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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 PICK-UP LOCATIONS) SELECT SELEC

Lincoln, NE 68528 North South Midtown Millard Maple 7414 N th30 S th 4204 S 50. th. St 411 N 84. th . St 5730 S 144 St 15335 W Maple Omaha, NE 68112 Omaha, NE 68117 Omaha, NE 68114 Omaha, NE 68137 Omaha, NE 68116

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