Fillable Printable Application For Star Of Texas License Plate

Application For Star Of Texas License Plate

Application for the

Star of Texas Award

License Plate

Department Use Only

License No __________________

Mo/Yr of Exp

Date Issued

Instructions

The Star of Texas Award, issued by the Texas Governor’s Office, honors first responders (peace officers, firefighters, or emergency medical

personnel) and others who assist first responders that are seriously injured or killed in the line of duty. Proof of eligibility includes a copy of the

Star of Texas !ward certificate or letter from the Governor’s Office.

Submit the completed application; payment in the form of a personal check, money order, or cashier’s check; and proof of eligibility that you are a

recipient of the Star of Texas Award to your local county tax assessor-collector’s office. There is no specialty plate fee; however, your annual

registration fee must be paid. Do not mail cash. The license plate may be personalized for an additional fee (see below). Personalization fees will

not be refunded once the application is submitted. Contact your county tax assessor-collector if you have questions.

NOTE: When the specialty plate is issued, additional fees may be collected to establish a single expiration date for both the new specialty plate

and the vehicle registration. If you order online or by mail, please contact your county tax assessor-collector’s office in three weeks to verify your

plate is ready for issuance.

Applicant Information

First Name

Middle Name

Last Name

Suffix (if any)

Address

City

State

ZIP

County

Phone Number

Vehicle Information

Vehicle Identification Number

Current TX Plate

Year

Make

Body Style

Empty Weight (lbs.)

Vehicle Type: Passenger cars and trucks (up to 18,000 lbs.), motorcycles, and trailers

 Passenger Car  Truck  Motorcycle / Moped  Trailer

Personalize Your Plate – To personalize your specialty plate, there will be an additional $40 fee per year.

Show selection(s) exactly as you want them to appear on your license plate(s). You may list more than one option in the event the personalization

you have chosen is already issued.

 A selection that has already been issued, is deemed offensive, or conflicts with the regular license plate numbering system cannot be

approved.

 In the blocks below, describe each of your selected personalized letters, numbers, and/or symbols. The available symbols include: a

period, a dash, a blank space, a Texas silhouette (use an asterisk “*“ to indicate), a heart (use an at “@” to indicate), and a star (use an

ampersand “&” to indicate).

 Passenger car, truck, and trailer plates are limited to six (6) characters total, including the International Symbol of Access or punctuation

characters.

 Motorcycle/moped plates are limited to four (4) characters total.

 The International Symbol of Access “ ” counts as two (2) characters. If you are disabled and applying for personalized specialty

plates, use a percent sign “%” to indicate the International Symbol of Access.

Personalization fee will not be refunded once the application is submitted.

Selection 2

Selection 3

Selection

International Symbol of Access

To display the International Symbol of Access on your license plate, attach a signed Application for Persons with Disabilities Parking Placard

and/or License Plate (Form VTR-214) to this application to show your eligibility. Contact your county tax assessor-collector’s office if you have

questions.

Certification – State law makes falsifying information a third degree felony

I certify I am a recipient of the Governor’s Star of Texas !ward, and my signature indicates the information above is correct.

__________________________________________________________________________ ______________________________

Signature Date

VTR-101 Rev 09/17 Form available online at www.TxDMV.gov