Form 184 – Fill Out and Use This PDF

License Plate Number

Current Tab #

Exp. Mo.

Exp. Year

Zone

Gr. wt/seat

Horsepower

ReplaceorTransferRenewal, InformationRegistration

Reason for Replacement

r

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r

(Notary Required)

Lost

Stolen

Mutilated

Destroyed

Never Received

Surrendered

Surrendered Plate Number

r One Plate

r Two Plates

Vehicle License Is Being Transferred From

Year

Make

Title Number

Horsepower

__ __ __ __

Vehicle Identification Number

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r Vehicle out of state (Notary not required) - vehicle described above has not been within the

state of Missouri for the sixty (60) day period immediately preceding the date of this

Certification

application

for registration,

but

will be

submitted for

inspection

at

an official

safety

inspection station within ten (10) days after entering the state by me or my agent.

r Non-use (Notary required) - the motor vehicle described above has not been operated on

public roads or the highways of Missouri by me or my agent during the period of

__________________________________ to __________________________________.

and

I hereby certify that the statements herein are true to the best of my knowledge. I also certify that I

Signature

have and will maintain, during the period of registration, financial responsibility with respect to

each motor vehicle that I own, license or operate on the streets or highways. Any false affidavit

is a crime under Section 575.050 of Missouri law. You must present your insurance card (a

copy is acceptable) or other acceptable proof of financial responsibility.

Signature of Owner ___________________________________________________________

Driver License Number or Federal Employer Identification Number______________________

License

$

Reservation

$

Additional HP

$

Transfer

$

Fail to Transfer or Renew

$

Fees

Replacement(s)

$

Renewal Penalty

$

Reinstatement

$

Subtotal

$

Notary

$

Processing or Agent

$

Total

$

Donations Creditsand

r $1 Blind

r $1 Organ

WWI Memorial Trust Fund

r $1 r $10

r Other

$

Surrendered Plate Credit

$

Office OnlyUse

r PP

r FHVUT

rrY E INS

rrY E Safety

rrY E EMISS

Embosser or black ink rubber stamp seal

Subscribed and sworn before me, this

day of

year

State

County (or City of St. Louis)

My Commission Expires (MM/DD/YYYY)

r Application for License completed and signed by the applicant.

r Paid personal property tax receipt or a statement of non-

r Appropriate registration and processing fees posted at

assessment from the county (or city of St. Louis) in which you

http://dor.mo.gov/motorv/fees.php#regisfees.

resided on January 1st of the previous year. The property tax

r Proof of ownership (a copy of the registration receipt, title, or

receipt or statement of non-assessment must be in the owner’s

name. One receipt must be presented for the previous year to

copy of title). If no title number, record office number and title

renew a one-year registration and two receipts must be

application date in appropriate box.

presented for the last two years to renew a two-year registration.

r Vehicle safety inspection (if required) NOT more than 60 days

r Insurance card or other acceptable proof of financial responsibility.

old or 90 days old if newly purchased from a Missouri dealer

and the safety inspection provided by the Missouri dealer was

Note: Vehicle safety inspection, vehicle emissions inspection, paid

completed within 60 days prior to the purchase date. A safety

personal property tax receipt or statement of non-assessment, and

inspection is NOT required for all trailers, ATVs, or new motor

insurance card are not required when applying for an ATV decal.

vehicles (not previously titled).

Note: See http://dor.mo.gov/motorv/help.php for vehicles that are

r Vehicle emissions inspection (if required) not more than 60 days

exempt from safety and or emissions inspection.

old must be submitted by residents in the city of St. Louis and

the following counties: Franklin, Jefferson, St. Charles, and St.

Louis. Applies only to certain passenger vehicles and trucks

with a manufacturer’s gross weight rating of 8,500 pounds or less.

Please follow the order of the instructions provided below, beginning

8. Expiration Month and Year — Record the month and year that

with Type of Registration when completing the application. If there

the current license plates expire.

is no instruction for a particular field, simply provide the information

9. License Transfer or Replace Information — Year, Make, Vehicle

requested, such as Owner’s Name and Address. Please write legibly.

Identification Number, Title Number, Taxable Horsepower —

Instructions:

Record the information from the previous vehicle in the

1.

Registration Process — Check the appropriate block.

designated areas.

2.

Year, Make, Vehicle Identification Number, Title Number, and

10. $1 Blind Fund, $1 Organ Fund, and WWI Memorial Trust Fund —

Body Style — Record in the designated areas. If you hand write

Check appropriate block(s) if you wish to donate to the fund(s).

the application, record only one character in each block within the

11. Signature — One owner must sign the application for license.

Vehicle Identification Number.

3.

Fuel — Enter the appropriate code.

All incorrect or incomplete applications will be rejected.

4.

Kind of Vehicle (KOV), Horsepower (HP), Zone, and Gross

Submit the required items and fees to your local contract office or

Weight or Seating Capacity — Record the correct code.

mail to: Motor Vehicle Bureau, P.O. Box 2046, Jefferson City, MO

For passenger vehicles provide the taxable horsepower. For

65105-2046.

trucks, enter the appropriate zone of operation and the truck’s

Direct inquiries to (573) 526-3669 or visit our website at:

licensed gross weight or seating capacity.

http://dor.mo.gov/.

5.

Mileage — Record the odometer reading from the vehicle

Remember to sign the application and submit proof of ownership,

inspection, when applicable.

appropriate inspection(s), paid personal property tax receipt(s), proof

6.

Purchase date — Record the date vehicle was purchased.

of insurance, registration fees, and applicable processing fees.

7.

License Plate Number — Record current license plate on vehicle,

when applicable.