Form T-218 - Authorization To Apply For A Regular Issue License Plate Following The Reinstatement Of Driving Privilege

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T-218 (Rev. 3- 2012)
Douglas J. MacGinnitie
Vicki Lambert
Commissioner
Director
State of Georgia
Department of Revenue
Motor Vehicle Division
P. O. Box 740381
Atlanta, Georgia 30374-0381
(404) 968-3800
FAX (404) 362-6522
Authorization to Apply for a Regular Issue License Plate Following the Reinstatement of Driving
Privilege
Section I.
Suspended Driver’s Information
______________________________________________________________
_______________________
(Full Legal Name)
(Date of Birth)
_________________________________________________________________________________________________
(Address Including City, State & Zip
)
_________________________________
_______________________________
___________________________
(Driver’s License Number)
(Special License Plate Number)
(Telephone Number Including Area Code)
Section II.
Vehicle & Insurance Information
____________________ _________________
__________
________________________________________
(Year & Make Vehicle)
(Model Name or Number)
(Color)
(Vehicle Identification Number - VIN)
__________________________________________
_____________________________________________
(Insurance Company’s Name)
(Policy Number)
Period of Coverage: from ____________________________thru ____________________________________________
(From Date)
(Thru Date)
Signature of Applicant and Confirmation of Reinstatement of Driving
Section III.
Privilege
I hereby certify that the special license plate issued for the above-referenced vehicle pursuant to §40-2-136 of the OCGA
will be surrendered to the County Tag Agent at the time that I apply for a regular issue license plate. I further acknowledge
that I must provide proof of valid insurance to the Tag Agent at the time that I make application for a regular issue license
plate, and the vehicle must be eligible for registration pursuant to §40-2-26(d) of the OCGA.
* I have attached the required certified copy of a Georgia Motor Vehicle Report that is provided by the Georgia Department
of Drivers Services.
____________________________________________
_____________________________
(Applicant’s Signature)
(Date)
The driving privilege and/or driver’s license of the above-named driver have been reinstated, and he/she now is eligible
to apply for a regular issue license plate for the above-referenced vehicle pursuant to §40-2-136(c)(4) of the OCGA.
DOR SEAL
_____________________________________________
______________________________
(Authorized Department of Revenue Signature)
(Date)

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