Form SFN51628 "Application for North Dakota Veteran's Number Plate" - North Dakota

What Is Form SFN51628?

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

Form Details:

  • Released on November 19, 2018;
  • The latest edition provided by the North Dakota Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form SFN51628 by clicking the link below or browse more documents and templates provided by the North Dakota Department of Transportation.

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Download Form SFN51628 "Application for North Dakota Veteran's Number Plate" - North Dakota

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APPLICATION FOR NORTH DAKOTA
MOTOR VEHICLE DIVISION
ND DEPT OF TRANSPORTATION
VETERAN'S NUMBER PLATE
608 E BOULEVARD AVE
North Dakota Department of Transportation, Motor Vehicle
BISMARCK ND 58505-0780
Telephone (701) 328-2725
SFN 51628 (11-2018)
Fax (701) 328-1487
Website: https://dot.nd.gov
Applicant's Legal Name
Telephone Number
Mailing Address
City
State
ZIP Code
Title Number
Year and Make of Vehicle
Vehicle Identification Number
Current License Plate No.
North Dakota law allows individuals eligible for interment in the North Dakota Veterans' Cemetery to obtain special license plates.
To obtain the veteran number plate, an initial fee of $15 is due. Thereafter, an annual fee of $10 will be due in addition to the
regular license fee. Please complete this application and return to the Motor Vehicle Division with the $15 fee. You will be
assigned the next available number within our numbering scheme.
Please choose one of the following military service emblems:
Check One:
Air Force
Army
Coast Guard
Marines
Navy
Purple Heart*
Non-Branch
*You are allowed one Purple Heart plate exempt from all annual fees. Would you like to claim this exemption for this vehicle?
Yes
No - I have already claimed the exemption on another vehicle or I do not wish to claim the exemption.
I certify, in applying for this license plate, that I am eligible for interment in the North Dakota Veterans' Cemetery, eligible to use
the emblem chosen above, and an owner of the vehicle described above.
Applicant's Signature
Date
The Purple Heart plate requires a signature for verification of eligibility from the county Veterans' Service Office or the State
Department of Veterans' Affairs.
County Veterans' Service Office or State Department Veterans' Affairs Signature
Date
You may choose a personalized plate not exceeding a total of five (5) characters and spaces. This request requires a fee of $25
per year in addition to the veteran plate fee and the annual registration fee.
PLEASE MAKE SURE ALL LETTERS ARE CAPITALIZED AND WRITTEN CLEARLY
First Choice:
Second Choice:
Meaning of Plate (Required)
Meaning of Plate (Required)
APPLICATION FOR NORTH DAKOTA
MOTOR VEHICLE DIVISION
ND DEPT OF TRANSPORTATION
VETERAN'S NUMBER PLATE
608 E BOULEVARD AVE
North Dakota Department of Transportation, Motor Vehicle
BISMARCK ND 58505-0780
Telephone (701) 328-2725
SFN 51628 (11-2018)
Fax (701) 328-1487
Website: https://dot.nd.gov
Applicant's Legal Name
Telephone Number
Mailing Address
City
State
ZIP Code
Title Number
Year and Make of Vehicle
Vehicle Identification Number
Current License Plate No.
North Dakota law allows individuals eligible for interment in the North Dakota Veterans' Cemetery to obtain special license plates.
To obtain the veteran number plate, an initial fee of $15 is due. Thereafter, an annual fee of $10 will be due in addition to the
regular license fee. Please complete this application and return to the Motor Vehicle Division with the $15 fee. You will be
assigned the next available number within our numbering scheme.
Please choose one of the following military service emblems:
Check One:
Air Force
Army
Coast Guard
Marines
Navy
Purple Heart*
Non-Branch
*You are allowed one Purple Heart plate exempt from all annual fees. Would you like to claim this exemption for this vehicle?
Yes
No - I have already claimed the exemption on another vehicle or I do not wish to claim the exemption.
I certify, in applying for this license plate, that I am eligible for interment in the North Dakota Veterans' Cemetery, eligible to use
the emblem chosen above, and an owner of the vehicle described above.
Applicant's Signature
Date
The Purple Heart plate requires a signature for verification of eligibility from the county Veterans' Service Office or the State
Department of Veterans' Affairs.
County Veterans' Service Office or State Department Veterans' Affairs Signature
Date
You may choose a personalized plate not exceeding a total of five (5) characters and spaces. This request requires a fee of $25
per year in addition to the veteran plate fee and the annual registration fee.
PLEASE MAKE SURE ALL LETTERS ARE CAPITALIZED AND WRITTEN CLEARLY
First Choice:
Second Choice:
Meaning of Plate (Required)
Meaning of Plate (Required)