Form ITD 3397 Disability Veteran or Disability Purple Heart Plates Application - Idaho

Form ITD3397 is a Idaho Department of Transportation form also known as the "Disability Veteran Or Disability Purple Heart Plates Application". The latest edition of the form was released in November 1, 2018 and is available for digital filing.

Download a PDF version of the Form ITD3397 down below or find it on Idaho Department of Transportation Forms website.

ADVERTISEMENT
Disability Veteran or Disability Purple Heart Plates Application
ITD 3397 (Rev.11-18)
Supply #019638778
Step 1 – Owner/Vehicle Information
Applicant’s Last Name
First Name
Middle Name
Idaho Driver License No., SSN, or EIN
Last Name
First Name
Middle Name
Idaho Driver License No., SSN, or EIN
Physical Idaho Address
City
State
Zip
Mailing Address (if different from above)
City
State
Zip
Daytime Phone Number (8:30 a.m. to 4:30 p.m.) Applicant’s E-Mail Address
Current Idaho License Plate Number
Expiration Date
Vehicle Identification Number (VIN)
Idaho Title Number
Vehicle Year
Make
Body Type
Model
Color
Vehicle plate type
Passenger Vehicle
Motorhome
Camp Trailer
Motorcycle
Non-Commercial truck (8,001 to 26,000 GVW) weight
___
Commercial truck (8,001 to 26,000 GVW) weight__
___
(Must have applicants name on title)
Step 2 – Select a Plate
These plates cannot be personalized or display the Branch of Service and/or Conflict
nd
Applicants are limited to only ONE set of no fee disabled veteran standard or disabled veteran purple heart plates. A 2
standard
disability Purple Heart plate, for qualifying applicants, can be applied for but incurs standard registration fees. Please complete step 3.
Plate Type
Supporting Documents Needed
Program Fee
100% Rating Letter from Veteran Affairs
Disabled Veteran Plate
symbol
www.veterans.idaho.gov
Limited to One
100% Rating Letter from Veteran Affairs
Disabled Veteran Plate (without chair
www.veterans.idaho.gov
Set
symbol)
Disabled Veteran Purple Heart Plate
100% Rating Letter from Veteran Affairs
Free of Charge
www.veterans.idaho.gov
symbol
Copy of DD+214 or equivalent required showing purple
heart awarded
Step 3 – Disabled Purple Heart with fees
There are a maximum of 2 Purple Heart plates allowed per plate size (i.e. 2 for passenger car/truck and 2 for motorcycle)
Copy of DD+214 or equivalent required showing purple
No program fee
Disabled Purple Heart Plate
symbol
heart awarded with completed medical certification field
Registration Fees Apply
*For non-disability Purple Heart Plates please complete form ITD 3587
Medical Certification
for Disabled Purple Heart Recipients only)
(
This section must be completed and signed by a licensed physician, a licensed physician’s assistant, or by a licensed advanced-
practice professional nurse. (Please check appropriate box and Print clearly.)
Printed Name of Medical Professional Certifying Eligibility
Address
(Print Legibly)
City, State, Zip Code
Practitioners National Provider Identifier (required) Office Phone Number
Authorized Signature
Date
(
)
-
~ Check here if purchasing Idaho State Parks Passport
Extra $10.00 for 1 Year
Extra $20.00 for 2 Years
~
Do Not Send Money! You will be billed for your fees or you may authorize payment with your MasterCard or Visa
MasterCard or Visa Number
Expiration Date
Security Code Authorized Signature
Disability Veteran or Disability Purple Heart Plates Application
ITD 3397 (Rev.11-18)
Supply #019638778
Step 1 – Owner/Vehicle Information
Applicant’s Last Name
First Name
Middle Name
Idaho Driver License No., SSN, or EIN
Last Name
First Name
Middle Name
Idaho Driver License No., SSN, or EIN
Physical Idaho Address
City
State
Zip
Mailing Address (if different from above)
City
State
Zip
Daytime Phone Number (8:30 a.m. to 4:30 p.m.) Applicant’s E-Mail Address
Current Idaho License Plate Number
Expiration Date
Vehicle Identification Number (VIN)
Idaho Title Number
Vehicle Year
Make
Body Type
Model
Color
Vehicle plate type
Passenger Vehicle
Motorhome
Camp Trailer
Motorcycle
Non-Commercial truck (8,001 to 26,000 GVW) weight
___
Commercial truck (8,001 to 26,000 GVW) weight__
___
(Must have applicants name on title)
Step 2 – Select a Plate
These plates cannot be personalized or display the Branch of Service and/or Conflict
nd
Applicants are limited to only ONE set of no fee disabled veteran standard or disabled veteran purple heart plates. A 2
standard
disability Purple Heart plate, for qualifying applicants, can be applied for but incurs standard registration fees. Please complete step 3.
Plate Type
Supporting Documents Needed
Program Fee
100% Rating Letter from Veteran Affairs
Disabled Veteran Plate
symbol
www.veterans.idaho.gov
Limited to One
100% Rating Letter from Veteran Affairs
Disabled Veteran Plate (without chair
www.veterans.idaho.gov
Set
symbol)
Disabled Veteran Purple Heart Plate
100% Rating Letter from Veteran Affairs
Free of Charge
www.veterans.idaho.gov
symbol
Copy of DD+214 or equivalent required showing purple
heart awarded
Step 3 – Disabled Purple Heart with fees
There are a maximum of 2 Purple Heart plates allowed per plate size (i.e. 2 for passenger car/truck and 2 for motorcycle)
Copy of DD+214 or equivalent required showing purple
No program fee
Disabled Purple Heart Plate
symbol
heart awarded with completed medical certification field
Registration Fees Apply
*For non-disability Purple Heart Plates please complete form ITD 3587
Medical Certification
for Disabled Purple Heart Recipients only)
(
This section must be completed and signed by a licensed physician, a licensed physician’s assistant, or by a licensed advanced-
practice professional nurse. (Please check appropriate box and Print clearly.)
Printed Name of Medical Professional Certifying Eligibility
Address
(Print Legibly)
City, State, Zip Code
Practitioners National Provider Identifier (required) Office Phone Number
Authorized Signature
Date
(
)
-
~ Check here if purchasing Idaho State Parks Passport
Extra $10.00 for 1 Year
Extra $20.00 for 2 Years
~
Do Not Send Money! You will be billed for your fees or you may authorize payment with your MasterCard or Visa
MasterCard or Visa Number
Expiration Date
Security Code Authorized Signature
Ordering Veteran/
Disabled Veteran
Application For
No fees required for eligible veterans.
Purple Heart
Applicants must be veterans with a 100% service
Disability Plates
connected permanent disability. Call the
Veterans Administration Regional Office in
1. Clearly print all requested information on the
Boise, Idaho at (208) 429-2145 or (800) 827-
Disability Veteran
application form.
1000 to find out if you meet eligibility
requirements and to request a Disabled Veteran
2. Use one form for each vehicle.
or
Plate Eligibility Letter. You may also visit their
3. Attach the required military documents.
office at 550 West Fort Street in Boise. Limited
Disability
Military license plates will not be issued
to one set
without the required documentation.
Purple Heart
Disabled Purple Heart
4. Do not send fees with the application. You
A purple heart recipient who qualifies for a
Plates
will be billed or you may include your
disabled veteran fee exemption under section 49-
MasterCard or Visa number and card
403, Idaho Code, shall have a choice between a
expiration date.
purple heart recipient license plate or a disabled
veteran license plate and shall not be charged a
plate fee or a fee for registration or reregistration
Mail the application to:
of the motor vehicle. The provisions of this
Idaho Transportation Department
subsection shall apply to the vehicle originally
Special Plates
purchased under this authorization and also to
PO Box 7129
any vehicle subsequently purchased and owned
Boise, ID 83707-1129
by the same veteran. The privilege shall not
extend to more than one (1) vehicle owned by
Write to the address above or call (208) 334-
the veteran at a time.
8649 for more information about special license
plates.
A fee would apply for qualifying applicants
applying for a second set of Purple Heart plates.
E-mail applications to:
Please contact the Idaho Division of Veterans
specialplates@itd.idaho.gov
Services for more information on eligibility
Disabled Purple Heart
requirements. You can contact the IDVS by:
Fax application to:
Disabled Veteran
(208) 334-8542
Internet:
http://www.veterans.idaho.gov
You can obtain additional application forms via
E-Mail:
webmaster@veterans.idaho.gov
the Internet at:
http://www.itd.idaho.gov/dmv/
Mail: Idaho Division of Veterans Services
351 Collins Road
Boise ID 83702-4519
ITD 3397 (Rev. 11-18)
Phone: (208) 780-1300
Supply # 019638778
itd.idaho.gov
ADVERTISEMENT
Page of 2