Form Mvd 10353 – Fill Out and Use This PDF

BEFORE COMPLETING APPLICATION PLEASE READ "GENERAL INFORMATION" ON THE REVERSE SIDE OF THIS FORM

APPLICANT'S NAME

ADDRESS

CITY, STATE, ZIP CODE

VEHICLE INFORMATION: Vehicle must be currently titled & registered in New Mexico in applicant's name.

MILITARY SERVICE In all cases, submit a copy of form DD-214, honorable discharge certificate and any other INFORMATION: documentation supporting your request for special plate and decal.

SELECT ONLY ONE (1) OF THE FOLLOWING DECALS TO BE AFFIXED IN THE TOP CENTER DEPRESSION ON YOUR LICENSE PLATE. CAUTION: APPLICATION WILL BE REJECTED IF CHOICE OF DECAL IS NOT SUPPORTED BY ACCOMPANYING DOCUMENTATION.

GENERAL INFORMATION AND INSTRUCTIONS

AllapplicationsforaMilitaryServicespecialplateareprocessedbymailbytheVehicleServicesBureauinSantaFe, NewMexico. Anyapplicationreceivedwithouttherequiredinformation,certification,documentationorpayment(if applicable)willbereturnedtotheapplicant. Ifanapplicantdoesnothavethenecessarymilitaryservicedocumentationto support their request, the applicant should contact the appropriate branch of service or the New Mexico Veterans Service Commission for assistance prior to completing the application. Applicants for aPearlHarborSurvivorplate must use application form MVD-11019. NewMexicoNationalGuard plates are issued through that service, and not the Vehicle Services Bureau.

Onlypassengervehiclesandlighttrucksunder26,000poundsareauthorizedtodisplayaMilitaryServicespecialplate. ThevehiclemustbecurrentlytitledandregisteredinNewMexicointheapplicant’sname,orberegisteredandtitledatthe sametimetheapplicationforaMilitaryServicespecialplateismade. IfthevehicleiscurrentlyregisteredinNewMexico, acopyoftheCertificateofRegistrationmustaccompanytheapplicationfortheMilitaryServicespecialplate,alongwith any other required documentation. If the vehicle is not currently registered in New Mexico, the vehicle must be taken to a localMotorVehicleDivisionfieldofficeforinspection,titlingandregistrationbeforeapplyingforaMilitaryServicespecial plate.

The Military Service Medal of Honor, Purple Heart, Ex-Prisoner of War and Disabled Veteran special plates are issuedtoqualifyingapplicantswithoutthepaymentofanyspecialplatefeeorstatutoryregistrationfees. Applicantswho qualify for more than one category of these free Military Service special plates are entitled by law to receive ONLY ONE category of these plates. For example, if you are qualified to receive both the Medal of Honor and the Disabled Veteran plates, you may select the one of your choice, but NOT both of them. However, you may apply for two plates of the same category for two vehicles you own.

To receive the Military ServiceArmedForcesVeteranspecial plate, you must pay a one-time $15.00 special plate fee ($7.00 for veteran motorcycle), as well as the statutory registration fee. Any person who is qualified to receive one of the free Military Service special plates may also purchase theArmedForcesVeteranplate for use on other vehicles they own. For example, a qualified veteran who owns 3 vehicles could have a DisabledVeteranplate and 2 Armed Forces Veteran plates OR 2 Purple Heart plates and 1 Armed Forces Veteran plate. However, he could not have 2 Purple Heart plates and 1 Disabled Veteran plate.

To receive the new DisabledVeteranplate with the wheelchair symbol for use on motor vehicles owned by the person, the applicant must provide satisfactory proof that he has suffered theloss, or the complete use of, one or both legs at or abovetheankleorofoneorbotharmsatorabovethewrist.Ifthedisabilityisnotofthisnature,thequalifieddisabled veteran can apply for the DisabledVeteranplate without the wheelchair insignia.

The free Military Service special plates have the word “PERMANENT” in the lower right corner instead of an annual validation sticker. The ArmedForcesVeteranplate must be renewed annually and is issued an annual validation sticker. The $15.00 special plate fee ($7.00 for veteran motorcycle) for the Armed Forces Veteran plate is waived for each year a stickerisissued.

REMINDERS: IfapersonwhohasbeenissuedanyMilitaryServicespecialplatedies,theplatebecomesinvalidanda regularlicenseplate,forapplicablefees,mustbeobtainedforthevehicle(s). However,thesurvivingspouseoftheholder of an Ex-Prisoner of War plate may apply to keep the plate.

It is against the law to falsely represent yourself as being the recipient of a military award or to claim armed forces veteran statusinordertoobtainanyMilitaryServicespecialplate.

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