Form TC-817 "Application for Personalized Plates and Replacement of Existing Personalized Plates" - Utah

What Is Form TC-817?

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

Form Details:

  • Released on August 1, 2020;
  • The latest edition provided by the Utah State Tax Commission;
  • 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 TC-817 by clicking the link below or browse more documents and templates provided by the Utah State Tax Commission.

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Download Form TC-817 "Application for Personalized Plates and Replacement of Existing Personalized Plates" - Utah

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Utah State Tax Commission
Division of Motor Vehicles • PO Box 30412 • Salt Lake City, UT 84130 • 801-297-7780 or 1-800-368-8824
TC-817
Application for Personalized Plates and
Rev. 8/20
Replacement of Existing Personalized Plates
Get forms at tax.utah.gov/forms
Your vehicle must have a current registration. This application is for a (check one):
Clear form
New Order
Replacement
The fee is $16 for a standard plate or $21 for a special group plate.
Section 1: Vehicle Information
Current Utah plate no. Date registration expires VIN
Make
Model
Year
Section 2: Applicant Information
Date of application
These plates will be
Motorcycle
Trailer
Automobile/truck/van/utility
placed on a (check one):
Registered owner's name
Daytime telephone number (required)
Mailing address
Is this a new address?
Yes
No
City
State
ZIP code
Email address
Section 3: Plate and Character Selection
 
Check one:
• Standard (use up to 7 characters)
• Motorcycle Standard (use up to 4 characters)
• Disabled Person (use up to 5 characters)

Life Elevated Arches ($61)
Life Elevated Arches ($61)
Life Elevated Arches ($66)

Life Elevated Skier ($61)
Life Elevated Skier ($61)
Life Elevated Skier ($66)
In God We Trust ($61)
In God We Trust ($61)
Disabled Standard ($66)
(only up to 5 characters)
(only up to 3 characters)
• Radio (use up to 6 characters)
• Utah Special Group Plate (use up to 5 characters)

Amateur Radio ($21)
On the line below, enter the plate type from the list on the following pages:
Search & Rescue Radio ($21)
Special plate type/name
Enter your choices below as you would like them displayed on your plate. Approved personalized plates will be made exactly as shown on
this form and are issued on a first-come, first-serve basis. For this reason, we encourage you to provide three unique choices, in order of
preference. If a choice is not available or not allowed under Utah Code §41-1a-411, we may consider your next choice. Do not use
special characters (period, apostrophe, dash, etc.).
Character alignment (check one):
Left
Center
Right
1st Choice
2nd Choice
3rd Choice

Explain the meaning of these
Explain the meaning of these
Explain the meaning of these
characters:
characters:
characters:
I understand that my application for personalized plates is subject to availability and to the guidelines in Utah Code §41-1a-411. This
application will not be approved if it does not meet these guidelines. I also understand that acceptance of this application and payment of
fees does not mean my application will be approved.
Signature
X
You must pay the application fee plus any required contribution (special group plates only) with this application. Make your check or
money order payable to the Utah State Tax Commission. Mail the application and your payment to: Utah State Tax Commission, Division of
Motor Vehicles, Miscellaneous Services Unit, PO Box 30412, Salt Lake City, UT 84130.
Utah State Tax Commission
Division of Motor Vehicles • PO Box 30412 • Salt Lake City, UT 84130 • 801-297-7780 or 1-800-368-8824
TC-817
Application for Personalized Plates and
Rev. 8/20
Replacement of Existing Personalized Plates
Get forms at tax.utah.gov/forms
Your vehicle must have a current registration. This application is for a (check one):
Clear form
New Order
Replacement
The fee is $16 for a standard plate or $21 for a special group plate.
Section 1: Vehicle Information
Current Utah plate no. Date registration expires VIN
Make
Model
Year
Section 2: Applicant Information
Date of application
These plates will be
Motorcycle
Trailer
Automobile/truck/van/utility
placed on a (check one):
Registered owner's name
Daytime telephone number (required)
Mailing address
Is this a new address?
Yes
No
City
State
ZIP code
Email address
Section 3: Plate and Character Selection
 
Check one:
• Standard (use up to 7 characters)
• Motorcycle Standard (use up to 4 characters)
• Disabled Person (use up to 5 characters)

Life Elevated Arches ($61)
Life Elevated Arches ($61)
Life Elevated Arches ($66)

Life Elevated Skier ($61)
Life Elevated Skier ($61)
Life Elevated Skier ($66)
In God We Trust ($61)
In God We Trust ($61)
Disabled Standard ($66)
(only up to 5 characters)
(only up to 3 characters)
• Radio (use up to 6 characters)
• Utah Special Group Plate (use up to 5 characters)

Amateur Radio ($21)
On the line below, enter the plate type from the list on the following pages:
Search & Rescue Radio ($21)
Special plate type/name
Enter your choices below as you would like them displayed on your plate. Approved personalized plates will be made exactly as shown on
this form and are issued on a first-come, first-serve basis. For this reason, we encourage you to provide three unique choices, in order of
preference. If a choice is not available or not allowed under Utah Code §41-1a-411, we may consider your next choice. Do not use
special characters (period, apostrophe, dash, etc.).
Character alignment (check one):
Left
Center
Right
1st Choice
2nd Choice
3rd Choice

Explain the meaning of these
Explain the meaning of these
Explain the meaning of these
characters:
characters:
characters:
I understand that my application for personalized plates is subject to availability and to the guidelines in Utah Code §41-1a-411. This
application will not be approved if it does not meet these guidelines. I also understand that acceptance of this application and payment of
fees does not mean my application will be approved.
Signature
X
You must pay the application fee plus any required contribution (special group plates only) with this application. Make your check or
money order payable to the Utah State Tax Commission. Mail the application and your payment to: Utah State Tax Commission, Division of
Motor Vehicles, Miscellaneous Services Unit, PO Box 30412, Salt Lake City, UT 84130.
Personalized License Plate Descriptions and Fees
Rev. 8/20
Plate type
Plate Description & Contribution Requirements
Fee
Amateur Radio
Provide a copy of a current FCC license with assigned call numbers.
$21
Autism Awareness
Annual contribution of at least $25 must be made in support of autism awareness programs.
$91
Boy Scouts
Annual contribution of at least $25 must be made to the Boy Scouts of America.
$91
Boys and Girls Club
Annual contribution of at least $25 must be made to Boys and Girls Club.
$91
Cancer Research
Annual contribution of at least $35 must be made in support of cancer research.
$101
Children’s Issues
Annual contribution of at least $25 must be made to the Guardian Ad Litem organization and
$91
the Children’s Museum of Utah.
Collegiate
Annual contribution in support of the selected school is required. The minimum annual contribution is:
$91
$25 for the Dixie State University, LDS Business College, Salt Lake Community College, Snow College,
Southern Utah University, Utah State University, Utah Valley University, Weber State University, or Western
Governor’s University.
$30 for Westminster College.
$96
$35 for Brigham Young University.
$101
$40 for University of Utah.
$106
Civil Air Patrol
Recognizes and commemorates the Utah Wing of the Civil Air Patrol. This plate is available to any person
$66
Recognition Plate
making the request.
Disabled Person
Provide a complete form TC-842, Disabled Person and Physician Disability Certification.
$66
Disabled Veteran
Provide a letter from the Utah Department of Veterans’ and Military Affairs or United States Military entity,
$66
certifying the veteran’s disabled status. This plate does not qualify for parking in a disabled parking space.
Emergency Medical
Requires a certificate of current EMT training.
$66
Technician (EMT)
Farm Truck
This p
late may be issued to trucks used exclusively to transport farm products or supplies.
$66
Firefighter
Annual contribution of at least $15 must be made to the Firefighter Support Fund. Provide any one of
$81
the following: evidence of current membership in the Utah Firefighter’s Association; an official identification
card issued by a firefighting entity identifying the applicant as an employee or volunteer; or a letter on
letterhead from a firefighting entity or from the county/municipality in which the firefighting entity is located,
identifying the applicant as an employee, retired employee or volunteer of the firefighting entity.
Former Prisoner
Provide a copy of Form DD214 or a Statement of Service from the Department of Veterans’ Affairs.
$66
of War (POW)
Gold Star
Provide a document showing classification of death as listed by the U. S. Secretary of Defense, a casualty
$66
report, a telegram from the U. S. Secretary of Defense, or another document that verifies the applicant is a
recipient of the Gold Star award.
Honoring Heroes
Annual contribution of at least $35 must be made to the Public Safety Honoring Heroes foundation.
$101
Humanitarian Service
Annual contribution of at least $25 must be made in support of various Utah humanitarian service organizations.
$91
National Guard
Provide copy of military photo ID.
$66
No More Homeless
Annual contribution of at least $25 must be made in support of No More Homeless Pets in Utah.
$91
Pets
Pearl Harbor Survivor
Provide a copy of a membership card issued by the Pearl Harbor Survivors Association.
$66
Public Education
Annual contribution of at least $25 must be made to the Utah Association of Public School Foundations.
$91
Support
Purple Heart
Provide a copy of a membership card in the Military Order of the Purple Heart Association or military
$50
discharge form DD214 issued by the National Personnel Records Center.
Soccer (RSL)
Annual contribution of at least $25 must be made to the National Professional Men's Soccer Team Support of Building
$91
Communities restricted account.
Search and Rescue
Provide a copy of a current Search and Rescue membership card, picture identification card, or a letter on
$66
letterhead from a County Sheriff certifying that the applicant is a current member of a Search and Rescue team.
Personalized License Plate Descriptions and Fees
Rev. 8/20
Plate type
Plate Description & Contribution Requirements
Fee
Search and Rescue
Provide documentation verifying call numbers from the county sheriff and a required item from the Search
$21
Radio
and Rescue plate as shown above.
Share the Road
Annual contribution of at least $25 must be made to the Share the Road Bicycle Support Fund.
$91
Snowmobiler
Initial contribution of at least $25 must be made in support of snowmobile safety education programs.
$91
No annual contribution is required.
Soil Conservation
Initial contribution of at least $25 must be made in support of agricultural education programs. No annual
$91
contribution is required.
Special Interest
Vehicle must be 20 years old or older or must meet the requirements in Utah Code §41-1a-102(70). Provide a
$66
Statement of Facts (TC-569D) detailing the reason why your vehicle meets these requirements.
Utah Jazz
Annual contribution of at least $25 must be made to the National Professional Men's Basketball Team support
$91
of women and children issues.
Utah Housing
Annual contribution of at least $30 must be made in support of affordable housing programs. Provide proof of
$96
Opportunity
membership in a trade organization for real estate licensees which has more than 15,000 Utah members.
(Realtor)
Utah Law
Initial contribution of at least $35 must be made to the Utah Law Enforcement Memorial Endowment Fund.
$101
Enforcement
An annual contribution of $35 must be made thereafter.
Memorial
Veterans
Initial contribution of at least $25 must be made to the Utah Department of Veterans’ and Military Affairs.
$91
An annual contribution of $10 must be made thereafter. Applicant may select the Air Force, American Legion,
Army, Coast Guard, Marines, or Navy plate.
Veteran Combat
Initial contribution of at least $25 must be made to the Utah Department of Veterans’ and Military Affairs.
$91
Theater
An annual contribution of $10 must be made thereafter. Applicant may select the Army Combat Infantry Badge,
Army Combat Action Badge, Air Force Combat Action Medal, or the Marine & Navy Combat Action Ribbon.
Must obtain proof of qualification for the campaign or combat theater award requested from the Utah Department of
Veterans’ and Military Affairs.
Vintage
Vehicle must be at least 30 years old and not driven for general daily transportation.
$66
Wildlife
Annual contribution of at least $25 must be made in support of wildlife and wildlife habitat preservation.
$91
Applicant may select the Kestrel, Elk, Trout, or Mule Deer plate.
Women’s Suffrage
Recognizes and commemorates women's suffrage. This plate is available to any person making the request.
$66
Zion National Park
Annual contribution of at least $25 must be made in support of Zion National Park preservation.
$91
All plates, except Amateur Radio, Search and Rescue Radio, and Purple Heart, require payment of an additional $10 fee when renewing for the
next registration year. Any personalized plate that has not been renewed within six months of its expiration date will be forfeited.
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