When car enthusiasts, veterans, college alumni, or anyone interested in customizing their vehicle's appearance think about distinctive license plates in Virginia, the DMV VSA 10 form is their starting point. This versatile document, last updated on June 10, 2010, serves as the gateway to obtaining various types of license plates, including standard, personalized, special, and disabled plates, along with souvenir plates that hold sentimental value for collectors. Applicants have the liberty to choose from a range of categories—such as heritage, scenic, college-related, military, and clean fuel—tailoring their vehicle's identity to their interests or affiliations. In completing the form, applicants are also required to provide detailed information about their vehicle and insurance status, ensuring compliance with Virginia's road safety regulations. The back section of the form offers critical additional details, highlighting fees, policies on personalized plate character combinations, and the specific requirements for obtaining clean fuel license plates, among other considerations. Notably, the form emphasizes that all personalized plate requests are subject to DMV screening to prevent offensive or inappropriate content, underscoring the DMV's commitment to maintaining public decorum on the road. Applying for these plates is made convenient through options to submit in person at customer service centers, via mail, or online, illustrating Virginia DMV's efforts to provide accessible service options for all.
| Question | Answer |
|---|---|
| Form Name | DMV Form VSA 10 |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 1 |
| Avg. time to fill out | 42 sec |
| Other names | dmvNOW, vsa 10 form, 2010, VSA |
VSA 10 (06/10/2010)
LICENSE PLATE APPLICATION
Purpose: Use this form to request souvenir, standard, personalized or special license plates.
Instructions: Review the Additional Information Section on the back of this form. Return completed form, with the appropriate fees, to any DMV customer service center or DMV Select Center. Or, mail the application and fees to DMV at the address above. You can apply online at www.dmvNOW.com. For other inquiries call DMV DIRECT at
APPLICATION TYPE (check one)
VEHICLE LICENSE PLATES
VEHICLE LICENSE PLATES - DISABLED
SOUVENIR LICENSE PLATES
TRANSFER EXISTING LICENSE PLATES
LICENSE PLATE TYPE REQUESTED (check one)
STANDARD (Blue and White) |
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LIGHTHOUSE |
HERITAGE |
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SCENIC (Mountain To Seashore) |
SCENIC (Autumn) |
SCENIC (Patriot) |
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COLLEGE: __________________________ Locality: |
City County ______________ |
MILITARY ___________________________________ |
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(No initials or abbreviations) |
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SPECIAL INTEREST: ______________________________________________________ |
CLEAN FUEL _______ ____________ |
___________ |
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(Organization Name - If organization has more than one license plate, specify design type) |
Vehicle Year |
Make |
Model |
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(Review the Clean Fuel License Plates |
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OTHER_______________________________ (Note: some plates require certification) |
section on the reverse side of this form.) |
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(Any plate not listed above) |
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PERSONALIZED LICENSE PLATES: To request a personalized vehicle or souvenir plate, review the Personalized License Plates Policy on the reverse side of this form. Check this box and enter your choices below.
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PERSONALIZED LICENSE PLATE CHOICES |
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FEE |
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APPLICANT INFORMATION
OWNER'S NAME (last) |
(first) |
(mi) |
DAYTIME TELEPHONE NUMBER |
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CURRENT MAILING ADDRESS
CITY
STATE
ZIP CODE
CURRENT PLATE NUMBER
PLATE TYPE
PLATE EXPIRATION DATE
VEHICLE TITLE NUMBER
VEHICLE IDENTIFICATION NUMBER
IF PAYING BY CREDIT CARD, ENTER CARD NUMBER AND EXPIRATION DATE
CERTIFICATION/SIGNATURES
I/We certify that (Check only ONE box)
This vehicle is insured with liability coverage by a company licensed to do business in Virginia. Coverage must be in effect at the time of application and must remain in effect as long as the vehicle is registered, even if the vehicle is not driven or is inoperable.
This vehicle is not insured; therefore, I am remitting the applicable uninsured motor vehicle fee. This fee provides NO insurance coverage.
Failure to comply with Virginia's insurance requirements will result in suspension of your driver's license and vehicle license plates. I certify that all information contained herein is true and correct. For a corporation, an authorized representative must sign.
APPLICANT SIGNATURE |
DATE (mm/dd/yyyy) |
DATE (mm/dd/yyyy)
VSA 10 (06/10/2010) page 2
ADDITIONAL INFORMATION
Special license plate fees can be $10, $15, or $25 annually or a
If you are renewing early, registration, special license plate, and personalized license plate fees will be prorated for the months remaining on your current vehicle registration.
The Department of Motor Vehicles (DMV) will not honor a change of choice or refund after the order has been sent to the manufacturer.
You may purchase samples of most special license plates.
Personalized License Plates Policy
All personalized character combinations are screened by DMV to ensure compliance with DMV's Personalized License Plate Policy.
The combination of characters used to personalize a license plate must not violate DMV's Personalized Plate Policy. DMV reserves the right to refuse and/or recall the issuance of any combination of objectionable characters if they, in anyway, carry a connotation that may be reasonably seen by a person viewing a license plate as 1) profane, obscene, or vulgar in nature, 2) sexually explicit or graphic, 3) excretory related, 4) describing intimate body parts or genitals, 5) describing drugs, drug culture or drug use, 6) condoning or encouraging violence, 7) describing illegal activities or illegal substances, 8) socially, racially, ethnically offensive, or disparaging.
Personalized license plates require special handling; allow up to 60 days for delivery. Plates will be mailed directly to the applicant.
Indicate your choices in order of preference. The maximum number of characters allowed on standard and scenic license plates is
7 ½. The maximum number of characters allowed on a heritage license plate is 6 ½. Six characters are allowed on all other license plates bearing logos. License plates with logos may sometimes accommodate an additional ½ space when personalized. A blank space and a dash are the only two characters that are ½ characters. An ampersand is considered a full character. Spaces, dashes, and ampersands cannot be used consecutively.
Visit our website www.DMVNOW.com to create a plate or ask a DMV representative to determine availability.
New Special Interest License Plate Development Information (College/Special Interest Plates)
All application and refund inquiries should be directed to the sponsor who is maintaining and facilitating collection of the 350
When the 350
The entire special license plate process could take up to two years depending on the direction of the sponsor. It generally takes about nine months to develop a new plate once the 350
Clean Fuel License Plates
A vehicle (hybrid) registered with clean special fuel license plates issued by DMV on or after July 1, 2006, are not eligible for occupancy exemptions in the
A hybrid vehicle must qualify as a clean special fuel vehicle under the super
Hybrid vehicle assessment standards were set by the Virginia Department of Environmental Quality (DEQ) and adopted by DMV to ensure that only the cleanest hybrid vehicles are eligible for clean special fuel license plates.
Not all hybrid vehicles qualify for the clean special fuel license plate. For a list of qualifying hybrid vehicles, visit our website at www.dmvNow.com. The list of vehicles is updated as new hybrids are introduced to the market and assessed by DEQ.
Other License Plates - Certification Required
Antique License Plates require submission of the Antique License Plate Applicant Certification (VSA 10 B) with form VSA 10.
Gold Star License Plates require submission of the Gold Star License Plate Applicant Certification (VSA 10 A) with form VSA 10.
Disabled License Plates require submission of the Disabled Parking Placards or License Plates Application (MED 10) with form VSA 10.