Fillable Printable Application For Replacement Plate And/Or Sticker

Application For Replacement Plate And/Or Sticker

North Carolina Division of Motor Vehicles

3148 Mail Service Center

Raleigh, NC 27697-3148

Application for Replacement Plate and/or Sticker

MVR-18 (Rev. 7/17)

VEHICLE SECTION

YEAR MAKE BODY STYLE SERIES MODEL VEHICLE IDENTIFICATION NUMBER

OWNER SECTION

Owner 1 ID# ___________________ ________________________________________________________________________________________

Full Legal Name of Owner 1 (First, Middle, Last, Suffix) or Company Name

Owner 2 ID# ___________________ ________________________________________________________________________________________

Full Legal Name of Owner 2 (First, Middle, Last, Suffix) or Company Name

Residence Address (Individual) Business Address (Firm)

City and State Zip Code Tax County

Mail Address (If different from above)

I certify for the motor vehicle described above that I have financial responsibility as required by law.

__________________________________________________________________________________ _______________________________________________________________________

Insurance company authorized in N.C. Policy Number

Plate # being replaced _________________________

Sticker # being replaced _______________________

__________________________________________________________________________________________________________________

REASON FOR REPLACEMENT PLATE AND/OR STICKER

Check applicable block below

If the registration plate is mutilated, faded or rusted, or if an incorrect sticker has been attached, the plate must be returned with this application. If the sticker is mutilated,

defective or for the incorrect year or month, same must be attached in the upper left corner of this application.



 Lost



 Mutilated



 Rusted



 Incorrect year sticker



 Stolen



 Faded



 Defective Sticker



 Other _________________________

I, the owner(s) of the vehicle described on this application, do hereby certify that the registration plate, the year sticker, the month sticker or all as identified in this applica-

tion has/have not been taken up by an enforcement officer and that I am entitled to a replacement of same as provided by law. I further certify there has been no registration

plate revocation and I have, as of this date, financial responsibility as required by law covering the vehicle as described.

Signature of owner(s) _________________________________________________________________________________________

Date ____________________________ County __________________________________________________________________ State __________________

I certify that the following person(s) personally appeared before me this day, each acknowledging to me that he or she voluntarily signed the foregoing document for the

purpose stated therein and in the capacity indicated: _____________________________________________________________________________ (name(s) of principal(s)).

Notary Notary Printed

Signature ____________________________________________________________ or Typed Name ______________________________________________________

(SEAL)

My Commission Expires ______________________________________________