The surrendering Tax Collector, License Plate Agent, or DMS office must retain a copy of the completed form for their records for 12 months.
Surrendered by: one of the following: Tax Collector/License Plate Agent, Driver License Office, Dealership, or Other Source.
Pride: submit a copy with Plates to Pride.
Certificate: the Vendor Employee certifies that these license plates have been destroyed by the employee in accordance with Department procedures.
Plate numbers: Beginning License Plate Number, Ending License Plate Number, Total and Grand Total.
| Question | Answer |
|---|---|
| Form Name | Form HSMV 84003 |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 74 |
| Avg. time to fill out | 13 min |
| Other names | HSMV 84003, HSMV84003, HSMV-84003, HSMV 84003 form, Form HSMV 84003, Florida HSMV 84003, Receipt and Certificate of Disposal for Obsolete License Plates |
| Edition | 09/2023 |
| Issuing agency | Florida Department of Highway Safety and Motor Vehicles |
| Where to send | Revenue Audit Section, Division of Motorist Services, by fax, mail, or email |
| Official source | Form HSMV 84003 (Rev 09/2023), Florida Department of Highway Safety and Motor Vehicles |
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