Wisconsin Title & License Plate Application Form Page 4
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4MV1-2
5/2015
REV1015
Section E – Consent to Purchase
I certify that I have legal custody of the person named as owner
Date Signed
Signature (legal custodian, parent or guardian)
UNDER 18
and consent to the purchase by such person and registration of
X
YEARS OLD
the vehicle described in the applicant’s name.
County
Date my commission expires
Date subscribed and sworn to before me Notary Signature
NOTARY
X
PUBLIC
Section F – Non-Operation
The vehicle described on this application has not been operated upon public highways between dates indicated.
From:
Through:
Section G – License Plate Types
Vehicle type and use determines the vehicle registration. Fees shown are annual unless otherwise indicated.
V EHICLE will be used “For Hire”
See instructions for Gross Weight Fee Schedule.
Authority Number:
Automobile
AUT
Passenger Vehicle/Auto fee = $75. Check if ........................................................................................................
Motorcycle
CYC
Motorcycle of less than 1500 lbs. two-year registration only.
M OTORCYCLE/MOPED
Plates expire in April of even numbered years. Fee = $23. ...............................................................................
manufactured for highway use
and displays required Federal
MPD
Moped (a maximum speed of 30 mph, 50 cc or less if automatic transmission, 130 cc or less if
Certification Label.
operative pedals) Two-year registration only - plates expire in April of even numbered years. Fee = $23......
NOTE: If this box is not checked,
the entire application will
Recreation
MTM
Motor Home used as temporary or recreational dwelling. Fee = column “H” of fee schedule.
be returned.
RVT
RV Trailer (walls rigid, collapsible or non-collapsible - for human habitation.)
Show length at right. Fee = $15. .............................................................................................................
RV TRAILER LENGTH:
Note: If manufactured housing unit, contact the Dept. of Safety & Professional Services at: (608) 266-2112.
Farm
FRM
Farm Truck used primarily for transporting my farm produce and supplies and NOT for traveling to
MOTOR CARRIER CLASS
and from a non-farm occupation (if 38,000 pounds or more, truck must be used EXCLUSIVELY for
transporting farm produce and supplies.) Fee = column “E” of fee schedule.
Include $5 permit fee if operating vehicle
ONLY in Wisconsin. No permit fee is
Farm Truck Tractor used EXCLUSIVELY for transporting supplies, farm equipment and products.
required for semi-trailers.
Annual Fee = column “J” of fee schedule.
Check one
DPF
Dual Purpose Farm (Farm and non-farm activity) register at gross wt. when used for non-farm occupation.
Private - No permit fees (1)
Farm activity, maximum gross wt. is 12,000 lbs. Fee = column “A” of fee schedule.
Rental - Private (5)
Rental - For Hire ... $5 (6)
FTL
Farm Trailer used exclusively for farm purposes. Fee = column “F” of fee schedule.
Rental - Private & For Hire ... $5 (7)
Intrastate (operate inside Wisconsin
Truck
HTK/LTK Truck operated private or under authority. Fee = column “A” of fee schedule.
only) For Hire, PC or LC ... $5 (8)
and/or
Check Consecutive Monthly Registration block if applicable ...........................................................................
Interstate (operate outside Wisconsin)
For Hire (9)
Tractor
DPV
Dual Purpose Truck interchanges between a truck and motor home. Fee = column “A” of fee schedule.
NOTE: All For Hire Carriers must show
(Registered at gross wt. when used as a truck) .................................................................................................
Authority Number(s)
TOR
Truck Tractor normally used with semi-trailer. Fee = column “B” of fee schedule.
(LC, MC, PC, RC)
Check Consecutive Monthly Registration block if applicable ............................................................................
Authority Number(s):
Road Tractor Fee = column “A” of fee schedule .................................................................................................
DAIRY
Motor vehicle transporting Dairy products EXCLUSIVELY. Fee = column “C” of fee schedule if truck-tractor.
(Column “D” if truck, column “F” if trailer.) Must qualify by Wisconsin Statute ......................................................
WOOD
Vehicle transporting Raw Forest Products EXCLUSIVELY. Fee = column “C” of fee schedule if truck-tractor.
(Column “D” if truck, column “F” if trailer.) Must qualify by Wisconsin Statute ......................................................
SEMI
Semitrailer used with a Truck Tractor
Fee = $50. for non-expiring License Plate, not transferable. ...........................................................................
Trailer
TRL
Trailer registration is optional for private operation 3,000 lbs. or less. Fee = $37.50.
Apply for a US DOT Number:
If over 3,000 lbs., registration required. Fee = column “G” of fee schedule.
Phone: 1-800-832-5660
Trailer for rental or For Hire must be registered.
Internet:
Check Consecutive Monthly Registration block if applicable. ...........................................................................
CONSECUTIVE MONTHLY REGISTRATION
Bus
BUS
Bus capacity = 16 or more persons. Fee = column “A” of fee schedule ..............................................................
Used exclusively for one of the following:
• To transport concrete pipe or block and
BBX
Urban Mass Transportation Bus Fee = $5. (5 year plate)
related materials; calcium chloride liquid;
BSB
School Bus Fee = $5. (5 year plate) Pre-sale inspection required ......................................................................
recycled metal salvage materials; logs or
pulpwood; dirt, fill or aggregates; fresh
HSV
Human Service Vehicle Fee = $75. Funded by WisDOT transportation assistance ..........................................
milk; perishable fresh fruits or vegetables
DEV
Driver Education Vehicle Fee = $5. (5 year plate)
for canning, freezing, dehydrating or
storage prior to processing, including
Special
MUN
Municipal–Owned by municipality
Regular
Official
Fee of $5. when original plate issued.
return of waste; petroleum products;
or as a weight transfer machine for
Use
SOV
State Owned Vehicle
Fee of $1. to transfer plates.
purposes associated with truck or tractor
SPZ
Vehicle owned privately and used exclusively for one of the following. Fee = column “F” of fee schedule.
pulling competitions or events.
Check one:
Seasonal hauling of my carnival rides & equipment.
• To transport gravel, concrete or cement
and bituminous road construction
Transporting my grading, ditching, or excavating equipment.
materials; or agricultural lime, feed, grain
SUX
Special Mobile Equipment – refer to form MV2953 for more information.
or fertilizer.
TMP
Intransit/Temporary Operation 30/90 day plate to operate a vehicle except buses,
• As a Motor Truck or Truck-Tractor
owned or leased by a retail lumberyard
For Hire or IRP vehicles. Fee = $3.
used exclusively to transport building
SPX
Vehicle owned, operated and used exclusively for one of the following. Fee = $5. (5 yr. plate)
construction materials from retail
Check one:
Motor Bus for charitable purposes
lumberyards to building construction sites.
Motor Bus for parade participants
• To tow stalled or disabled vehicles.
Other qualifying vehicles
PASSENGER CAPACITY
Special
PER
Personalized Plate – attach form MV2428.
Bus
School Bus
HSV
Plates*
DIS
Disabled Person – attach form MV2162.
VET
Disabled Veteran – attach form MV2172.
wisconsindmv.gov/specialplates
AMA
Amateur Radio (FCC License) –
School Bus approved for registration:
COL
Collector Vehicle (20 or more years old) – attach form MV2323.
X
CLS
Vehicle Collector Special Plate used on a vehicle by a collector instead of regular plates.
Fee = regular registration plus $15 issuance fee. Show Collector Plate #: __________________________
(Signature)
* A full listing of all Special Plates is available on the Internet at: wisconsindmv.gov/specialplates or email:
special-plates.dmv@dot.wi.gov. All “MV” forms referenced on this application, including special plate forms, are available on the
Internet at: wisconsindmv.gov/vehicleforms.
(Badge Number)
(Date)
Print
Remember to print a copy for yourself.
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