Form 4601: Application for Missouri Military Personalized License Plates

In Owner's Name (Step 1), fill in the name exactly as it is shown on the title of the vehicle to which you intend to register this license plate.

Fill in your current address, daytime telephone number, and license plate number that you currently have on the vehicle.

Check the category of license plate that belongs on the vehicle to which you intend to register this plate.

Local truck plates are limited to a 50 mile radius.

You may add the disabled person symbol to any plates.

You must also submit an original signed physician's statement for disabled person's license plates (Form 1776) from an advance practice registered nurse, licensed physician, chiropractor, physician's assistant, podiatrist, or optometrist or a statement from the United States Department of Veteran Affairs must be submitted that states the disability is permanent.

The physician's statement is valid for 90 days after completion by an authorized medical professional.

Step 2: Check the type of license plate you would like issued.

For all plates listed as “Stock,” the Missouri Department of Revenue will select your license plate configuration.

Personalization of any one set of qualifying military specialty plates will be at no fee.

Each additional set will be at the fee noted on the front of the form.

Personalized plate choices (complete only if applying for personalized plates. Please include more than one choice.)

Plate Design Total number of characters allowed. A dash, space, or an apostrophe counts as one character. (Only one dash, one space, or one apostrophe is allowed.)

You may use a combination of letters and numbers.

Please print clearly using all capital letters.

Signs and symbols cannot be used except for one space, one dash, or one apostrophe.

Note: The Missouri Department of Revenue will not issue license plates that contain any letters, numbers, or a combination of letters and numbers which are obscene, profane, patently offensive or contemptuous of a racial or ethnic group, offensive to good taste or decency, or would present an unreasonable danger to the health or safety of the applicant, or other users of streets and highways, or of the public in any location where the vehicle with such plate may be found. The Missouri Department of Revenue will not issue plates that conflict with the regular license numbering system.

Enter the Year, Make, Model and VIN Number of the Vehicle Plate Will Be Attached To.

Enter the First Choice, Second Choice, Third Choice, Fourth Choice, Fifth Choice and Sixth Choice, each with a "Description of what the configuration above stands for".

Must be completed by all applicants. These license plates will not be mailed. Indicate name of license office where plates are to be picked up.

Enter the Office, the Office Number, the Street and the City.

Sign the application on the Signature of Owner or Applicant line.

Disabled Veteran Plates: The applicant must submit a statement from the United States Department of Veteran Affairs no more than one year from the date of application stating their disability is service connected.

Limited to one set at no fee, per owner.

Wartime Disabled Plates: You must submit a copy of your Disabled American Veteran (DAV) membership identification card and a copy of a current photo identification card with this application.

Retired Military Plates: The applicant must submit proof of retired status from a particular branch of the United States Armed Forces.

You must renew your personalized military license plates within 60 days of expiration to ensure the military personalized plates are held in your name.

Make check or money order (do not send cash) payable to the Missouri Department of Revenue and forward with this application to: Missouri Department of Revenue, Motor Vehicle Bureau, Personalized License Plate Section, PO Box 569, 301 West High St, Room 370, Jefferson City MO 65105-0569.

Applications must be completed, signed, and submitted with the fee noted on the front of the application.

Any false statement in this application is a violation of the law and may be punished by fine or imprisonment or both.

Military license plates are issued only to those vehicles titled in Missouri.