Form Hsmv 83043 PDF Details

When individuals or entities in the State of Florida wish to personalize their vehicle's license plate, they are required to navigate through the specifics outlined in the HSMV 83043 form provided by the Department of Highway Safety and Motor Vehicles – Division of Motorist Services. This document not only serves as the application for a personalized license plate but also offers comprehensive guidelines on how to properly complete and submit the form to the local Tax Collector's office. It meticulously details owner or lessee identification requirements, vehicle information, and a certification process, ensuring all applicants are the rightful owners or lessees of the vehicles for which the personalized plates are being requested. The form also includes sections for selecting the type of specialty license plate desired, with considerations for graphics and character limits specific to the license plate type chosen. With instructions provided on both the front and back, applicants are guided on required documentation, such as proof of Florida insurance and the current registration certificate, alongside the associated fee structure. Moreover, the form cautions about selection restrictions, particularly concerning the rejection of plates with obscene or objectionable words, emphasizing the importance of thoughtful personalization. This initial step towards acquiring a personalized license plate is crucial in expressing individuality or affinity while ensuring compliance with Florida's vehicular regulations.

QuestionAnswer
Form NameForm Hsmv 83043
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other nameshsmv 83043, florida personalized plate form, dhsmv csr, E-mail

Form Preview Example

STATE OF FLORIDA

DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES – DIVISION OF MOTORIST SERVICES

SUBMIT THIS FORM TO YOUR LOCAL TAX COLLECTOR OFFICE

www.flhsmv.gov/offices/

APPLICATION FOR PERSONALIZED LICENSE PLATE

INSTRUCTIONS ARE INDICATED ON REVERSE SIDE

Date of Application ____________________________

PLEASE CONTACT YOUR LOCAL COUNTY TAX COLLECTOR'S OFFICE, LICENSE PLATE AGENCY

OR REFER TO THE REVERSE SIDE OF THIS FORM FOR FEE INFORMATION.

OWNER / APPLICANT IDENTIFICATION

Owner’s / Lessee’s Name:

Sex:

Date of Birth:

Street Address:

 

 

 

City:

 

 

State:

 

 

Zip:

 

 

 

 

 

 

 

 

 

 

 

Owner’s / Lessee’s D/L Number:

 

 

Owner’s / Lessee’s E-mail Address:

 

 

 

 

FEID#:

 

 

 

 

 

 

 

 

 

 

 

Co-Owner’s / Co-Lessee’s Name:

 

 

 

 

 

Sex:

Date of Birth:

 

 

 

 

 

 

 

 

 

 

 

Street Address:

 

 

 

City:

 

 

State:

 

 

Zip:

 

 

 

 

 

 

 

 

 

 

 

Co-Owner’s / Co-Lessee’s D/L Number:

 

 

Co-Owner’s / Co-Lessee’s E-mail Address:

 

 

 

 

FEID#:

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Current Decal Number:

 

Current License Plate Number:

Vehicle Type:

 

 

 

 

 

 

 

 

 

 

 

 

 

Title Number:

 

Vehicle Identification Number:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle Make:

Year:

 

 

Color:

 

 

Vehicle Weight:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CERTIFICATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

This is to certify that I am/we are the registered owner/lessee or co-owner/co-lessee of the motor vehicle referenced above.

I/we authorize my/our name, address, and renewal date to be provided to the organization sponsoring the specialty license plate selected.

Under penalties of perjury, I/we declare that I/we have read the foregoing document and that the facts stated in it are true.

Signature(s):

LICENSE PLATE SELECTION (see reverse side for plate choices)

Enter the type of specialty license plate requested:

Specify the intended meaning/explanation for your personalized license plate configuration choice (nickname, initials, etc.):

Please Note:

Use no more than the number of characters authorized for the type of license plate you have requested (including a space or hyphen, see reverse side).

For license plates with center graphic, allow two spaces for the logo or characters will cover the graphic design.

Centered Graphic

Left Graphic

Specialty Motorcycle

(7 characters, may also have an additional space or hyphen.

(5 characters)

(6 characters)

A regular motorcycle may have a Florida graphic.)

 

 

LOGO

A B C

D

1

1ST CHOICE

2ND CHOICE

3RD CHOICE

4TH CHOICE

INSTRUCTIONS

1.Carefully read all information on the front and back of this application before completing the application.

2.Complete the application form and submit it to your local county tax collector's office or license plate agency with the following items:

a.PROOF OF FLORIDA INSURANCE: Proof of personal injury protection (PIP) and property damage liability insurance (PDL) must be submitted in the form of a card, policy, binder, certificate of insurance or affidavit.

b.A copy of your current registration certificate or renewal notice.

c.Remittance fees (payable to your county tax collector/license plate agency).

3.Please allow six to eight weeks for the manufacture and delivery of the license plate. The license plate will be delivered to your county tax collector's office or license plate agency.

HSMV 83043 (Rev. 01/14) S

www.flhsmv.gov

IMPORTANT INFORMATION ABOUT YOUR CHOICE

You may check personalized plate availability at the department’s website located at:https://services.flhsmv.gov/MVCheckPersonalPlate/

Your local county tax collector's office or license plate agency may assist you in determining if a specific type of license plate is available, as well as the choice for personalization and the total cost of the license plate you desire, including trucks (with a net weight of more than 5,000 pounds), "for-hire" vehicles and trailers.

•Your choice may include letters, numbers, a space or hyphen as characters. License plates that have 7 characters may have an additional space or hyphen. However, license plates that have 5 characters, may NOT have an additional space or hyphen.

•Requests with obscene or objectionable words will be rejected. If a personalized license plate has been issued and later determined to be obscene or objectionable, the department will recall the license plate.

TYPE OF LICENSE PLATES

Personalized license plates for motorcycles are only available as a "Florida Graphic" or "Motorcycle Specialty" license plate.

Amount Includes All Fees (SEE "FEE EXCEPTIONS" BELOW).

 

TYPE OF LICENSE PLATE

 

MAXIMUM

FEES

 

 

CHARACTERS

 

 

 

 

 

 

 

 

 

 

 

AIR FORCE **

ARMY **

 

COAST GUARD **

 

 

INDIAN RIVER LAGOON **

MARINECORPS**

NAVY **

5

$77.65

OLYMPIC SPIRIT **

SALUTES VETERANS **

SHARE THE ROAD **

 

 

TAMPA BAY ESTUARY **

 

 

 

 

 

 

 

 

 

 

CHOOSE LIFE **

EVERGLADES RIVER OF GRASS **

SALUTES FIREFIGHTERS **

5

$82.65

SUPPORT LAW ENFORCEMENT **

POLICE ATHLETIC LEAGUE **

PROTECT WILD DOLPHINS **

 

 

 

 

 

 

 

 

FISH FLORIDA**

 

 

 

5

$84.65

 

 

 

 

 

A STATE OF VISION **

AGRICULTURE EDUCATION **

AMERICAN RED CROSS **

 

 

ANIMAL FRIEND **

CATCH ME, RELEASEME

CHALLENGER/COLUMBIA **

 

 

CONSERVE WILDLIFE**

DISCOVER FLORIDAHORSES

DISCOVER FLORIDA

 

 

OCEANS ** DONATEORGANS**

END BREAST CANCER **

ENDLESS SUMMER

 

 

FLORIDAHORSEPARK

FLORIDASHERIFF'SYOUTH RANCHES

FRATERNALORDER OF POLICE

 

 

FREE MASONRY **

GO FISHING **

HORSE COUNTRY **

5

$87.65

HOSPICE EVERYDAY IS A GIFT **

INGODWETRUST**

KEEP KIDS DRUG FREE **

 

 

KIDS DESERVEJUSTICE**

NASCAR **

 

PARENTS MAKE A DIFFERENCE **

 

 

PLAYTENNIS**

PROTECT FLORIDA WHALES **

PROTECT OUR REEFS **

 

 

ST. JOHNS RIVER **

(***)SAVE OUR SEAS **

SAVEWILD FLORIDA

 

 

SPORTSMEN'S NATL. LAND TRUST *

STOP CHILD ABUSE **

SUPPORT AUTISM PROGRAMS **

 

 

SUPPORT HOMEOWNERSHIPFOR ALL**

SUPPORT OUR TROOPS **

TREES ARE COOL **

 

 

VISIT OUR LIGHTS **

 

 

 

 

 

MOTORCYCLE SPECIALTY **

 

 

 

6

$79.65

FLORIDAGRAPHIC *

FLORIDA STATE MOTTO *

 

7

$57.65

 

 

 

 

 

SPECIAL OLYMPICS FLORIDA *

STATE WILDFLOWER *

 

7

$77.65

 

 

 

 

 

AGRICULTURE *

INVEST IN CHILDREN *

 

7

$82.65

SCOUTINGTEACHESVALUES *

STATE OF THE ARTS*

SUPPORT EDUCATION *

 

 

HELPING SEA TURTLES SURVIVE *

 

 

 

7

$85.65

(***)AQUACULTURE *

FAMILYFIRST*

FAMILY VALUES *

 

 

GOLF CAPITAL OF THE WORLD *

HISPANIC ACHIEVERS *

IMAGINE*

7

$87.65

LIVETHEDREAM*

PROTECT THEPANTHER *

PROTECT FLORIDA SPRINGS

*SAVE THEMANATEE*

STOP HEART DISEASE*

SUPPORT SOCCER *

 

 

UNITED WE STAND *

 

 

 

 

 

COLLEGIATE:

 

 

 

 

 

BARRYUNIVERSITY **

 

BETHUNE-COOKMAN UNIVERSITY **

 

 

CLEARWATER CHRISTIAN COLLEGE **

 

EDWARD WATERS COLLEGE **

 

 

EMBRY-RIDDLE AERONAUTICAL UNIVERSITY **

FLAGLER COLLEGE **

 

 

 

FLORIDA A & M UNIVERSITY **

 

FLORIDA ATLANTIC UNIVERSITY **

 

 

FLORIDACOLLEGE **

 

FLORIDA GULF COAST UNIVERSITY **

 

 

FLORIDA INSTITUTE OF TECHNOLOGY **

 

FLORIDA INTERNATIONAL UNIVERSITY **

 

 

FLORIDA MEMORIAL UNIVERSITY **

 

FLORIDA SOUTHERN COLLEGE **

 

 

FLORIDA STATE UNIVERSITY **

 

JACKSONVILLE UNIVERSITY **

 

5

$87.65

LYNN UNIVERSITY**

 

NEW COLLEGE OF FLORIDA **

 

 

 

NOVA SOUTHEASTERN UNIVERSITY **

 

PALM BEACH ATLANTIC UNIVERSITY **

 

 

RINGLING SCHOOL OF ART AND DESIGN * *

 

ROLLINS COLLEGE **

 

 

 

SAINT LEO UNIVERSITY **

 

SAINT THOMAS UNIVERSITY **

 

 

SOUTHEASTERN UNIVERSITY **

 

STETSON UNIVERSITY **

 

 

 

UNIVERSITY OF CENTRAL FLORIDA **

 

UNIVERSITY OF FLORIDA **

 

 

 

UNIVERSITY OFMIAMI **

 

UNIVERSITY OF NORTH FLORIDA **

 

 

UNIVERSITY OF SOUTH FLORIDA **

 

UNIVERSITY OF TAMPA **

 

 

 

UNIVERSITY OF WEST FLORIDA **

 

WARNER SOUTHERN COLLEGE **

 

 

 

 

 

 

 

ECKERD COLLEGE*

 

FLORIDA HOSPITAL COLLEGE OF HEALTH SCIENCES*

7

$87.65

FLORIDA PROFESSIONAL SPORTS TEAM:

 

 

 

 

 

FLORIDAMARLINS**

FLORIDAPANTHERS **

JACKSONVILLE JAGUARS **

5

$87.65

MIAMIDOLPHINS**

MIAMI HEAT **

ORLANDO MAGIC **

 

 

TAMPABAYBUCCANEERS **

TAMPABAYLIGHTNING**

TAMPA BAY RAYS **

 

 

 

 

 

 

 

 

* Graphic design is centered on the plate. ** Graphic design is on the far left/right side of the plate. (***) If applyi ng for more than 10 license plates for the same ow ner, the fee is $72.65 per license plate.

FEE EXCEPTIONS: An additional branch fee of $.50 may be required by some county agencies.

An additional license plate mail fee of $2.95 is required if a license plate is mailed to the applicant. The annual or biennial registration tax is due in addition to these fees shown.

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

HSMV 83043 (Rev. 01/14) S

www.flhsmv.gov

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E-mail conclusion process detailed (portion 1)

2. Once the last segment is finished, you're ready to include the required specifics in LICENSE PLATE SELECTION see, Enter the type of specialty, Specify the intended, Please Note, Use no more than the number of, Centered Graphic, characters may also have an, Left Graphic characters, Specialty Motorcycle, characters, LOGO A B C D, ST CHOICE, ND CHOICE, RD CHOICE, and TH CHOICE so you're able to go further.

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