vietnam between July 1, 1958 to July 3, 1965, or
Vietnam Service Medal if applicant served in Vietnam between July 3, 1965 to March 28, 1973.
*
Active duty members will need to certify annually they are still serving at the time of the vehicle’s registration renewal. Once discharged from
active duty, they will need to present proof of at least 180 days of service and honorable discharge. If both of these conditions cannot be proven,
the applicant will need to surrender the Veteran plate and have a different type of license plate issued.
** Military ID’s cannot be duplicated/copied, they will be verified by a county associate and returned to
applicant.
VEHICLE INFORMATION
Year
Make
Vehicle ID Number (VIN)
Current Lic. Plate #, If Applicable
TYPE OF LICENSE PLATE APPLYING FOR
Please check box corresponding. Documentation for certification listed above as proof of eligibility.
Veteran
Active Duty Military Member; MUST certify active duty status when applying for and renewing license plate. Upon discharge from service, must
certify at least 180 days of active duty service and honorable discharge.
Veteran
Honorably Discharged Former Military Member; Certify at time of initial application only.
Vietnam Veteran
Military member, either active duty or discharged, who served in US Armed Forces in Vietnam during the Vietnam War. A Vietnam
Veteran may meet the qualifications to apply for either a Vietnam Veteran plate and/or a Veteran plate. Only one plate can be
issued for each vehicle, both plates cannot be issued for the same vehicle at the same time. An expired Veteran plate cannot be
displayed on the front of the vehicle and a Vietnam Veteran plate on the rear or vice versa.
VETERAN’S INFORMATION
I,
certify I am a resident of the state of Kansas.
Please print First, MI and Last Name
D
S
P
E
OCUMENTATION
UBMITTED AS
ROOF OF
LIGIBILITY (Check the box that applies and attach copy. Do NOT copy ID card.)
Current Military ID Card,
General Orders
Verified by County Motor Vehicle Associate:
(Initials of Associate)
DD214
Other, please specify:
I, the undersigned, declare under penalty of perjury under the laws of the state of Kansas that the foregoing is true and correct.
Signature of Applicant
Hand Printed Name of Person Signing
Date
VCO/TR-102, Rev.: 12-2012
Kansas county and state authorities reserve the right to reject any form that has been altered.
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