Form MVR-27SA "Application for an in God We Trust License Plate" - North Carolina

What Is Form MVR-27SA?

This is a legal form that was released by the North Carolina Department of Transportation - Division of Motor Vehicles - a government authority operating within North Carolina. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • The latest edition provided by the North Carolina Department of Transportation - Division of Motor Vehicles;
  • 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 printable version of Form MVR-27SA by clicking the link below or browse more documents and templates provided by the North Carolina Department of Transportation - Division of Motor Vehicles.

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Download Form MVR-27SA "Application for an in God We Trust License Plate" - North Carolina

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MVR-27SA
North Carolina Division of Motor Vehicles
3155 Mail Service Center
Raleigh, North Carolina 27699-3155
APPLICATION FOR AN
IN GOD WE TRUST
LICENSE PLATE
Remit a $30.00/$60.00 check or money order with this application.
Regular In God We Trust Fee
$30.00
Personalized In God We Trust Fee
$60.00
___ ___ ___ ___ S
NOTE:
You are allowed four (4) spaces for a personalized message.
A
The personalized spaces can be letters only or a combination of numbers and letters.
Numbers only are not permitted. The prefix/suffix must be the first/last letter on the plate.
The $30.00/$60.00 special fee is an (ANNUAL) fee due in addition to the regular license fee.
Home
NAME (To agree with certificate of title)
FIRST
MIDDLE
LAST
AREA CODE–TELEPHONE NUMBER
ADDRESS
Office
CITY
STATE
ZIP CODE
Current North Carolina
AREA CODE–TELEPHONE NUMBER
PLATE NUMBER
VEHICLE IDENTIFICATION NUMBER
DRIVER LICENSE #
YEAR
MODEL
MAKE
BODY STYLE
Owner's Certification of Liability Insurance
I CERTIFY FOR THE MOTOR VEHICLE DESCRIBED ABOVE THAT I HAVE FINANCIAL RESPONSIBILITY AS REQUIRED BY LAW.
PRINT OR TYPE FULL NAME OF INSURANCE COMPANY AUTHORIZED IN N.C. – NOT AGENCY OR GROUP
POLICY NUMBER – IF POLICY NOT ISSUED, NAME OF AGENCY BINDING COVERAGE
SIGNATURE OF OWNER
DATE OF CERTIFICATION
MVR-27SA
North Carolina Division of Motor Vehicles
3155 Mail Service Center
Raleigh, North Carolina 27699-3155
APPLICATION FOR AN
IN GOD WE TRUST
LICENSE PLATE
Remit a $30.00/$60.00 check or money order with this application.
Regular In God We Trust Fee
$30.00
Personalized In God We Trust Fee
$60.00
___ ___ ___ ___ S
NOTE:
You are allowed four (4) spaces for a personalized message.
A
The personalized spaces can be letters only or a combination of numbers and letters.
Numbers only are not permitted. The prefix/suffix must be the first/last letter on the plate.
The $30.00/$60.00 special fee is an (ANNUAL) fee due in addition to the regular license fee.
Home
NAME (To agree with certificate of title)
FIRST
MIDDLE
LAST
AREA CODE–TELEPHONE NUMBER
ADDRESS
Office
CITY
STATE
ZIP CODE
Current North Carolina
AREA CODE–TELEPHONE NUMBER
PLATE NUMBER
VEHICLE IDENTIFICATION NUMBER
DRIVER LICENSE #
YEAR
MODEL
MAKE
BODY STYLE
Owner's Certification of Liability Insurance
I CERTIFY FOR THE MOTOR VEHICLE DESCRIBED ABOVE THAT I HAVE FINANCIAL RESPONSIBILITY AS REQUIRED BY LAW.
PRINT OR TYPE FULL NAME OF INSURANCE COMPANY AUTHORIZED IN N.C. – NOT AGENCY OR GROUP
POLICY NUMBER – IF POLICY NOT ISSUED, NAME OF AGENCY BINDING COVERAGE
SIGNATURE OF OWNER
DATE OF CERTIFICATION
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