Form Mvr-16a - Application For Transporter Registration And Plates
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1
2North Carolina Division of Motor Vehicles
MVR-16A
Application for Transporter Registration and Plates
(Rev. 09/17)
ATTENTION: Incomplete or unsigned applications will be returned.
You must choose one:
Business
Individual
Owner 1 NC DL or ID# ___________
________________________________________________________________
Business Name or Full Legal Name of Owner (First Middle Last)
Owner 2 NC DL or ID# ___________
________________________________________________________________
Business Name or Full Legal Name of Owner (First Middle Last)
Business Address (Firm) or Residence Address (Individual):
____________________________________________________________________________
__________
Street, City, Zip Code
County
Mailing Address (if different from above):
____________________________________________________________________________
__________
Street, City, Zip Code
County
_______________________________
___________________________________
(Office) Area Code-Telephone Number
(Home) Area Code – Telephone Number
I have financial responsibility as required by law:
___________________________________
_______________________
_________________________
NC Insurance Company
Policy Number
Number of Plates Insured
I am qualified to obtain this plate(s) under
qualification number(s) _____________
Number of Plate(s) Requested: __________
(Listed on the reverse side)
If #3 or #10 were selected, you must declare your NC Dealer Number:____________________ or the name of your
repair facility:_____________________________________________
If #8 was selected, you must indicate the following:
NC Title number:________________________ Year__________ Make____________ Model___________
NC Title number:________________________ Year__________ Make____________ Model___________
NC Title number:________________________ Year__________ Make____________ Model___________
**If you have more than three vehicles to list under qualification #8, please submit a separate form.
I certify that this application and the information contained above is true and correct to the best of my knowledge and
further acknowledge that making false application or providing false information on this application is a Class I Felony
pursuant to G.S. 20-71 and G.S. 20-177.
__________
_______________________________
_______________________________
Applicant’s signature
Applicant's typed/handprinted name
Date
FEE: $18.00 per plate. **See below for additional charges:
$19.00 per plate for Randolph County Residents. ($1.00 Piedmont Authority for Regional Transporation (PART) Tax)
$33.00 per plate for Durham, Orange, and Wake County Residents. ($8.00 for Regional Transit Authority (RTA)
Tax & $7.00 for County Vehicle Registration Tax.)
Return application and fee to:
North Carolina Division of Motor Vehicles, 3148 Mail Service Center, Raleigh NC 27697
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