The MV-412 form, provided by the New York State Department of Motor Vehicles, is a crucial application for military personnel and veterans seeking to obtain custom license plates. It serves as a bridge for those who have served in various capacities, from the Air Force Reserve to Vietnam Veterans, enabling them to showcase their service and dedication through distinct vehicle plates. Applicants are required to select from a comprehensive list of military and veteran custom plates, ensuring the submission of appropriate proofs like letters of certification, membership cards, or DD-214 forms, depending on the specific plate requirements. The form meticulously outlines the initial costs, the possibility of personalization, annual fees, and usage restrictions for commercial registrations. Additionally, for those in need of the International Symbol of Access on their new plates, the submission of form MV-664.1 becomes necessary. The MV-412 form, thus, not only represents an opportunity for military members and veterans to honor their service but also encapsulates detailed procedural instructions to facilitate this acknowledgment through custom plates. With thoughtful considerations for various contingents, including provisions for recognizable decorations such as the Purple Heart and specific service periods like the Korean War, this application underscores a personalized approach to recognizing the sacrifices and contributions of the military and veteran communities.
| Question | Answer |
|---|---|
| Form Name | Mv 412 Form |
| Form Length | 3 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 45 sec |
| Other names | mv412 mv 412 form |
NewYork State Department of MotorVehicles
APPLICATION FOR MILITARYAND VETERAN CUSTOM PLATES
www.dmv.ny.gov
HOW TOAPPLY FOR MILITARY OR VETERAN CUSTOM PLATES
Select the type of plate you are requesting from the list below, then write it in the appropriate box on page 3 of theapplication form.
You must provide the appropriate proof(s) when you mail your application to the address shown on the application form. Required proof(s) and initial cost information are in parentheses after each plate.
NOTE: Plates marked below with an asterisk (*) can be issued: (1) in the name of the veteran or military member; or (2) in the name of the spouse of the veteran or military member. Plates will NOT be issued to both unless both spouses are eligible for the plates.
If you need the International Symbol ofAccess on your new plates and you do not have it on your current plates, you must also submit a completed form
*Air Force Reserve (Letter from CO certifying Reserve status or copy of activeAir Force Reserve
*Air National Guard (Letter from CO certifying
*Airborne (Copy of currentAirborneAssociation Membership Card or
American Legion (Copy of current membership
*Army National Guard (Letter from CO certifying
*Army Reserve (Letter from CO certifying Reserve status or copy of activeArmy Reserve
Coast GuardAuxiliary (Copy of currentAuxiliary Card - both
*Coast Guard Reserve (Letter from CO certifying Reserve status or copy of active Coast Guard Reserve
Combat Infantrymen (Copy of
Fee:$70.00;
Congressional Medal of Honor (Proof ofAward - Nofees;cannotbepersonalized;notforusewithacommercialregistration)
DisabledAmerican Veterans (Contact organization for
Disabled Veteran (This plate displays the International Symbol ofAccess ). Copy of
*EighthAir Force (Copy of current membership card
commercialregistration;
Former Prisoner of War
Forty and Eight (40 & 8) (Copy of current membership card
Gold Star Mother (Official document stating that child lost life while serving in the
Jewish War Veterans ofAmerica (Letter fromAssociation
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Korean War
Marine Corps League (Letter from
*Marine Corps Reserve (Letter from CO certifying Reserve status or copy of active Marine Corps Reserve
*Naval Militia (Letter from CO certifying
*Navy Reserve (Letter from CO certifying Reserve status or copy of active Navy Reserve
*Pearl Harbor Survivor (Copy of
*
Purple Heart Recipient (Proof of award: Copy of
Saratoga National Cemetery Honor GuardAssociation (Copy of current membership card and application authorized by the
*State Guard (Letter from CO certifying
U.S. NavalArmed Guard (Copy of
U.S. Submarine Veterans (Contact U.S. SubmarineVeteran’s Group for approval
$70.00;
U.S. Veteran (Copy of
Veterans of Foreign Wars (Copy of currentVeterans of ForeignWars Membership
Fee:$70.00;
Vietnam Veteran (Copy of
PersonalizedFee:$70.00);
VietnamVeteransofAmerica
War on Terror Veteran (Copy of
World War II Veterans (Copy of
NOTE: Notallmilitaryplatescanbepersonalized. Onlythoseplatesthatrefertoa“personalizedfee”canbepersonalized.
Don’t forget, write down on page 3 which military or Veteran plate you want to order!
For a complete listing of all custom plates of if you have any questions or need additional information,
call us at (518)
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NewYork State Department of MotorVehicles
APPLICATION FOR MILITARYAND VETERAN CUSTOM PLATES
www.dmv.ny.gov
IMPORTANT: Making a false statement in any registration application or in any proof of statements in connection with it, or deceiving or substituting in connection with this application, is a misdemeanor under Section 392 of theVehicle andTraffic Law, and may also result in the revocation or suspension of the registration and/or the applicant’s license pursuant to regulations established by the Commissioner.The act of renewing these plates shall constitute your certification that you remain eligible to continue holding these plates.
PLEASE PRINT INFORMATION BELOW
Which military/veteran plate are you applying for? (Refer to the list on pages 1 and 2.) _________________________________________________
(Example: Former POW, Purple Heart, U.S. Veteran, etc.)
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Date of Birth (Month/Day/Year) |
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Address (Include Street Number and Name and/or Rural Delivery Box No.) |
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Zip Code |
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Signature (Sign Name in Full) |
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Daytime Phone (include area code) |
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Current Plate Number |
Plate type: |
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Vehicle Model Year |
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Vehicle Make |
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o Passenger oCommercial |
o Motorcycle |
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Do your current plates have the |
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If you need the International Symbol ofAccess on your new plates and you do not have it on your current plates, |
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International Symbol ofAccess? |
oYes oNo |
you must also submit a completed form |
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I would like to apply for: |
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o Standard plates (number assigned by DMV) |
o Personalized plates |
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ISARequested (You must qualify) |
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Personalized Passenger or Commercial Plates
The military emblem or picture will be shown on the left side of the plate.Amaximum of sixspaces is allowed for the letter/number combination. If the International Symbol ofAccess is required, only fivespaces are allowed.You may provide up to three letter/ number combination choices.To show a space, put a period (.) on the line in the choice where you want the space.
1st ___ ___ ___ ___ ___ ___ 2nd ___ ___ ___ ___ ___ ___ 3rd ___ ___ ___ ___ ___ ___
Personalized Motorcycle Plates (US Veteran and Purple Heart only)
The military emblem or picture will be shown on the left side of the plate.Amaximum of fourspaces is allowed for the letter/number combination. If the International Symbol ofAccess is required, only threespaces are allowed.You may provide up to three letter/ number combination choices.To show a space, put a period (.) on the line in the choice where you want the space.
1st ___ ___ ___ ___ |
2nd ___ ___ ___ ___ |
3rd ___ ___ ___ ___ |
REQUIRED
For personalized plate combinations only. You must explain the meaning of your letter/number combination. DMV reserves the right to reject, recall or cancel any plate that is deemed objectionable.This includes plates that have already been issued.
1st Choice ________________________________________________________________________________________________
2nd Choice ________________________________________________________________________________________________
3rd Choice ________________________________________________________________________________________________
Payment Method: o Check |
o MasterCard |
o Discover |
oMoney Order |
o Visa |
o American Express |
Amount Enclosed $__________________
Name (as it appears on credit card)_______________________________________________________________________
CardAccount Number ___________________________________________ Expiration Date__________________________
Authorized Signature ç_________________________________________________________________________________
Pleasedonotsendcash! Make the check or money order payable to “Commissioner of MotorVehicles”.
Please allow 4 to 6 weeks for delivery. If there is an annual fee for your plate, the fee is in additionto the renewal fee to register your vehicle.You will be billed for the plates every two years when you renew your registration.
Return this completed form, the required proof, and payment to:
Department of MotorVehicles, Custom Plates Unit,
PO Box 2775,Albany,
Did you remember to write down which military or Veteran plate you would like to order?
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