APPLICATION FOR ALS ONE MA LICENSE PLATE
Design may be subject to change
Daytime Telephone: ________________
City/State/Zip: __________________________________________ Email: ________________________________
Current Plate # (if applicable) _______________________Ship Plate to: _________________________________
(Registry of Motor Vehicles branch location; visit to find out nearest branch)
Reg # Assigned: _____________
Check Received: ____________ Amt:
Check number: ___________
1. Fill out the information requested above.
3. Send this application with a $40 check for the special plate fee to the address below. Please note: Your check will
not be cashed until 750 pre orders are received.
4. Once your check is processed the $40.00 is non refundable.
Make check for $40 payable to Mass DOT (checks are good for one year). (Note: There is a $20 plate
swap fee plus any applicable registrations fees due at the time of plate pick-up. These fees will depend on your
current plate number and expiration year. For instance, your current plate may expire in August of 2015. If your
new plate expires in January of 2017, the registration system will charge you an additional amount for the extra time
you receive on your registration.)
4. Do not send this application and check to the RMV. Send to:
ALS ONE – LICENSE PLATE
8 INDUSTRIAL WAY
WHITMAN, MA 02382
5. You will be notified by mail that your plates have been shipped to the requested Registry of Motor Vehicles branch.
Bring your registration and current plates (if applicable) to the branch at that time. Before manufacturing of these
plates begins, 750 pre-orders need to be collected. Once that number is achieved, it will take approximately 6 months to
manufacture the plates and for them to reach the branches.
6. Registrations must be renewed every two years
7. If you are putting your plate on a newly acquired vehicle, you must pay applicable sales tax, title and registration fees
at the time of registration.
8. These special plates are available to Massachusetts residents using this form only; there is no online ordering process
at this time. License plates will use randomly assigned numbers only.
Registry Use Only
RMV Batch No. ___________________________________________
For more information about your ALS ONE license plate, please contact Jen DiMartino Thank you for your support.