How to Fill Out Form VTR-421

Form VTR-421 at a glance

What it is: Form VTR-421 is the Application for Military Meritorious Service License Plates.

Where and when to file: Texas Department of Motor Vehicles Vehicle Titles and Registration Division Special Plates Unit 4000 Jackson Avenue Austin, TX 78731

This application is for non-Disabled Veteran registration.

What to bring and attach to Form VTR-421

Active members must provide a copy of their military ID and proof that they are a recipient of the medal being applied for, such as an Officer Record Brief or Enlisted Record Brief.

Former members must provide proof of their honorable discharge and proof that they are a recipient of the medal being applied for, such as, a DD214.

Borinqueneers Congressional Gold Medal applicant must provide certification that you served in World War I, World War II, or the Korean War while assigned to the 65th Infantry Regiment.

Prisoner of War Medal applicant must provide an official United States government document or certification from the United States Department of Veterans Affairs certifying or identifying the applicant as a former prisoner of war.

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).

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

A filled-in Form VTR-421 example: a passenger car with the Purple Heart plate

Form VTR-421 example filled out, example: a passenger car with the Purple Heart plate
Dana Example applies for Military Meritorious Service license plates for a passenger car. Dana picks the Purple Heart plate for the first set and leaves the plate unpersonalized. The picture shows page 1 only, and none of its entries is real. Personalize Your Plate is left blank because Dana does not personalize the plate. Suffix is left blank because Dana's name has none. Unmarried Surviving Spouse is left blank because Dana is not a surviving spouse. License No, Mo/Yr of Exp and Date Issued are left blank because they are For County Use Only. The car weighs 3200 lbs, within the 18,000 lbs limit of the Passenger Car box. The fillable form has no Signature box, so the example leaves it for you to sign.

How to fill out Form VTR-421, box by box

For County Use Only

Form VTR-421 example filled out, for County Use Only

License No, Mo/Yr of Exp and Date Issued are For County Use Only.

First Name, Address, Email and Phone Number

Form VTR-421 example filled out, first Name, Address, Email and Phone Number

Enter First Name, Middle Name, Last Name, Suffix and County.

Enter Address, City, State and ZIP.

Enter Email and Phone Number.

Vehicle Information

Form VTR-421 example filled out, vehicle Information

Enter Vehicle Identification Number, Current TX Plate, Year, Make and Body Style.

Enter Empty Weight (lbs.) and check Passenger Car (up to 18,000 lbs.), Truck (up to 18,000 lbs.) or Motorcycle/Moped.

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

Specialty plate choice

Form VTR-421 example filled out, specialty plate choice

On page 1, in the box 'Circle your specialty plate choice below or enter your choice here', circle your specialty plate choice or enter your choice here: Air Force Cross; Air Medal; Air Medal with Valor; Airman's Medal; Army of Occupation Medal; Army Distinguished Service Cross; Borinqueneers Congressional Gold Medal; Bronze Star; Bronze Star with Valor; Coast Guard Medal; Defense Meritorious Service Medal; Defense Superior Service Medal; Distinguished Flying Cross; Distinguished Flying Cross with Valor; Distinguished Service Medal Air Force; Distinguished Service Medal Army; Distinguished Service Medal Coast Guard; Distinguished Service Medal Navy; Distinguished Service Medal Dept. of Defense; Distinguished Service Medal Dept. of Homeland Security; Distinguished Service Medal Dept. of Transportation; Legion of Merit; Meritorious Service Medal; Navy and Marine Corps Achievement Medal; Navy and Marine Corps Medal; Navy Cross; Pearl Harbor Survivor; Prisoner of War Medal; Purple Heart; Silver Star; Soldier's Medal.

Unmarried Surviving Spouse

Form VTR-421 example filled out, unmarried Surviving Spouse

Indicate if you are an unmarried surviving spouse:

As an unmarried, surviving spouse of a veteran who had or was eligible for Meritorious Service license plates, you are eligible to register your vehicle with a plate featuring the same military emblem.

To apply, you must enclose a written statement that you are unmarried and provide proof your spouse is deceased.

A new plate will be issued with the same emblem and a new plate number.

Indicate your eligibility as a “Surviving Spouse” by checking the box on page 1.

Certification, Signature and Date

Form VTR-421 example filled out, certification, Signature and Date

State law makes falsifying information a third degree felony. I, the applicant listed above, meet the eligibility requirements as listed on page 2 of this application and am providing proof to that effect.

Sign on Signature and enter the Date.

Personalize Your Plate

Form VTR-421 example filled out, personalize Your Plate

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). (checked October 22, 2026)

Show personalizations exactly as you want them to appear on your license plate(s).

You may list more than one option in the event the personalization you have chosen has been issued.

Enter your desired personalized letters, numbers, and/or symbols in the blocks.

The available symbols include: a period, a dash, a blank space, a Texas silhouette (use an asterisk “*” to indicate), a heart (use an at “@” to indicate), and a star (use an ampersand “&” to indicate).

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

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

You are not required to use all the blocks provided.

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

The International Symbol of Access “ “ counts as two (2) characters and will be located at the beginning of the plate number.

If you are disabled and applying for personalized specialty plates, use a percent “%” to indicate the International Symbol of Access.

To display the International Symbol of Access on your license plate, attach a signed Application for Persons with Disabilities Parking Placard and/or License Plate (Form VTR-214) to this application to show your eligibility.

More rules for Form VTR-421

Texas title and vehicle registration must be in your name.

Joint vehicle ownership between you and a spouse is permissible.

Submit a separate application for additional vehicles to the Vehicle Titles and Registration Division, Special Plates Unit.

Please note: Valid identification may be required when obtaining or renewing vehicle registration.

Common questions about Form VTR-421

Where do I file it?

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 Special Plates Unit 4000 Jackson Avenue Austin, TX 78731 Do not mail cash.

Are there fees?

There are no registration or specialty plate fees for the first set of plates. To order additional sets of plates, the annual registration fee must be paid to your local county tax assessor-collector. There is no specialty plate fee for additional sets. The personalization fee will not be refunded once the application is submitted.

When is this form not the right one?

Vehicle is for personal use only.

Where to get help with Form VTR-421

Contact the Specialty Plates Unit at (512) 374-5010 if you have any questions.

Contact your county tax assessor-collector's office if you have questions.

Sources

[1] Form VTR-421 (Rev. 12/2025), Application for Military Meritorious Service License Plates, Texas Department of Motor Vehicles (the Official source link on this page).

Form VTR-421 PDF Details

Texas title and vehicle registration must be in your name.

Active members: must provide a copy of their military ID and proof that they are a recipient of the medal being applied for.

Former members: must provide proof of their honorable discharge and proof that they are a recipient of the medal being applied for.

Unmarried surviving spouse: if your spouse was a veteran with or eligible for these plates, enclose a statement that you are unmarried and proof your spouse is deceased.

Leased vehicle: if the vehicle is leased, attach a copy of the lease agreement.

Plate characters: passenger car and truck plates are limited to six (6) characters total, including punctuation characters; motorcycle and moped plates, four (4).

QuestionAnswer
Form NameForm VTR-421
Form Length2 pages
Fillable?Yes
Fillable fields29
Avg. time to fill out5 min
Edition12/2025
Where to sendTexas Department of Motor Vehicles, Vehicle Titles and Registration Division, Special Plates Unit, 4000 Jackson Avenue, Austin, TX 78731
Who signsThe applicant
Matches the agency's fileYes, checked October 25, 2026
Other namesVTR-421, VTR 421, Form VTR-421, Form 421, Military Meritorious Service License Plates
Official sourceForm VTR-421 (Rev 12/2025),