Form 570 - Application For Missouri Historic Or Personalized Historic License Plates Page 2

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Historic vehicles may be driven to and from events, to repair facilities within a 100-mile limit, and may be driven up to 1,000 miles per
year for personal use. The owner of the historic vehicle shall be responsible for keeping a log of the miles driven for personal use each
calendar year. Such log must be kept in the historic vehicle when the vehicle is driven on any state road.
A Historic Vehicle Log, Form-4012, can be downloaded from the following web site:
This permanent registration is not transferrable. If the vehicle is disposed of, historic license plates must be returned to the Director of
Revenue for cancellation.
Disabled Person Plates (applies to personalized historic only): An original signed Physician’s Statement for Disabled Person’s
License Plates (Form-1776) from an advance practice registered nurse, licensed physician, chiropractor, physician’s assistant,
podiatrist, or optometrist must be submitted that states the disability is permanent. The physician’s statement is valid for 90 days after
completion by an authorized medical professional.
License plates will be issued only to those vehicles that are titled and registered in Missouri.
Instructions for Regular Historic License Plates
Application must be completed (record the owner’s name as shown on the title), signed, and submitted with the following:
• $25.25 permanent registration fee and a $3.50 processing fee;
• Personal property tax receipt or non-assessment statement from the previous year;
• Proof of current insurance which includes year, make, vehicle identification number, and expiration date; and
• Copy of title or copy of receipt of application for title.
Additional Instructions for Personalized Historic License Plates
Please submit a $15.00 annual fee for personalized historic license plates, which is required in addition to the requirements listed above,
and is payable every year upon reapplication.
If you currently have historic plates on the vehicle referenced on the front of this application, the $25.25 permanent registration fee is not due.
Please indicate your current historic plate in the Historic License Number area on the front of the application.
A personalized license plate may consist of no more than six characters plus a dash, space, or apostrophe. A personalized motorcycle
license plate may consist of no more than six characters or five characters plus a space, dash, or apostrophe.
Please print capital letters and numbers as follows:
The Missouri Department of Revenue will not issue plates that contain any letters, numbers, or a combination of letters and numbers
which are obscene, profane, patently offensive or contemptuous of a racial or ethnic group, offensive to good taste or decency, or would
present an unreasonable danger to the health or safety of the applicant, of other users of streets and highways, or of the public in any
location where the vehicle with such plate may be found. The Missouri Department of Revenue will not issue plates that conflict with the
regular license numbering system.
Additional Instructions for Year of Manufacture License Plates
The owner of any historic vehicle possessing a license plate issued by the state of Missouri that is over 25 years old in which the year of
issuance of such plate is consistent with the year of manufacture of the vehicle may register such plate as a historic vehicle plate as set
forth in 301.131, RSMo, provided the plate configuration does not conflict with the current numbering system. If you are in possession
of a plate that is consistent with the year of manufacture of the vehicle, please submit a picture of the plate that clearly shows the plate
number and year with this application and the requirements listed above. If you have any questions, please contact the Motor Vehicle
Bureau at (573) 526-3669.
Example: A 1965 vehicle can be registered using a Missouri license plate from 1965.
Form 570 (Revised 06-2013)
Mail to:
Phone: (573) 526-3669
Visit dor.mo.gov
Motor Vehicle Bureau
P.O. Box 569
Fax: (573) 751-5209
for additional information.
E-mail: mvbmail@dor.mo.gov
Jefferson City, MO 65105-0569

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