Form TD-420-500 "Military License Plate Application" - Washington

What Is Form TD-420-500?

This is a legal form that was released by the Washington State Department of Licensing - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 1, 2019;
  • The latest edition provided by the Washington State Department of Licensing;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form TD-420-500 by clicking the link below or browse more documents and templates provided by the Washington State Department of Licensing.

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Download Form TD-420-500 "Military License Plate Application" - Washington

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Click here to START or CLEAR, then hit the TAB button
Military License Plate Application
Military members, veterans, and spouses or family members can apply for a military license plate. For fee information,
contact any vehicle licensing office or visit dol.wa.gov.
To get service award or veterans remembrance emblems use form TD-420-075,
Veteran/Military Service Award
Emblem
Application.
Step 1 – Owner/Vehicle Information
PRINT or TYPE Name of registered owner
Claim # or Social Security # (DAV applicants only)
Mailing address (Street address or PO Box, City, State, ZIP code)
(Area code) Daytime telephone
Email
Current Washington license plate
Tab expiration: Month/Year
Vehicle Identification Number (VIN)
Year
Make
Vehicle plate type
Car or truck
Motorcycle
Trailer plate – large
Trailer plate – small
Step 2 – Select a Plate
Attach required documents and applicable fees in a check or money order, payable to Department of Licensing.
• Plates available from Special Plate Unit (mail only) – Send to: Special Plate Unit, Dept of Licensing,
PO Box 9909, Olympia, WA 98507-8500
• Plates available at vehicle licensing offices – Take or mail this form to any vehicle licensing office
Plates with an * are not available as trailer plates.
Can I
What supporting documents
Where can I
personalize
Plate type
do I need to provide?
get the plate?
the plate?
Letter from
Dept of Veteran Affairs
Special Plate Unit
Yes
Gold
Star*
Tab only
(dva.wa.gov)
DD214 or letter from Dept of Veteran Affairs Special Plate Unit
No
Medal of
Honor*
Tab only
Rating letter from Dept of Veteran Affairs
Special Plate Unit
No
Disabled American
veteran*
Tab only
DD214 or letter from Dept of Veteran Affairs Special Plate Unit
No
Former prisoner of
war*
Tab only
Copy of DD214
Special Plate Unit
Yes
Purple
Heart*
Copy of MARS license
Special Plate Unit
No
Military Affiliate Radio
System* (MARS)
Vehicle licensing
Copy of DD214
No
Pearl Harbor
survivor*
office
Complete this section ONLY if applying for an Armed Forces plate
Copy of DD214, military ID, or signed
Vehicle licensing
Armed forces
– U.S. flag background
Yes
Declaration of Fact (see Step 3)
office
(select branch and free decal below)
Branch shown on plate – Armed forces plate ONLY (select one)
Army
Navy
Air Force
Marines
Coast Guard
National Guard
Free decal – Armed forces plate ONLY (select one)
Veteran
Disabled veteran
Army retired
Retired
Army Guard
Active duty
Air Guard
Fallen hero
Reserves
Gold Star
Family
Step 3 – Declaration of Fact
I certify that I am eligible for a military license plate because I am:
Veteran
Active duty military
Family member of a deceased veteran
Reservist
National Guard member
Family member of a qualified veteran or military member
X
Print completed form; sign and date here.
Date and place (city or county) signed
Applicant signature
TD-420-500 (R/5/20)WA Page 1 of 2
Click here to START or CLEAR, then hit the TAB button
Military License Plate Application
Military members, veterans, and spouses or family members can apply for a military license plate. For fee information,
contact any vehicle licensing office or visit dol.wa.gov.
To get service award or veterans remembrance emblems use form TD-420-075,
Veteran/Military Service Award
Emblem
Application.
Step 1 – Owner/Vehicle Information
PRINT or TYPE Name of registered owner
Claim # or Social Security # (DAV applicants only)
Mailing address (Street address or PO Box, City, State, ZIP code)
(Area code) Daytime telephone
Email
Current Washington license plate
Tab expiration: Month/Year
Vehicle Identification Number (VIN)
Year
Make
Vehicle plate type
Car or truck
Motorcycle
Trailer plate – large
Trailer plate – small
Step 2 – Select a Plate
Attach required documents and applicable fees in a check or money order, payable to Department of Licensing.
• Plates available from Special Plate Unit (mail only) – Send to: Special Plate Unit, Dept of Licensing,
PO Box 9909, Olympia, WA 98507-8500
• Plates available at vehicle licensing offices – Take or mail this form to any vehicle licensing office
Plates with an * are not available as trailer plates.
Can I
What supporting documents
Where can I
personalize
Plate type
do I need to provide?
get the plate?
the plate?
Letter from
Dept of Veteran Affairs
Special Plate Unit
Yes
Gold
Star*
Tab only
(dva.wa.gov)
DD214 or letter from Dept of Veteran Affairs Special Plate Unit
No
Medal of
Honor*
Tab only
Rating letter from Dept of Veteran Affairs
Special Plate Unit
No
Disabled American
veteran*
Tab only
DD214 or letter from Dept of Veteran Affairs Special Plate Unit
No
Former prisoner of
war*
Tab only
Copy of DD214
Special Plate Unit
Yes
Purple
Heart*
Copy of MARS license
Special Plate Unit
No
Military Affiliate Radio
System* (MARS)
Vehicle licensing
Copy of DD214
No
Pearl Harbor
survivor*
office
Complete this section ONLY if applying for an Armed Forces plate
Copy of DD214, military ID, or signed
Vehicle licensing
Armed forces
– U.S. flag background
Yes
Declaration of Fact (see Step 3)
office
(select branch and free decal below)
Branch shown on plate – Armed forces plate ONLY (select one)
Army
Navy
Air Force
Marines
Coast Guard
National Guard
Free decal – Armed forces plate ONLY (select one)
Veteran
Disabled veteran
Army retired
Retired
Army Guard
Active duty
Air Guard
Fallen hero
Reserves
Gold Star
Family
Step 3 – Declaration of Fact
I certify that I am eligible for a military license plate because I am:
Veteran
Active duty military
Family member of a deceased veteran
Reservist
National Guard member
Family member of a qualified veteran or military member
X
Print completed form; sign and date here.
Date and place (city or county) signed
Applicant signature
TD-420-500 (R/5/20)WA Page 1 of 2
Step 4 – Personalized Plate (complete ONLY if requesting a personalized plate)
Personalized plate instructions
• Check to see if your plate is available at dol.wa.gov. Certain letter and number combinations are not allowed.
• List plate choice in order of preference.
• Characters:
• You can use letters, numbers, dashes, or spaces. You cannot use unusual characters: #, %, &, @, etc. Spaces and
dashes are considered characters; leave a box empty to indicate a space.
• Clearly show the letter or number characters “I,” “1,” “O,” or “0” (zero). Because of similarities with “I” or “1” and “O” or
“0” (zero), we treat them as the same. If one version already exists, you won’t be able to use the other. For example,
ROOT = R00T and SING = S1NG.
• Enter the meaning of the plate
• Unacceptable plates include those which may be: sexual or vulgar in nature; blasphemous; misleading; related to illegal
substances; implying ethnic, lifestyle, or gender slurs; or are contrary to our mission to promote highway safety.
• Complaints may result in the cancellation of a personalized plate.
• We will make the plate exactly as indicated on the application.
• Allow at least 8 weeks to receive your plates.
Standard-size plates have 1–7 characters; motorcycle and small trailer plates have 1–6 characters.
Plate choices
1.
2.
3.
WASHINGTON
WASHINGTON
WASHINGTON
MONTH
YEAR
MONTH
YEAR
MONTH
YEAR
TAB
TAB
TAB
TAB
TAB
TAB
E V E R G R E E N S T A T E
E V E R G R E E N S T A T E
E V E R G R E E N S T A T E
Meaning:
Meaning:
Meaning:
Step 5 – Disabled Parking Privilege
If you also require disabled parking privileges, complete the
Disabled Parking Application for Individuals
(form TD-420-073).
Mail the following to the Special Plate Unit:
• Completed Military License Plate Application and required documents
• Completed Disabled Parking Application for Individuals
• Signed authorization from your healthcare provider
• Applicable fees in a check or money order, payable to Department of Licensing
Special Plate Unit
Department of Licensing
PO Box 9909
Olympia, WA 98507-8500
NOTE: You may have other disabled parking options, contact Customer Service at (360) 902-3770 for additional
information.
RCW 41.04.005, .007; 46.18
TD-420-500 (R/5/20)WA Page 2 of 2
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