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Application for Specialty Plates

J INDICATE R Application for Specialty Plates PLEASE RETURN YOUR Application WITH PAYMENT TO: Specialty PLATE OPTIONS (SEE REVERSE FOR PLATE IMAGES AND FEES) Nebraska Department of Motor Vehicles Driver and Vehicle Records Division INDICATE REQUESTED MESSAGE AND MESSAGE MEANING BELOW: PO Box 94789 Lincoln, NE 68509 Call 402-471-3918 Office Location: 301 Centennial Mall South 1st Choice: 2nd Choice: 3rd Choice: Meaning: Rev. 1/22 Registered Owner Information Name: Address: City: State: NE ZIP: Phone: ( ) Vehicle Information Please check vehicle type (choose one): Passenger (Pickup, SUV, Truck, RV) Motorcycle/Autocycle Trailer (Mini Truck or Mobile Home) VIN: Current Plate Number: Title Number: County of Registration: County Number: Lessor: If a resident of Douglas or Lancaster County, office location where Plates will be picked up: (SEE INSTRUCTION PAGE FOR P)

processed. Due to the issuance of alpha/numeric plates in some counties messages containing three alpha followed by three numeric characters (ABC 123) cannot be processed regardless of spacing. • Messages determined by the DMV to express, connote, or imply objectionable, obscene or offensive words or

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