Fillable Printable Military License Plate Application
Fillable Printable Military License Plate Application
Military License Plate Application
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Military License Plate Application
Military members, veterans, and spouses or family members can apply for a military license plate. For fee information,
contact any vehicle licensing office or visit dol.wa.gov.
To get service award or veterans remembrance emblems use form TD-420-075, Veteran/Military Service Award
Emblem Application.
Step 1 – Owner/Vehicle Information
PRINT or TYPE Name of registered owner Claim # or Social Security # (DAV applicants only)
Mailing address (Street address or PO Box, City, State, ZIP code)
(Area code) Daytime telephone Email
Current Washington license plate Tab expiration: Month/Year Vehicle Identification Number (VIN) Year Make
Vehicle plate type
Car or truck Motorcycle Trailer plate – large Trailer plate – small
Step 2 – Select a Plate
Attach required documents and applicable fees in a check or money order, payable to Department of Licensing.
• Plates available from Special Plate Unit
(mail only) – Send to: Special Plate Unit, Dept of Licensing,
PO Box 9909, Olympia, WA 98507-8500
• Plates available at vehicle licensing offices – Take or mail this form to any vehicle licensing office
Plates with an * are not available as trailer plates.
Plate type
What supporting documents
do I need to provide?
Where can I
get the plate?
Can I
personalize
the plate?
Gold Star* Tab only
Letter from Dept of Veteran Affairs
(dva.wa.gov)
Special Plate Unit Ye s
Medal of Honor*
DD214 or letter from Dept of Veteran Affairs Special Plate Unit No
Disabled American veteran* Tab only
Rating letter from Dept of Veteran Affairs Special Plate Unit No
Former prisoner of war* Tab only
DD214 or letter from Dept of Veteran Affairs Special Plate Unit No
Purple Heart*
Copy of DD214 Special Plate Unit Ye s
Military Affiliate Radio System* (MARS)
Copy of MARS license Special Plate Unit No
Pearl Harbor survivor*
Copy of DD214
Vehicle licensing
office
No
Complete this section ONLY if applying for an Armed Forces plate
Armed forces – U.S. flag background
(select branch and free decal below)
Copy of DD214, military ID, or signed
Declaration of Fact (see Step 3)
Vehicle licensing
office
Ye s
Branch shown on plate – Armed forces plate ONLY (select one)
Army Navy Air Force Marines Coast Guard National Guard
Free decal – Armed forces plate ONLY (select one)
Veteran Disabled veteran Army retired Retired Army Guard Active duty
Air Guard Fallen hero Reserves Gold Star Family
Step 3 – Declaration of Fact
I certify that I am eligible for a military license plate because I am:
Veteran Active duty military Family member of a deceased veteran
Reservist National Guard member Family member of a qualified veteran or military member
Date and place (city or county) signed Applicant signature
TD-420-500 (R/7/17)WA Page 1 of 2
Click here to START or CLEAR, then hit the TAB button
Print completed form; sign and date here.
WASHINGTON
MONTH YEAR
TAB TAB
EVERGREEN STATE
WASHINGTON
MONTH YEAR
TAB TAB
EVERGREEN STATE
WASHINGTON
MONTH YEAR
TAB TAB
EVERGREEN STATE
Step 4 – Personalized Plate (complete ONLY if requesting a personalized plate)
Personalized plate instructions
• Check to see if your plate is available at dol.wa.gov. Certain letter and number combinations are not allowed.
• List plate choice in order of preference.
• Characters:
• You can use letters, numbers, dashes, or spaces. You cannot use unusual characters: #, %, &, @, etc. Spaces and
dashes are considered characters; leave a box empty to indicate a space.
• Clearly show the letter or number characters “I,” “1,” “O,” or “0” (zero). Because of similarities with “I” or “1” and “O” or
“0” (zero), we treat them as the same. If one version already exists, you won’t be able to use the other. For example,
ROOT = R00T and SING = S1NG.
• Enter the meaning of the plate
• Unacceptable plates include those which may be: sexual or vulgar in nature; blasphemous; misleading; related to illegal
substances; implying ethnic, lifestyle, or gender slurs; or are contrary to our mission to promote highway safety.
• Complaints may result in the cancellation of a personalized plate.
• We will make the plate exactly as indicated on the application.
• Allow at least 8 weeks to receive your plates.
Standard-size plates have 1–7 characters; motorcycle and small trailer plates have 1–6 characters.
Plate choices
1.
Meaning:
2.
Meaning:
3.
Meaning:
Step 5 – Disabled Parking Privilege
If you also require disabled parking privileges, complete the Disabled Parking Application for Individuals
(form TD-420-073).
Mail the following to the Special Plate Unit:
• Completed Military License Plate Application and required documents
• Completed Disabled Parking Application for Individuals
• Signed authorization from your healthcare provider
• Applicable fees in a check or money order, payable to Department of Licensing
Special Plate Unit
Department of Licensing
PO Box 9909
Olympia, WA 98507-8500
NOTE: You may have other disabled parking options, contact Customer Service at (360) 902-3770 for additional
information.
NOTE FOR GOLD STAR TAB ONLY: If you are a widow/widower, you have the option of using on a new or existing plate.
Contact Customer Service at (360) 902-3770 for additional information.
RCW 41.04.005, .007; 46.18
TD-420-500 (R/7/17)WA Page 2 of 2
