Form MVR-27PP-A "Application for a New Special License Plate Category" - North Carolina

What Is Form MVR-27PP-A?

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 August 1, 2019;
  • 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 fillable version of Form MVR-27PP-A 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-27PP-A "Application for a New Special License Plate Category" - North Carolina

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MVR-27PP-A (08/19)
APPLICATION FOR A NEW SPECIAL LICENSE PLATE CATEGORY
NAME OF ORGANIZATION: _________________________________________________________________________________
NAME OF CONTACT PERSON FOR ORGANIZATION: ___________________________________________________________
ADDRESS OF CONTACT PERSON: ____________________________________________________________________________
PHONE NUMBER(S): (
) __________________________________________________________________________________
Application Process:
1. FORM MVR-27PP-A MUST BE SUBMITTED TO THE ORGANIZATION PRIOR TO FEBRUARY 15 OF THE CURRENT LEGISLATIVE
YEAR. THIS SHOULD INCLUDE THE ADDITIONAL PROPOSED FEE FOR THE PLATE TO BE CONSIDERED FOR LEGISLATIVE
APPROVAL.
2. IF THE PLATE IS NOT AUTHORIZED BY LEGISLATION, DMV WILL REFUND THE FEES COLLECTED TO THE
ORGANIZATION.
____________________________________________________________________________________________________________________________________
PLEASE REMIT THIS APPLICATION WITH THE PAYMENT OF THE STANDARD SPECIAL PLATE FEE TO THE
ORGANIZATION. THERE IS AN ADDITIONAL $30.00 FEE FOR PERSONALIZED PLATE REQUESTS. ALL FEES MUST BE
MADE PAYABLE TO THE ORGANIZATION
.
ANY REFUND REQUESTS MADE BY POTENTIAL PURCHASERS IS THE RESPONSIBILITY OF THE PERSON, ORGANIZATION,
OR LEGAL ENTITY SEEKING THE PLATE, NOT THE NCDMV.
STANDARD SPECIAL PLATE FEE:
$______________
_________ FIRST IN FLIGHT BACKGROUND
PERSONALIZED PLATE FEE:
$______________
_________ FIRST IN FREEDOM BACKGROUND
_________ NATIONAL/STATE MOTTO BACKGROUND
TOTAL FEES REMITTED:
$______________
_________ COLOR BACKGROUND W/WHITE BOX
WHEN APPLYING FOR A PERSONALIZED LICENSE PLATE, THE PREFIX OR SUFFIX ASSIGNED WILL BE THE FIRST OR
LAST LETTER(S) ON THE PLATE. THIS LEAVES ONLY FOUR (4) SPACES FOR A PERSONALIZED MESSAGE. THE FOUR
SPACES MAY BE A COMBINATION OF LETTERS AND NUMBERS BUT CANNOT BE NUMBERS ONLY OR CONFLICT
WITH ANOTHER CLASSIFICATION OF LICENSE PLATES.
NOTE: YOU ARE ALLOWED FOUR (4) SPACES FOR A PERSONALIZED MESSAGE: ____ ____ ____ ____
ND
ST
2
OPTION IF 1
CH0ICE IS NOT AVAILABLE: ____ ____ ____ ____
NAME (To agree with certificate of title)
_________________________________________________________________
(H)________________________________
FIRST
MIDDLE
LAST
AREA CODE-TELEPHONE NUMBER
(C)________________________________
________________________________________________________________
AREA CODE-TELEPHONE NUMBER
ADDRESS
____________________________
________________________________________________________________
NC PLATE NUMBER
CITY
STATE
ZIP CODE
_____________________________
DRIVER LICENSE #
_______________________________________
________________________________________
YEAR
MODEL
MAKE BODY STYLE
VEHICLE IDENTIFICATION NUMBER
___________________________________________________________________________________________________________________________
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
________________________________________________
__________________________________________
SIGNATURE OF OWNER
DATE OF CERTIFICATION
_ _
MVR-27PP-A (08/19)
APPLICATION FOR A NEW SPECIAL LICENSE PLATE CATEGORY
NAME OF ORGANIZATION: _________________________________________________________________________________
NAME OF CONTACT PERSON FOR ORGANIZATION: ___________________________________________________________
ADDRESS OF CONTACT PERSON: ____________________________________________________________________________
PHONE NUMBER(S): (
) __________________________________________________________________________________
Application Process:
1. FORM MVR-27PP-A MUST BE SUBMITTED TO THE ORGANIZATION PRIOR TO FEBRUARY 15 OF THE CURRENT LEGISLATIVE
YEAR. THIS SHOULD INCLUDE THE ADDITIONAL PROPOSED FEE FOR THE PLATE TO BE CONSIDERED FOR LEGISLATIVE
APPROVAL.
2. IF THE PLATE IS NOT AUTHORIZED BY LEGISLATION, DMV WILL REFUND THE FEES COLLECTED TO THE
ORGANIZATION.
____________________________________________________________________________________________________________________________________
PLEASE REMIT THIS APPLICATION WITH THE PAYMENT OF THE STANDARD SPECIAL PLATE FEE TO THE
ORGANIZATION. THERE IS AN ADDITIONAL $30.00 FEE FOR PERSONALIZED PLATE REQUESTS. ALL FEES MUST BE
MADE PAYABLE TO THE ORGANIZATION
.
ANY REFUND REQUESTS MADE BY POTENTIAL PURCHASERS IS THE RESPONSIBILITY OF THE PERSON, ORGANIZATION,
OR LEGAL ENTITY SEEKING THE PLATE, NOT THE NCDMV.
STANDARD SPECIAL PLATE FEE:
$______________
_________ FIRST IN FLIGHT BACKGROUND
PERSONALIZED PLATE FEE:
$______________
_________ FIRST IN FREEDOM BACKGROUND
_________ NATIONAL/STATE MOTTO BACKGROUND
TOTAL FEES REMITTED:
$______________
_________ COLOR BACKGROUND W/WHITE BOX
WHEN APPLYING FOR A PERSONALIZED LICENSE PLATE, THE PREFIX OR SUFFIX ASSIGNED WILL BE THE FIRST OR
LAST LETTER(S) ON THE PLATE. THIS LEAVES ONLY FOUR (4) SPACES FOR A PERSONALIZED MESSAGE. THE FOUR
SPACES MAY BE A COMBINATION OF LETTERS AND NUMBERS BUT CANNOT BE NUMBERS ONLY OR CONFLICT
WITH ANOTHER CLASSIFICATION OF LICENSE PLATES.
NOTE: YOU ARE ALLOWED FOUR (4) SPACES FOR A PERSONALIZED MESSAGE: ____ ____ ____ ____
ND
ST
2
OPTION IF 1
CH0ICE IS NOT AVAILABLE: ____ ____ ____ ____
NAME (To agree with certificate of title)
_________________________________________________________________
(H)________________________________
FIRST
MIDDLE
LAST
AREA CODE-TELEPHONE NUMBER
(C)________________________________
________________________________________________________________
AREA CODE-TELEPHONE NUMBER
ADDRESS
____________________________
________________________________________________________________
NC PLATE NUMBER
CITY
STATE
ZIP CODE
_____________________________
DRIVER LICENSE #
_______________________________________
________________________________________
YEAR
MODEL
MAKE BODY STYLE
VEHICLE IDENTIFICATION NUMBER
___________________________________________________________________________________________________________________________
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
________________________________________________
__________________________________________
SIGNATURE OF OWNER
DATE OF CERTIFICATION