Transcription of Form 4601 - Application for Missouri Military Personalized ...
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Form 4601 - Application for Missouri Military Personalized ...
R Passenger r Recreational Vehicle (motor home)r Beyond Local 6 Truck r Local 6 Truck (limited to a 50 mile radius)r Beyond Local 12 Truck r Local 12 Truck (limited to a 50 mile radius)r Beyond Local 18 Truck r Local 18 Truck (limited to a 50 mile radius)r Beyond Local 24 Truck r Local 24 Truck (limited to a 50 mile radius) r Motorcycle r Motortricycle r AutocyclePersonalized plate choices (complete only if applying for Personalized plates. Please include more than one choice.)Type of license plate to be issued (some license plates require proof of eligibility - see reverse)Step 2 Owner s Name Street, RR, or Box Number City State ZIP CodeDaytime Phone Number Current Plate NumberName must appear as shown on vehicle title(Please select which category of license plate you need)(__ __ __)__ __ __-__ __ __ __ Step 1 Any false statement in this Application is a violation of the law and may be punished by fine or imprisonment or all plates listed as Stock, the Missouri Department of Revenue will select your license plate fee shown below with this Air Force ($15)r Air Medal ($15)r Armed Forces Expediti
A copy of the identification card issued by the Pearl Harbor Association, Inc. verifying he or she is a Pearl Harbor Survivor. • Purple Heart Plates: The applicant must submit a copy of one of the seven (7) documents listed at the bottom of this page, which must …
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