Form Hsmv 83034 PDF Details

The HSMV 83034 form serves as a vital resource for military veterans and their families in Florida, enabling them to apply for military service-related license plates as a testament to their service and sacrifice. With an array of plates available, ranging from recognition of specific honors such as the Medal of Honor, Silver Star, and Purple Heart, to designations for veterans of particular conflicts like Vietnam, Korea, and World War II, this form facilitates a personalized acknowledgment of military service. Applicants are required to provide proof of eligibility, such as government documentation of service or specific awards. The form also accommodates the survivors and spouses of veterans, allowing them to honor their loved ones. While most applications can be processed at local county tax collector's offices or license plate agencies, certain distinctions require direct submission to the Department of Highway Safety and Motor Vehicles. Through the provisions outlined in Florida statutes, the form stipulates eligibility for these commemorative plates to a variety of vehicles, ensuring broad accessibility for those wishing to display their military pride or memorialize a loved one's service.

QuestionAnswer
Form NameForm Hsmv 83034
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesfl hsmv83034, application military related, 83034 hsmv, hsmv 83034

Form Preview Example

FLORIDA DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES

APPLICATION FOR MILITARY SERVICE RELATED LICENSE PLATES

SUBMIT APPLICATION TO YOUR LOCAL COUNTY TAX COLLECTOR'S OFFICE OR LICENSE PLATE AGENCY

www.flhsmv.gov/offices

ALL APPLICATIONS FOR MEDAL OF HONOR, SILVER STAR, DISTINGUISHED SERVICE CROSS, NAVY CROSS,

AIR FORCE CROSS, DISTINGUISHED FLYING CROSS, OR WORLD WAR II VETERAN MUST BE SUBMITTED TO THE DIVISION OF MOTORIST SERVICES

See Reverse Side of this form for Address, Provisions of Law, and Instructions

 

1. I,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

hereby certify that I am a legal resident of Florida, residing at

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Address)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(City)

 

 

 

 

 

 

 

 

 

(State)

(Zip)

 

and I am the registered owner of the following described motor vehicle:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YEAR

 

 

 

 

 

 

MAKE

 

 

 

 

 

 

 

 

CURRENT LICENSE PLATE NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TITLE NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE IDENTIFICATION NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OWNER/LESSEE'S DATE OF BIRTH

 

 

 

 

 

 

 

SEX

OWNER/LESSEE'S DL NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OWNER/LESSEE’S EMAIL ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. This is to certify that I,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

, am applying (and providing proof of eligibility, as

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

listed below) for the following license plate as indicated:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ex-Prisoner of War

 

 

 

 

Purple Heart

 

 

 

Medal of Honor

 

 

Pearl Harbor Survivor

 

 

 

US Paratrooper

 

 

Operation Iraqi Freedom

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Operation Enduring Freedom

 

 

 

Gold Star

 

Veteran of US Armed Forces

 

Combat Infantry Badge

 

 

Combat Action Badge

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Combat Medical Badge

 

 

Vietnam War Veteran

 

 

 

Korean War Veteran

 

 

Silver Star

 

 

 

Distinguished Service Cross

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Navy Cross

 

 

Air Force Cross

 

Operation Desert Shield Veteran

 

Operation Desert Storm Veteran

 

 

Combat Action Ribbon

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Distinguished Flying Cross

 

 

 

 

 

 

 

Woman Veteran

 

Air Force Combat Action Medal

 

 

 

 

Navy Submariner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

World War II Veteran

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ex-Prisoner of War or Un-remarried

 

Proof from the US Government of being a legal ex-prisoner of war while in the service of the Armed Forces

 

Surviving Spouse of Ex-Prisoner of War

 

of the United States or as a civilian serving with the consent or authorization of the US Government.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Purple Heart Medal Recipient or

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Un-remarried

Surviving Spouse of Purple

 

Proof from the US Government of being a recipient of the Purple Heart Medal.

 

 

 

 

 

Heart Medal Recipient

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Medal of Honor

 

 

 

 

 

 

 

 

 

 

 

Proof from the US Government of being a recipient of the Medal of Honor.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pearl Harbor Survivor

 

 

 

 

 

 

 

 

 

 

 

Proof of membership in the Pearl Harbor Survivors Association or proof of active military duty in Pearl Harbor

 

 

 

 

 

 

 

 

 

 

 

 

on December 7, 1941.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

US Paratrooper

 

 

 

 

 

 

 

 

 

 

 

Proof of completion of US Army Jump School or of being decorated as a parachutist during military training.

 

 

 

 

 

 

 

 

 

 

 

 

($20 annual use fee and $5 processing fee is required).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Operation Iraqi Freedom

 

 

 

 

 

 

 

 

 

 

 

Proof of active or former military duty in Iraq during Operation Iraqi Freedom or in Afghanistan during Operation

 

 

 

 

 

 

 

 

 

 

 

 

Enduring Freedom or proof the applicant was awarded the Iraq Campaign Medal, Afghanistan Campaign Medal,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Operation Enduring Freedom

 

 

 

 

 

 

 

or Global War on Terrorism Expeditionary Medal as appropriate.

 

 

 

 

 

Gold Star

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Proof from the US Government that the service member was killed while serving and proof of relationship to

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

the service member.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Veteran of the United States Armed Forces

 

Proof from the US Government of release or discharge from any branch of the United States Armed Forces.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Combat Infantry Badge

 

 

 

 

 

 

 

 

 

 

 

Proof from the US Government of being a recipient of the Combat Infantry Badge or proof of membership

 

 

 

 

 

 

 

 

 

 

 

 

In the Combat Infantrymen’s Association, Inc., or other proof of being a recipient of the Combat Infantry Badge.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Combat Action Badge

 

 

 

 

 

 

 

 

 

 

 

Proof from the US Government of being a recipient of the Combat Action Badge, or other proof of being a

 

 

 

 

 

 

 

 

 

 

 

 

recipient of the Combat Action Badge.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Combat Medical Badge

 

 

 

 

 

 

 

 

 

 

 

Proof from the US Government of being a recipient of the Combat Medical Badge, or other proof of being a

 

 

 

 

 

 

 

 

 

 

 

 

recipient of the Combat Medical Badge.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vietnam War Veteran

 

 

 

 

 

 

 

 

 

 

 

Proof from the US Government of being deployed and serving in Vietnam during the military deployment in

 

 

 

 

 

 

 

 

 

 

 

 

Indochina. Proof that the applicant was awarded the Vietnam Service Medal.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Korean War Veteran

 

 

 

 

 

 

 

 

 

 

 

Proof from the US Government of being deployed and serving in Korea during the military deployment in Korea.

 

 

 

 

 

 

 

 

 

 

 

 

Proof that the applicant was awarded the Korean Service Medal.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Navy Cross

Distinguished Service Cross

 

Proof from the US Government of being a recipient of the Navy Cross, Distinguished Service Cross, Silver Star,

 

Silver Star

Air Force Cross

 

 

 

 

 

 

 

or Air Force Cross.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Operation Desert Shield Veterans

 

 

 

 

 

 

 

Proof from the US Government that a current or former member was deployed and served in Saudi Arabia,

 

 

 

 

 

 

 

 

Kuwait, or another area of the Persian Gulf during Operation Desert Shield or Operation Desert Storm or proof

 

Operation Desert Storm Veterans

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

the applicant was awarded the Southwest Asia Service Medal.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HSMV 83034 - REV. 04/16

www.flhsmv.gov

Combat Action Ribbon

Proof of being a recipient of the Combat Action Ribbon. Proof may be on the member’s DD-214 or

other military documents.

 

 

 

Distinguished Flying Cross

Proof of being a recipient of the Distinguished Flying Cross.

 

 

 

Woman Veteran

Proof of service from the United States Armed Forces. Proof may include a DD-214 or other

 

similar documents that show her service in the United States Military.

Air Force Combat Action Medal

Proof of being a recipient of the Air Force Combat Action Medal.

 

 

Navy Submariner

Proof of being a recipient of the Submariner designation.

 

 

WorldWar II Veteran

Proof of service from the United States Armed Forces. The proof should include service dates between

 

December 8, 1941 to September 2, 1945.

Signature of the applicant for the above indicated license plate

Applicant's phone number

PROVISIONS OF LAW:

Section 320.089, Florida Statutes, provides that the license plates specified on the reverse side of this form may only be issued to the following types of vehicles:

•Automobiles (private or lease).

•Trucks for private use (weighing 7,999 pounds or less).

•Motor homes or truck campers which are NOT "for hire" or "commercial" use.

INSTRUCTIONS:

•Sections 1 and 2 on the reverse side of this form must be completed when requesting any of the Military Service Related License Plates.

•Application and documentation for Ex-Prisoner of War, Purple Heart, Pearl Harbor Survivor, US Paratrooper, Operation Iraqi Freedom, Operation Enduring Freedom, Gold Star, Combat Infantry Badge, Combat Action Badge, Combat Medical Badge, Vietnam War Veteran, Korean War Veteran, Operation Desert Storm Veteran, Operation Desert Shield Veteran, Veteran of the United States Armed Forces, Combat Action Ribbon, and Woman Veteran license plates should be processed at your local county tax collector’s office or license plate agency.

•Application and documentation for Medal of Honor, Silver Star, Distinguished Service Cross, Navy Cross, Air Force Cross, Distinguished Flying Cross, or World War II Veteran MUST be submitted to the Department for processing. The mailing address is:

Department of Highway Safety and Motor Vehicles Title and Registration Issuance

2900 Apalachee Parkway, MS #72 Tallahassee, Florida 32399

Check your local phone book government pages or visit the following website for current mailing addresses: www.flhsmv.gov/offices

HSMV 83034 - REV. 04/16

www.flhsmv.gov

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florida military plates form conclusion process clarified (stage 1)

2. The next step is to fill in the next few blank fields: Navy Cross, Air Force Cross, Operation Desert Shield Veteran, Operation Desert Storm Veteran, Combat Action Ribbon, Distinguished Flying Cross, World War II Veteran, Woman Veteran, Air Force Combat Action Medal, Navy Submariner, ExPrisoner of W ar or Unremarried, Proof from the US Government of, Proof from the US Government of, Medal of Honor, and Proof from the US Government of.

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wwwflhsmvgov, HSMV REV, and HSMV REV in florida military plates form

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