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Motor Vehicle Division Prestige License Plate Application

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Motor Vehicle Division Prestige License Plate Application For State or County use only: Denied Refund Form MV-9B (Rev. 08-2017) Web and MV Manual Georgia Department of Revenue - Motor Vehicle Division Prestige License Plate Application ______________________________________________________________________________________ Purpose of this Form: This form is to be used by a vehicle owner to request the manufacture of a Special Prestige (Personalized) License Plate. This form should not be used to record a change of ownership, change of address, or change of license plate classification. How to submit this form: After reviewing the MV-9B form instructions, this fully completed form must be submitted to your local County tag office. Please refer to our website at https://mvd.dor.ga.gov/motor/tagoffices/SelectTagOffice.aspx to locate the address(es) for your specific County. OWNER INFORMATION First Name Middle Initial Last Name Suffix Owners’ Full Legal Name: Mailing Address: City: State: Zip: Telephone Number: Owner(s)’ Full Legal Name: First Name Middle Initial Last Name Suffix If secondary Owner(s) are listed Mailing Address: City: State: Zip: Telephone Number: VEHICLE INFORMATION Vehicle Identification Number (VIN): Year: Make: Model: LICENSE PLATE COMBINATION Private Passenger Vehicle (Includes Motor Home and Non-Commercial Trailer) Note: Private passenger vehicles cannot exceed seven (7) letters and/or numbers including spaces. Meaning: ___________________________ Meaning: ___________________________ Meaning: ___________________________ (Required) (Required) (Required) Motorcycle Note: Motorcycles cannot exceed six (6) letters and/or numbers including spaces. Meaning: ___________________________ Meaning: ___________________________ Meaning: ___________________________ (Required) (Required) (Required) Note: No punctuation or symbols are allowed on a license plate. Only letters, numbers, and spaces are allowed. I request that a personal prestige license plate be manufactured. I understand that when I register my vehicle with this license plate, the following fees will be collected: a one time $35 manufacturing fee, $20 annual tag fee, $35 annual special tag fee, vehicle ad valorem tax (if applicable), and $1 if the plate is to be mailed. I understand that a refund of the manufacturing fee will not be made if I decide that I do not want the license plate ordered; I do not register the plate within a 24 month period; I check the wrong box; or I become ineligible for it, e.g. become a resident of another state. State of Georgia Driver’s License Number: _________________________ _____________ Signature Date Have a question? Visit our website at http://dor.georgia.gov/motor-vehicles or scan the QR code above for more information. INSTRUCTIONS How to complete the MV-9B Form OWNER’S INFORMATION Complete the registrant information. The mailing address block should contain the physical address of the registrant. VEHICLE INFORMATION Complete the vehicle information for which a personal prestige license plate is being requested. LICENSE PLATE COMBINATION Indicate if you are applying for a personal prestige license plate for a private passenger vehicle or for a motorcycle. Enter up to three (3) desired combinations in the license plate message boxes. The first available choice will be approved. No other combination will be checked for availability. Below each license plate, record the meaning of each combination, i.e. my initials, etc. FEES Manufacturing Fee: $35 (One time) Annual Tag Fee: $20 Annual Special Tag Fee: $35 Ad Valorem Tax (If applicable) APPLICATION REVIEW AND APPROVAL PROCESS If a Special Prestige license plate combination is approved and later determined to be obscene, profane, or defamatory in nature the Department of Revenue reserves the right to recall the license plate. Any text combination which falls within the following prohibited categories will be denied: obscene, refers to sex, disparages a religious belief or being, disparages an ethnicity, gender, or sexual orientation, indicates a position or office held, trademark or copyright, crime or criminal activity, or makes reference to drugs or alcohol, contains any combination of: GBI, FBI, GSP, GOV, H8, HA8, HAT, HAYTR, AYTR, ANTI, ANTE, SUCK, SUK, BLOW, or 69. Any person whose application for a prestige license plate is denied may appeal the denial within thirty (30) days of notice being sent of the denial. A panel of three members, designated by the Commissioner, will review all appeals. The application will be denied only where all three member of the panel vote to deny the appeal and provide a written statement of their reasons for denial of the appeal. PLEASE NOTE A separate form is required for each vehicle license plate. You cannot apply for more than one license plate on Form MV-9B. Personal prestige license plates are not issued as souvenirs. Personal prestige license plates are only issued on the standard peach plate background. If you have any questions, please contact: Your County Tag Office or DOR/MVD at 1-855-406-5221 or [email protected].
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