Form MVR-27CGM "Application for a Coast Guard Auxiliary Member License Plate" - North Carolina

What Is Form MVR-27CGM?

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:

  • Released on March 1, 2017;
  • 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-27CGM 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-27CGM "Application for a Coast Guard Auxiliary Member License Plate" - North Carolina

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MVR-27CGM
(Revised 3/17)
North Carolina Division of Motor Vehicles
3155 Mail Service Center
Raleigh, NC 27699-3155
APPLICATION FOR A
Coast Guard Auxiliary Member
LICENSE PLATE
Remit a $10.00 check or money order with this application.
Regular Coast Guard Auxiliary
First In Flight background
Member $10.00
First In Freedom background
I hereby certify that I am member of the Coast Guard Auxiliary Member (N.C.G.S. 20.79.4)
_____________________________________________________________________.
(signature to agree with registration of the vehicle)
The $10.00 special fee is an (ANNUAL) fee due in addition to the regular license fee.
NAME(To agree with certificate of title)
Home
________________________________________________________________
FIRST
MIDDLE
LAST
_______________________
AREA CODE-TELEPHONE NUMBER
________________________________________________________________
ADDRESS
Office/Cell
______________________
________________________________________________________________
AREA CODE-TELEPHONE NUMBER
CITY
STATE
ZIP CODE
Current North Carolina
_________________________________________
__________________
Vehicle Identification Number
Plate 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-27CGM
(Revised 3/17)
North Carolina Division of Motor Vehicles
3155 Mail Service Center
Raleigh, NC 27699-3155
APPLICATION FOR A
Coast Guard Auxiliary Member
LICENSE PLATE
Remit a $10.00 check or money order with this application.
Regular Coast Guard Auxiliary
First In Flight background
Member $10.00
First In Freedom background
I hereby certify that I am member of the Coast Guard Auxiliary Member (N.C.G.S. 20.79.4)
_____________________________________________________________________.
(signature to agree with registration of the vehicle)
The $10.00 special fee is an (ANNUAL) fee due in addition to the regular license fee.
NAME(To agree with certificate of title)
Home
________________________________________________________________
FIRST
MIDDLE
LAST
_______________________
AREA CODE-TELEPHONE NUMBER
________________________________________________________________
ADDRESS
Office/Cell
______________________
________________________________________________________________
AREA CODE-TELEPHONE NUMBER
CITY
STATE
ZIP CODE
Current North Carolina
_________________________________________
__________________
Vehicle Identification Number
Plate 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