Application For Als One Ma License Plate Template - Als Knights printable pdf download

APPLICATION FOR ALS ONE MA LICENSE PLATE

Design may be subject to change

Customer Information:

Name:

License #:

Address: ______________________________________________

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: ___________

INSTRUCTIONS:

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. ___________________________________________

Approved _________________________________

For more information about your ALS ONE license plate, please contact Jen DiMartino Thank you for your support.

Application For Als One Ma License Plate Template - Als Knights