Form PS-43 "Application for Firefighter Plates" - Maine

What Is Form PS-43?

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

Form Details:

  • Released on January 1, 2013;
  • The latest edition provided by the Maine Department of the Secretary of State;
  • 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 PS-43 by clicking the link below or browse more documents and templates provided by the Maine Department of the Secretary of State.

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Download Form PS-43 "Application for Firefighter Plates" - Maine

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STATE OF MAINE
APPLICATION FOR FIREFIGHTER PLATES
I, ________________________________________________________________________________
(NAME OF APPLICANT)
of________________________________________________________________________________,
(STREET)
(TOWN)
(ZIP CODE)
an active member of the ______________________________________ Fire Department, hereby make
application for a firefighter plate and enclosed is the one-time $5.00 plate fee and a copy of my current
registration to which the plate will be assigned. I fully understand should I cease to be a firefighter, the
Fire Chief shall immediately notify the Secretary of State. I understand the plate must be returned to the
Secretary of State unless I retire from the department and the Fire Chief authorizes me to continue to use
my firefighter plates.
_____________________________________
(SIGNATURE OF APPLICANT)
FIRE CHIEF’S CERTIFICATE:
I hereby certify that the person above named is an active member of the __________________________
Fire Department. I understand that should this person cease to be a member of this Fire Department, I will
notify the Secretary of State, Bureau of Motor Vehicles.
I have assigned plate number _________________ to the above Firefighter.
 Check here if vanity plate is desired: The fee for a vanity plate is $25.00; the fee for firefighter plates
is a one-time $5.00 fee. Please submit this application along with a vanity plate application (MV-45), a copy
of your current registration, and the appropriate fee.
(SIGNATURE OF FIRE CHIEF, ACTING FIRE CHIEF, OR ASSISTANT FIRE CHIEF)
(TITLE)
NOTE:
The vehicle to which the firefighter plate will be assigned must be registered in the name of
the active firefighter. The special registration plate for firefighters may be used only on one
motor vehicle. The registered vehicle weight of this vehicle may not exceed 10,000 pounds.
(29-A MRSA, §519)
Please submit the completed application, along with the $5.00 fee (unless vanity plate fee desired; see above
instructions) and a photocopy of your current registration to:
Specialty Plate Clerk
Bureau of Motor Vehicles
29 State House Station
Augusta, Maine 04333-0029
SECRETARY OF STATE
PLEASE MAKE CHECK PAYABLE TO:
PS-43
Rev. 1-2013
STATE OF MAINE
APPLICATION FOR FIREFIGHTER PLATES
I, ________________________________________________________________________________
(NAME OF APPLICANT)
of________________________________________________________________________________,
(STREET)
(TOWN)
(ZIP CODE)
an active member of the ______________________________________ Fire Department, hereby make
application for a firefighter plate and enclosed is the one-time $5.00 plate fee and a copy of my current
registration to which the plate will be assigned. I fully understand should I cease to be a firefighter, the
Fire Chief shall immediately notify the Secretary of State. I understand the plate must be returned to the
Secretary of State unless I retire from the department and the Fire Chief authorizes me to continue to use
my firefighter plates.
_____________________________________
(SIGNATURE OF APPLICANT)
FIRE CHIEF’S CERTIFICATE:
I hereby certify that the person above named is an active member of the __________________________
Fire Department. I understand that should this person cease to be a member of this Fire Department, I will
notify the Secretary of State, Bureau of Motor Vehicles.
I have assigned plate number _________________ to the above Firefighter.
 Check here if vanity plate is desired: The fee for a vanity plate is $25.00; the fee for firefighter plates
is a one-time $5.00 fee. Please submit this application along with a vanity plate application (MV-45), a copy
of your current registration, and the appropriate fee.
(SIGNATURE OF FIRE CHIEF, ACTING FIRE CHIEF, OR ASSISTANT FIRE CHIEF)
(TITLE)
NOTE:
The vehicle to which the firefighter plate will be assigned must be registered in the name of
the active firefighter. The special registration plate for firefighters may be used only on one
motor vehicle. The registered vehicle weight of this vehicle may not exceed 10,000 pounds.
(29-A MRSA, §519)
Please submit the completed application, along with the $5.00 fee (unless vanity plate fee desired; see above
instructions) and a photocopy of your current registration to:
Specialty Plate Clerk
Bureau of Motor Vehicles
29 State House Station
Augusta, Maine 04333-0029
SECRETARY OF STATE
PLEASE MAKE CHECK PAYABLE TO:
PS-43
Rev. 1-2013