Fillable Printable Plates Mvr27Sm
Fillable Printable Plates Mvr27Sm
Plates Mvr27Sm
North Carolina Division of Motor Vehicles
3155 Mail Service Center
Raleigh, North Carolina 27697-3155
APPLICATION FOR
FRIENDS OF THE GREAT SMOKY MOUNTAINS
NATIONAL PARK
Remit a $30.00/$60.00 check or money order with this application.
qRegular Great Smoky Mountains National Park $30.00
qPersonalized Great Smoky Mountains National Park$60.00
The $30.00/$60.00 special fee is an (ANNUAL) fee due in addition to the regular license fee.
NAME (To agree with certificate of title)
FIRSTMIDDLELAST
ADDRESS
CITYSTATEZIP CODE
Current North Carolina
PLATE NUMBERVEHICLE IDENTIFICATION NUMBER
DRIVER LICENSE #YEARMODELMAKEBODY STYLE
MVR-27 SM
(Rev. 9/17)
Home
AREA CODE–TELEPHONE NUMBER
Office
AREA CODE–TELEPHONE NUMBER
Owner's Certification of Liability Insurance
I CERTIFY FOR THE MOTOR VEHICLE DESCRIBED ABOVE THAT I HAVE FINANCIAL RESPONSIBILITY AS REQUIRED BY LAW.
PRINT OR TYPE FULL NAME OF INSURANCE COMPANY AUTHORIZED IN N.C. – NOT AGENCY OR GROUP
POLICY NUMBER – IF POLICY NOT ISSUED, NAME OF AGENCY BINDING COVERAGE
SIGNATURE OF OWNERDATE OF CERTIFICATION
LICENSE PLATE
NOTE: You are allowed four (4) spaces for a personalized message. ___ ___ ___ ___
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