Vtr 421 Form PDF Details

The VTR-421 form is a critical document for active or former members of the United States Armed Forces who aim to obtain Military Meritorious Service License Plates in Texas. Tailored to honor the service and valor of military personnel, this application facilitates the acquisition of special license plates representing various distinguished military medals such as the Air Force Cross, Navy Cross, Silver Star, and many others. Applicants must provide proof of eligibility, including service records and proof of receipt of one of the specified medals. Additionally, surviving spouses of veterans previously granted these plates may also apply, underlining the form’s consideration for families honoring a deceased loved one's military service. The form elucidates the process, encompassing details of the application submission, the personalization options for the plates with a distinct fee structure, and the exemption from the registration fee for the first set of plates. It's designed to ensure that recognition of military merit is accessible, allowing for personalization for an added touch of uniqueness, while diligently outlining the conditions under which the plates can be issued or transferred. This detailed guide helps applicants navigate through the intricacies of the application process, ensuring compliance and understanding of the legal and procedural prerequisites for honoring military service through Texas vehicle registration.

QuestionAnswer
Form NameVtr 421 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesform vtr 421, personalizations, personalization, vtr

Form Preview Example

Application for Military

Meritorious Service

License Plates

For County Use Only

License Number

Mo/Yr of Exp

Date Issued

Instructions

Submit the completed application, payment (if personalized) in the form of a personal check, money order or cashier's check, and proof of eligibility to the department at the following address:

Texas Department of Motor Vehicles

Vehicle Titles and Registration Division (SPB)

4000 Jackson Ave. Austin, TX 78731

There is no registration fee for the first set of plates. There is also no specialty plate fee. If you order additional sets of plates, your annual registration fee must be paid to your local county tax assessor-collector. Plates may be personalized for an additional $40 fee, make your selection on page 2. Do not mail cash with your application. Personalization fees will not be refunded once application is submitted. Contact Special Plates Branch (SPB) at 512-374-5010 if you have any questions.

Applicant Information Type or print only

First Name

Middle Initial

Last Name

Suffix

County

Mailing Address

City

State

Zip Code

E-mail

Day Phone

Vehicle 1

Vehicle Identification Number

Current TX Plate

Year

Make

Body Style

Empty Weight (lbs.)

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle Type:

 

Passenger Car

 

 

Truck

 

 

Motorcycle/Moped

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle 2

 

 

 

 

 

 

 

 

 

 

 

Vehicle Identification Number

Current TX Plate

Year

Make

Body Style

Empty Weight (lbs.)

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle Type:

 

Passenger Car

 

 

Truck

 

 

Motorcycle/Moped

 

 

Plate Type Note: All plates below are available for passenger cars, trucks (up to 18,000 lbs.), and motorcycles/mopeds.

 

Air Force Cross

 

Distinguished Flying Cross

 

Navy and Marine Corps Medal

 

Air Medal

 

Distinguished Service Medal, Air Force

 

Navy Cross

 

 

 

 

Air Medal with Valor

 

Distinguished Service Medal, Army

 

Prisoner of War Medal

 

 

 

 

Airman's Medal

 

Distinguished Service Medal, Coast Guard

 

Silver Star

 

 

 

 

Army Distinguished Service Cross

 

Distinguished Service Medal, Department of Defense

 

 

 

Bronze Star

 

Distinguished Service Medal, Department of Homeland Security

 

 

 

Bronze Star with Valor

 

Distinguished Service Medal, Department of Transportation

 

 

 

Coast Guard Medal

 

Distinguished Service Medal, Navy

 

Soldier's Medal

 

 

 

 

Defense Meritorious Service Medal

 

Legion of Merit

 

Surviving Spouse

 

 

 

 

Defense Superior Service Medal

 

Meritorious Service Medal

 

 

 

 

 

 

Eligibility Requirements

Proof that you are an active member of the United States Armed Forces, and proof (such as an Officer Record Brief (ORB) or Enlisted Record Brief (ERB) and copy of your military ID) or a former member with proof of honorable discharge, and proof (such as a DD-214) that you are the recipient of one of the medals above.

Prisoner of War Medal: Official U.S. Government document or certification from the U.S. Department of Veterans Affairs certifying or identifying the applicant as a former prisoner or war.

As an unmarried, surviving spouse of a veteran who had Meritorious Service license plates, you are eligible to register your vehicle with a plate featuring the same military emblem. To apply, you must complete this form, enclose a written statement that you are unmarried and provide proof that your spouse had this plate and is now deceased. A new plate will be issued with the same emblem, with a new plate number.

Affidavit State law makes falsifying information on this application a third-degree felony.

I meet the eligibility requirements as listed on this form, and am providing proof to that effect.

Signature of Applicant

Date

Form VTR-421 Rev 01/16

Online form at www.TxDMV.gov

Page 1 of 2

Application for Military Meritorious Service License Plates

General Requirements

Texas title and vehicle registration must be in your name.

If the plate is to be registered to a vehicle that is not titled in your name, attach a statement to this application stating that you have legal right of possession and control of this vehicle at all times.

If you recently filed an application for title, attach a copy of the title application receipt (VTR-500 RTS).

Joint vehicle ownership between you and a spouse is permissible.

Submit a separate application for more than two vehicles.

If the vehicle is leased, attach a photocopy of the lease agreement.

Vehicle is for personal use only.

Personalize Your Plate If you would like to personalize your specialty plate, there will be a $40 fee per year, in addition to the annual registration fee (if required).

Show selections exactly as you wish them to appear on your license plates. You may list more than one option in the event the personalization you have chosen is already issued.

A selection that has already been issued, is deemed offensive or conflicts with the regular license plate numbering system cannot be approved.

In the blocks below, describe each of your selected personalized letters, numbers, and/or symbols. The available symbols include: a period, a dash, a blank space, a Texas silhouette (use an asterisk (*)), a heart (use an “at” mark (@)) and a star (use an ampersand (&)).

Passenger car and truck plates are limited to six (6) characters total.

Motorcycle/moped plates are limited to four (4) characters total.

You are not required to use all the spaces provided.

The International Symbol of Access counts as two (2) characters. If you are disabled and applying for personalized specialty plates, use a percent sign (%) to indicate the International Symbol of Access.

Personalization fee will not be refunded once application is submitted.

 

1st Selection

 

 

2nd Selection

 

 

3rd Selection

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle One

Vehicle Two

International Symbol of Access

To display the International Symbol of Access on your license plate, attach a signed Form VTR-214 to this form to show your eligibility. Contact your county tax assessor-collector if you have questions.

Form VTR-421 Rev 01/16

Online form at www.TxDMV.gov

Page 2 of 2

How to Edit Vtr 421 Form Online for Free

form vtr 421 can be completed online in no time. Just open FormsPal PDF editor to accomplish the job right away. The tool is continually upgraded by our team, receiving new awesome functions and turning out to be greater. To get the ball rolling, go through these easy steps:

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This document will need specific information to be typed in, hence you must take the time to type in what is asked:

1. When submitting the form vtr 421, make sure to incorporate all of the necessary blank fields in their associated form section. It will help to speed up the work, allowing your details to be processed efficiently and correctly.

rts conclusion process described (portion 1)

2. Once the previous part is completed, go to type in the suitable information in all these - Bronze Star with Valor, Coast Guard Medal, Defense Meritorious Service Medal, Legion of Merit, Defense Superior Service Medal, Meritorious Service Medal, Distinguished Service Medal, Distinguished Service Medal Navy, Soldiers Medal, Surviving Spouse, Eligibility Requirements Proof, Enlisted Record Brief ERB and copy, Prisoner of War Medal Official US, with a plate featuring the same, and Affidavit State law makes.

Filling in section 2 of rts

It is easy to make a mistake when completing your Distinguished Service Medal, consequently you'll want to reread it before you'll send it in.

3. Your next part is easy - fill out all of the blanks in st Selection, nd Selection, rd Selection, Vehicle One, Vehicle Two, and International Symbol of Access To to conclude this segment.

Step # 3 in submitting rts

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