Form HSMV 84003 PDF Details

When it comes to managing the life cycle of license plates, the Hsmv 84003 form plays a crucial role, especially in their final stage—disposal. This document, officially titled "Receipt and Certificate of Disposal for Obsolete License Plates," serves as a formal ledger and certification that obsolete license plates have been properly surrendered and destroyed in line with specific Department procedures. Utilized by a variety of entities, including Tax Collectors, License Plate Agents, Driver License Offices, and Dealerships, the form ensures that the process of retiring old license plates is both regulated and recorded. It details the surrender by listing the names of the involved Tax Collector or License Plate Agent, including their agency number, the Driver License Office, the Dealership along with its county location, or any other source from which the plates were received. Additionally, the form requires signatures from relevant employees as evidence of compliance and accountability. With spaces to list the beginning and ending license plate numbers alongside their totals, the form provides a clear account of the quantity of plates disposed of, and by documenting the receiver of the disposed plates, along with dates of receipt and disposal, it closes the loop on the lifecycle of a license plate. Moreover, the stipulation that a copy of the completed form must be retained by the surrendering entity for 12 months underscores the importance of maintaining records for potential audits or reviews. Thus, the Hsmv 84003 form is more than just paperwork; it's a key component in the organized and lawful management of license plate disposal.

QuestionAnswer
Form Name Form HSMV 84003
Form Length 1 pages
Fillable? No
Fillable fields 0
Avg. time to fill out 15 sec
Other names obsolete license, hsmv 84003, receipt disposal, certificate disposal

Form Preview Example

Receipt and Certificate of Disposal for Obsolete License Plates

The License Plates listed below were surrendered by one of the following:

(Name of Tax Collector/License Plate Agent and Agency #)

(Name of Driver License Office)

(Name of Dealership and County Location)

(Other Source)

(Signature of the Agency Employee)

(Signature of the DL Employee)

(Signature of the Dealership's Employee)

(Signature of the Employee)

BEGINNING

ENDING

TOTAL

BEGINNING

ENDING

TOTAL

LICENSE PLATE

LICENSE PLATE

 

LICENSE PLATE

LICENSE PLATE

 

NUMBER

NUMBER

 

NUMBER

NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GRAND TOTAL

 

 

GRAND TOTAL

 

 

 

 

 

 

 

 

 

Plates received by:

 

 

 

 

 

 

 

(Name of Vendor/Company)

 

(Date Received)

 

I certify that these license plates have been destroyed by me in accordance with Department procedures.

(Name of Vendor Employee)

(Date of Disposal)

Submit a copy with Plates to Pride. The surrendering Tax Collector, License Plate Agent, or DMS office must retain a copy of the completed form for their records for 12 months.

HSMV 84003 (Rev. 10/20)

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Filling out part 1 of state of florida disposal of license plate

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