Veteran/ Military Service Award Emblem Application Military members or veterans can apply for an emblem packet. Each packet contains a U.S. veteran emblem and either a campaign ribbon and American flag or 2 campaign ribbons. Packets are $18 each. Requirements • You must provide proof that you are eligible to receive the emblems: • Former service members: Provide a copy of your DD 214 or other official military orders. • Active duty members: Provide a letter from a military office on their letterhead indicating what type of campaign medals were awarded. • You must be the legal or registered owner of the vehicle displaying the emblem. Take this application and supporting documentation to any vehicle licensing office (additional service fees may apply) or mail this application, required documents, and a check or money order for $18 per packet (payable to the Department of Licensing) to: Application and Issuance, Department of Licensing, PO Box 9048, Olympia, WA 98507. Display instructions • When the veteran emblem or military service aware emblem is displayed on a license plate, it must be displayed between the bottom license plate bolt holes. • U.S. flags and ribbon emblems must be displayed on the outside of each bottom license plate bolt hole. No more than two flags or small emblems may be affixed to any one license plate. If you have questions, email [email protected] or call (360) 902-3770.

Applicant Veteran name (Area code) Phone number

Mailing address (Street address or PO Box, City, State, ZIP code)

Current Washington plate number Vehicle identification number (VIN) Model year Make

Veterans remembrance/Military service emblem packets Enter number of emblems requested Air Force Cross Medal Emblem Navy Cross Medal Emblem Bronze Star Medal Emblem Silver Star Medal Emblem Distinguished Flying Cross Medal Emblem U.S. Veteran Emblem Distinguished Service Cross Medal Emblem U.S. Veteran Woman Emblem Select 2 ribbons for each emblem American flag(no eligibility required) Merchant Marines PacificWar Zone Medal Afghanistan Campaign Medal National Defense Medal Air Force Cross Medal Decal Navy Cross Medal Armed Forces Expeditionary Medal Ribbon Silver Star Medal Ribbon Armed Forces Service Medal Remembrance Decal Southwest Asia Service Medal Bronze Star Medal Vietnam Service Medal Distinguished Flying Cross Medal War on Terrorism Expeditionary Medal Distinguished Service Cross Medal War on Terrorism Service Medal Iraq Campaign Medal Remembrance Decal WWI Victory Medal (mail request to DOL address above) Korean Defense Medal Remembrance Decal WWII American Campaign Medal Korean Service Medal Remembrance Decal WWII Asiatic-Pacific Campaign Medal Kosovo Campaign Medal WWII European-African-Middle East Campaign Merchant Marines Atlantic War Zone V-Device (must have Distinguished Flying Cross or Merchant Marines Middle East War Zone Medal Bronze Star) Certification I certify under penalty of perjury under the law of Washington that I am eligible to purchase the veteran remembrance emblems above because I am: Veteran Member of the National Guard Active duty military Reservist X Date and place (city or county) signed Signature

RCW 46.18.295 TD-420-075 (R/4/20)WA