Disabled Veteran License Plates Request Form - Illinois

This "Disabled Veteran License Plates Request Form" is a Illinois-specific form released by the Illinois Secretary of State on January 1, 2013.

Download the form by clicking the link below, fill it out by hand, and mail it as per the guidelines provided by the department or the applicable legal instructions.

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Secretary of State
Disabled Veteran License Plates
Request Form
Secretary of State
This request may only be processed
Vehicle Services Department
in the Springfield office.
Special Plates Division, Rm. 541
D
501 S. Second St.
Disabled Veteran plates
V
Springfield, IL 62756-5100
also may be requested through
217-785-4175
Pick-a-Plate at www.cyberdriveillinois.com.
www.cyberdriveillinois.com
Disabled Veteran License Plates may be issued at no cost for the first set of plates to any U.S. Armed Forces Veteran if 1) the
veteran holds proof of a service-connected disability from the United States Department of Veterans’ Affairs and 2) a licensed
physician has certified that because of the service-connected disability the veteran qualifies for issuance of a disabled parking
placard or plate. Applicants who do not have this information may contact: Illinois Department of Veterans’ Affairs, 883 S.
Spring St., Springfield, IL 62704 and their VA medical center.
Disabled Veteran plates are multi-year and may be displayed on passenger vehicles, trucks and vans weighing 8,000 pounds
or less. Vehicles displaying Disabled Veteran plates may park in spaces reserved for persons with disabilities. The disabled vet-
eran must be present and must enter or exit the vehicle at the time the parking privileges are being used. Parking meter fees
and time limitations also are waived, except at meters, signs or other markings with time limitations of 30 minutes or less.
To request Disabled Veteran License Plates, please submit the appropriate request form along with your license plates regis-
tration or renewal application, the required military documentation and the following applicable fees to the address above.
Random-Number Disabled Veteran License Plates
• Newly-acquired vehicle/first-time issuance — $95-first set of plates ($95 title fee, no registration fee); $196-second set
of plates ($95 title fee, $101 registration fee)
• Currently titled vehicle/first-time issuance — No fee-first set of plates; $101-second set of plates ($101 registration fee)
• Current plates expire within 90 days — $29-first set of plates ($29 replacement fee); $130-second set of plates ($101
registration fee*, $29 replacement fee)
• Current plates do not expire within 90 days — $29-first and second set of plates ($29 replacement fee)
• Annual renewal — No fee-first set of plates; $101-second set of plates ($101 registration fee)
Note: Switching from current random-number Disabled Veteran plates to vanity and/or personalized Disabled
Veteran plates requires a $29 replacement fee. *Registration fee may vary based on current registration.
Vanity Disabled Veteran License Plates
Same fees as Random-Number Plates. No vanity fees required.
Personalized Disabled Veteran License Plates
Same fees as Random-Number Plates. No personalized fees required.
Printed by authority of the State of Illinois. January 2013 — VSD 756.3
Secretary of State
Disabled Veteran License Plates
Request Form
Secretary of State
This request may only be processed
Vehicle Services Department
in the Springfield office.
Special Plates Division, Rm. 541
D
501 S. Second St.
Disabled Veteran plates
V
Springfield, IL 62756-5100
also may be requested through
217-785-4175
Pick-a-Plate at www.cyberdriveillinois.com.
www.cyberdriveillinois.com
Disabled Veteran License Plates may be issued at no cost for the first set of plates to any U.S. Armed Forces Veteran if 1) the
veteran holds proof of a service-connected disability from the United States Department of Veterans’ Affairs and 2) a licensed
physician has certified that because of the service-connected disability the veteran qualifies for issuance of a disabled parking
placard or plate. Applicants who do not have this information may contact: Illinois Department of Veterans’ Affairs, 883 S.
Spring St., Springfield, IL 62704 and their VA medical center.
Disabled Veteran plates are multi-year and may be displayed on passenger vehicles, trucks and vans weighing 8,000 pounds
or less. Vehicles displaying Disabled Veteran plates may park in spaces reserved for persons with disabilities. The disabled vet-
eran must be present and must enter or exit the vehicle at the time the parking privileges are being used. Parking meter fees
and time limitations also are waived, except at meters, signs or other markings with time limitations of 30 minutes or less.
To request Disabled Veteran License Plates, please submit the appropriate request form along with your license plates regis-
tration or renewal application, the required military documentation and the following applicable fees to the address above.
Random-Number Disabled Veteran License Plates
• Newly-acquired vehicle/first-time issuance — $95-first set of plates ($95 title fee, no registration fee); $196-second set
of plates ($95 title fee, $101 registration fee)
• Currently titled vehicle/first-time issuance — No fee-first set of plates; $101-second set of plates ($101 registration fee)
• Current plates expire within 90 days — $29-first set of plates ($29 replacement fee); $130-second set of plates ($101
registration fee*, $29 replacement fee)
• Current plates do not expire within 90 days — $29-first and second set of plates ($29 replacement fee)
• Annual renewal — No fee-first set of plates; $101-second set of plates ($101 registration fee)
Note: Switching from current random-number Disabled Veteran plates to vanity and/or personalized Disabled
Veteran plates requires a $29 replacement fee. *Registration fee may vary based on current registration.
Vanity Disabled Veteran License Plates
Same fees as Random-Number Plates. No vanity fees required.
Personalized Disabled Veteran License Plates
Same fees as Random-Number Plates. No personalized fees required.
Printed by authority of the State of Illinois. January 2013 — VSD 756.3
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Random-Number Disabled Veteran License Plates Request Form
Name _____________________________________________________________________________________________
Address ___________________________________________________________________________________________
City/State/ZIP_______________________________________________________________________________________
Telephone Number___________________________________________________________________________________
License Plate Number________________________________________Expiration Date ____________________________
❏ Passenger
❏ B-Truck
Type of Plate
Vanity & Personalized Disabled Veteran License Plates Request Form
Vehicle Owner’s Name
Address
OFFICE USE ONLY
City
State
ZIP
Daytime Telephone Number (8 a.m. - 4:30 p.m.)
Current License Plate #
Expiration Date
1st choice
2nd choice
3rd choice
❏ Yes
❏ No
If your exact 1st, 2nd and 3rd choices are not available, would you like the next plate number available in that series?
If you want a space between letters, please indicate with a slash mark. An automatic space is required between letters and numbers.
Vanity Disabled Veteran Plates
Personalized Disabled Veteran Plates
A B C D
examples
A B C
1
Numbers 1-999
1 or 2 letters plus 1-99
or
or
Note: 4-letter Disabled Veteran plates cannot have a space. Spacing will vary with the type of plate requested.
1, 2, 3 or 4 letters
3 letters plus 1-9
Proper completion of this form is the customer’s responsibility.
Vanity/Personalized License Plates
• No refund or adjustment will be made for a change of choice or spacing after a plate has been ordered or if the request
form is incorrectly completed.
• The Secretary of State’s office is authorized to recall a plate determined to be obscene or offensive.
• All request forms should indicate whether you want the Secretary of State to assign one of your choices with the next
available number if your exact request is unavailable.
• If you wish to submit more than three requests, attach additional selections to the request form.
DO NOT
• Intermix letters and numbers
• Use a space between numbers
• Use lowercase letters
• Use characters, symbols, foreign words or symbols of punctuation, such as dashes or periods
• Select obscene or offensive combinations
First-Time Registrations
• Money must accompany request forms on all first-time registrations.
• A leased vehicle is eligible for vanity or personalized plates.
Printed by authority of the State of Illinois. January 2013 — VSD 756.3

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