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Fillable Printable Form CP-62.1 - Order Form for Personalized Plates - New York

Fillable Printable Form CP-62.1 - Order Form for Personalized Plates - New York

Form CP-62.1 - Order Form for Personalized Plates - New York

Form CP-62.1 - Order Form for Personalized Plates - New York

3. Motorcycle Organization Plates - Plate number will be computer generated.
If you want to personalize your Motorcycle Organization Plate, check the box for one
of the organizations below then use a maximum of 4 spaces for your personal choice.
Use a period (.) to indicate a blank space. The state silhouette cannot be used on a motorcycle plate.
The logo picture will appear on the left side of the plate. If the ISA is required, only 3 spaces are allowed.
1st ___ ___ ___ ___ 2nd ___ ___ ___ ___ 3rd ___ ___ ___ ___
Name as it appears on your current
registration (Last, First, Middle)
Mailing Address (Include
Number and Street)
Apt. #
City
State County ZIP
Date of Birth
/ /
Current Plate
Number
Vehicle Model
Year
Vehicle
Make
Has address changed in the last two years?
o Yes o No
oo
Male Female
Daytime Phone (include area code)
( )
Do your current plates have the
International Symbol of Access?
o Yes o No
If you need the International Symbol of Access on your new plates and you do not have it on your current plates,
you must also submit a completed form MV-664.1 or MV-400PH, which may be printed from the DMV web site.
5. Personalized Regional, Cause or Sports Picture Plates - Make your choice on page 2.
Circle class code: PAS COM. . . . . . . . . You will find the vehicle class code printed on the registration
sticker on your windshield or on the document itself.
The logo picture will appear on the left side of the plate, with a maximum of 6 spaces allowed. Use a period (.) to indicate a blank space.
The state silhouette cannot be used on these plates. If the ISA is required, only 5 spaces are allowed.
A maximum of 8 spaces is allowed. The state silhouette can be used ONE time as a divider within the plate number, but not at the beginning or end of the
number. The state silhouette cannot be used if the chosen plate number has no blank spaces remaining. Use the @ symbol to show where you want the
state silhouette to be on the plate and use a period (.) to indicate a space. All plate numbers will be centered on the plate unless you tell us to do otherwise.
If the ISA is required, only 6 spaces are allowed.
2. Personalized Motorcycle Plates - Verify vehicle class code as MOT on registration.
A maximum of 6 spaces is allowed. Use a period (.) to indicate a blank space. The state silhouette cannot be used on motorcycle plates.
All plate numbers will be centered on the plate unless you tell us to do otherwise.
1st ___ ___ ___ ___ ___ ___ 2nd ___ ___ ___ ___ ___ ___ 3rd ___ ___ ___ ___ ___ ___
If the ISA is required, only 5 spaces are allowed.
1. Personalized Plates
Circle class code: PAS COM TRC OMT OML HIF SPC TOW AGR CHC
NOTE:
l Plates are not ordered until we receive ALL required documents and fees.
l The next available number in the plate series will be assigned.
l Falsifying documents will result in cancellation of the custom plates.
l ALL custom plates are flat (that is, the letters/numbers are not raised). This allows more flexibility in plate designs.
l Plates will be mailed to the address on the vehicle’s registration file. If you have moved and you have not updated your
address on your registration record, please complete the change of address form (MV-232).
If you have any questions or need additional information, call us at (518) 402-4838 or visit our web site www.dmv.ny.gov
Complete and mail this form with your payment to the address shown below.
For faster service call 518-402-4838, or visit our web site www.dmv.ny.gov/cplates.htm anytime.
Do not use this form if you are interested in any of the plates in this box. Please refer to the proper form for ordering these plates.
Professional (use form MV-410) Emergency Services (use form MV-411) Military/Veteran (use form MV-412)
CP-62.1 (8/15)
PLATE SELECTION: In items 1, 2, 3 & 4, the word “SPACES” means any combination of numbers and letters, including blank spaces and the state
silhouette. You may provide up to 3 choices. Personalized plates cannot be all numbers, they must contain at least one letter. Plate numbers are assigned on a
first-come, first-served basis. DMV reserves the right to reject, recall or cancel any plate that is deemed objectionable. This includes plates that have already
been issued.
4. Standard Regional, Cause or Sports Picture Plates - Make your choice on page 2.
Circle class code: PAS COM. . . . . . . . . .You will find the vehicle class code printed on the registration
sticker on your windshield or on the document itself.
FEE: See Page 2
FEE: See Page 2
FEE: $60.00
FEE: $47.50
FEE: $35.00
FEE: $35.00
Please check one:
o AMA o BLUE KNIGHTS* (contact organization for approval 1-631-286-3361) o HOG* *Submit copy of current membership card.
PAGE 1 OF 2
__ __ __ __ __ __
__ __ __ __ __ __ __ __ __ __ __ __
1st
2nd 3rd
__ __ __ __ __ __ __ __
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
1st
2nd 3rd
ORDER YOUR NEW YORK STATE PERSONALIZED PLATES AND/OR
ORGANIZATION/CAUSE, SPORTS PICTURE PLATES OR REGIONAL PLATES TODAY!
TRL LTR SEM HOU
You will find the registration class code on the top left-hand side of your registration receipt or on your windshield sticker.
PERSONALIZED FEE:
$53.75
NASCAR Plates
FEE: Standard - $60.00, Personalized - $91.25
For details, call 518-402-4838 or visit www.dmv.ny.gov/cplates.htm
o NY Knicks - NBA
o Brooklyn Nets - NBA
CP-62.1 (8/15)
REGIONAL, CAUSE AND SPORTS PICTURE PLATE CHOICES (Please Check One)
Regional Plates
FEE: Standard - $60.00, Personalized - $91.25
Other Sports Plates
FEE: Standard - $60.00, Personalized - $91.25
Organization, College, University, Fraternity & Sorority Plates FEE: Varies
Please check our web site or call us for available choices and ordering instructions before sending this form.
Plate Choice :_________________________________________________________
Cause Plates
FEE: Standard - $53.75, Personalized - $85.00
o Saratoga/Cortez o Schenectady/Proctors Theater o Shelter Island o Tech Valley o Washington County
o Adirondacks
o Capital - Saratoga
o Catskills
o Central - Leatherstocking
o Chautauqua - Allegheny
o Finger Lakes
o Hudson Valley
o Long Island
o New York City
o Niagara Frontier
o 1000 Islands - Seaway
o Buffalo Bills - NFL
o NY Giants - NFL
o NY Jets - NFL
o NASCAR Driver
(EXAMPLE)
o New York Mets
o New York Yankees
o Birthplace of Baseball
FEE: Standard - $53.75, Personalized - $85.00
Major League Baseball Plates
FEE: Standard - $60.00, Personalized - $91.25
o Buffalo Bandits - Lacrosse
o Rochester Americans - Hockey
o Rochester Raging Rhinos-Soccer
o Buffalo Sabres - NHL
o NY Islanders - NHL
o NY Rangers - NHL
What county name (within the region selected above) do you want printed on this plate? _________________________
Current NY State Vehicle Plate Number _________________________
PAGE 2 OF 2
NASCAR Driver’s Name______________________________________
NASCAR Driver’s Number ___________________________
o NASCAR Fan
For a complete listing, visit
www.dmv.ny.gov/cplates.htm or call 518-402-4838.
Payment Method:
o Check o Money Order o MasterCard o Visa o Discover o American
Express
Name (as it appears on credit card)_______________________________________________
Credit Card Number _______________________________________________ Expiration Date ________________________________
Authorized Signature -_____________________________________ Daytime Phone No: ____________________________
Please do not send cash! Make check or money order payable to the “Commissioner of Motor Vehicles”. Please allow 4 to 6 weeks for
delivery. When renewing, the additional custom plate fee will be added to your vehicle registration renewal fee.
IMPORTANT: Making a false statement in any registration application or in any proof or statements in connection with it, or deceiving
or substituting in connection with this application, is a misdemeanor under Section 392 of the Vehicle and Traffic Law, and may also result
in the revocation or suspension of the registration and/or the applicant’s license pursuant to regulations established by the Commissioner.
Return completed form and payment to: DMV Custom Plates Unit, PO Box 2775, Albany NY 12220
Amount Enclosed
$_____________
o Drive Out Diabetes
o Erie Canal
o Keep Kids Drug Free
o Life Pass It On
o Love Your Library
o Marine & Coastal District
o National Multiple Sclerosis Society
o New York State Cultural Institutions
and Museums
o Our Best Friends
o Peace At Home
o State of the Arts
o Agriculture in the Classroom
o Autism Society of America
o Bluebird Environmental
o Conserve Habitat
o Discover Queens
o Drive for the Cure
o New York Yankees 2009 World Series Champions
o Brooklyn Dodgers
o NY Giants Super Bowl Champs - NFL
o NYS Fair
Standard - $43.75
Personalized - $75.00
o INEW YORK
Standard - $43.75
Personalized - $75.00
o Olympic Spirit
Standard - $48.75
Personalized - $80.00
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