Fillable Printable Vtr 420 Application For Military Veteran License Plates
Fillable Printable Vtr 420 Application For Military Veteran License Plates
Vtr 420 Application For Military Veteran License Plates
Application for
Military Service
License Plates
For County Use Only
License No
Mo/Yr of Exp
Date Issued
Instructions
Submit the completed application; payment (if required) in the form of a personal check, money order, or cashier’s check; and
proof of eligibility to your local county tax assessor-collector’s office. There is no specialty plate fee.
Your annual registration fee must be paid to your local county tax assessor-collector when your plates are issued. 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. The license plates may be personalized for an additional $40 fee; make your choice on page 2.
Do not mail cash. The personalization fee will not be refunded once the application is submitted.
If you order by mail, please contact your county tax assessor-collector’s office in three weeks to verify your plates are ready for
issuance. Contact your county tax assessor-collector if you have questions.
Applicant Information
First Name Middle Name Last Name Suffix County
Mailing Address
City
State
ZIP
Email
Phone Number
Vehicle 1
Vehicle Identification Number
Current TX Plate
Year
Make
Body Style
Empty Weight (lbs.)
Passenger Car Truck (up to 18,000 lbs.) Motorcycle/Moped Trailer
Vehicle 2
Vehicle Identification Number Current TX Plate Year Make Body Style
Empty Weight (lbs.)
Passenger Car Truck (up to 18,000 lbs.) Motorcycle/Moped Trailer
General Requirements
•
Texas title and vehicle registration must be in yourname.
•
If the plate is to be registered to a vehicle that is not titled in your name, attach a statement to this application stating
that you have legal right of possession and control of this vehicle at all times.
•
If you recently filed an application for title, attach a copy of the title application receipt (VTR-500-RTS).
•
Joint vehicle ownership between you and a spouse is permissible.
•
Submit a separate application for more than two vehicles.
•
If the vehicle is leased, attach a copy of the lease agreement.
•
Vehicle is for personal use only.
Certification
– State law makes falsifying information a third degree felony.
I meet the eligibility requirements as listed on page 3 of this application and am providing proof to that effect.
Signature Date
Form VTR-420 Rev. 9/2017 Page 1 of 3
Form available online at www.TxDMV.gov
Plate Type
– All plates are available for passenger cars and trucks (up to 18,000 lbs.). Plates available for motorcycles/mopeds
are indicated by (M); plates available for trailers are indicated by (T).
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Armored Cavalry Regiment (M) (T) Korea Veteran – National Defense Service Medal
Armed Forces Expeditionary Medal (M) (T) Kosovo Campaign Medal (M) (T)
Armed Forces Service Medal (M) (T) Marine Corps League
Combat Action Badge (M) (T) Marine Corps Expeditionary Medal (M) (T)
Combat Action Medal (M) (T) Merchant Marine Expeditionary Medal (M) (T)
Combat Action Ribbon, Coast Guard (M) (T) Military Outstanding Volunteer Service Medal (M)(T)
Combat Action Ribbon, Navy & Marines (M) (T) National Defense Service Medal, Desert Shield/Storm(M) (T)
Combat Infantryman’s Badge (M) (T) National Defense Service Medal, Korea (M) (T)
Combat Medical Badge (M) (T) National Defense Service Medal, Vietnam (M) (T)
Commendation Medal, Army (M) (T) Navy Expeditionary Medal (M) (T)
Commendation Medal, Air Force (M) (T) Operation Iraqi Freedom (M) (T)
Commendation Medal, Coast Guard (M) (T) Operation Enduring Freedom Afghanistan (M)
Commendation Medal, Joint Service (M) (T) Southwest Asia Service Medal, Desert Shield/Storm(M) (T)
Commendation Medal, Navy & Marines (M) (T) Tomb Guard (M) (T)
Commendation Medal with Valor, Army (M) (T) U.S. Air Force Academy (M)
Commendation Medal with Valor, Air Force (M) (T) U.S. Coast Guard Academy (M)
Commendation Medal with Valor, Coast Guard (M) (T) U.S. Merchant Marine Academy (M)
Commendation Medal with Valor, Joint Service (M) (T) U.S. Military Academy – West Point (M)
Commendation Medal with Valor, Navy & Marines (M) (T) U.S. Naval Academy (M)
Enduring Freedom (M) U.S. Paratrooper (M)
Global War on Terrorism Expeditionary Medal (M) (T) Vietnam Veteran – National Defense Service Medal (M)
Global War on Terrorism Service Medal (M) (T) Vietnam Service Medal (M) (T)
Inherent Resolve Campaign Medal (M) (T) Woman Veteran (M)
Korean Defense Service Medal (M) (T) World War II Veteran
Korean Service Medal (M) (T)
Personalize Your Plate – If you would like to personalize your specialty plate, there will be a $40 fee per year
in addition to the annual registration fee (if required).
Personalization fee will not be refunded once the application is submitted.
1
st
Choice 2
nd
Choice 3
rd
Choice
Vehicle 1
Vehicle 2
•
Show personalizations 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 has been issued.
•
A personalization that has been issued, is deemed offensive, or conflicts with the regular license plate numbering
system cannot be approved.
•
Enter your desired personalized letters, numbers, and/or symbols in the blocks below. 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 punctuation characters.
•
U.S. Paratrooper plates for cars and trucks are limited to five (5) characters total due to the plate design.
•
Motorcycle/moped plates are limited to four (4) characters total, including punctuation characters.
•
The International Symbol of Access “ ”counts as two (2) characters and will be located at the beginning of the
plate number. If you are disabled and applying for personalized specialty plates, use a percent “%” to indicate the
International Symbol of Access.
Form VTR-420 Rev. 9/2017
Form available online at www.TxDMV.gov
Page 2 of 3
F
of 3
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.
Eligibility Requirements
•
Active members must provide a copy of their military ID and proof they served as indicated or are a recipient of the
medal being applied for, such as an Officer Record Brief or Enlisted Record Brief.
•
Former members must provide proof of their honorable discharge and they served as indicated, or are a recipient of the
medal being applied for, such as aDD214.
World War II: You served in the U.S. or Allied Armed Forces during World War II.
Korea: You served in:
•
the Armed Forces between June 27, 1950, and July 27, 1954, and received the National Defense Service Medal;
•
a combat zone in Korea between June 27, 1950, and July 27, 1954, and received the Korean Service Medal; or
•
the Korean Demilitarized Zone beginning July 28, 1954, and received the Korean Defense Service Medal.
Vietnam: You served in:
•
the Armed Forces between January 1, 1961, and August 14, 1974, and received the National Defense Service
Medal; or
•
a combat zone in the Republic of Vietnam between July 1, 1958, and March 28, 1973, and received the
Vietnam Service Medal.
Desert Shield or Desert Storm: You served in:
•
the Armed Forces between Aug. 2, 1990, and Nov. 30, 1995, and received the National Defense Service Medal;
or
•
a combat zone in support of Operation Desert Shield or Desert Storm between August 2, 1990, and
November 30, 1995, and received the Southwest Asia Service Medal.
Enduring Freedom: You participated in Operation Enduring Freedom.
Operation Enduring Freedom Afghanistan: You participated in Operation Enduring Freedom Afghanistan.
Operation Iraqi Freedom: You participated in Operation Iraqi Freedom.
Marine Corps League: You are a member of the Marine Corps League or its Auxiliary.
Military Academies: You graduated from the listed academy.
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Armored Cavalry Regiment: You serve or have served in the 11th Armored Cavalry Regiment of the U.S. Army.
Tomb Guard: You serve or have served in the Third United States Infantry Regiment as a guard for the Tomb of the
Unknown Soldier and are awarded the Guard, Tomb of the Unknown Soldier Identification Badge.
U.S. Paratrooper: You passed proficiency tests while attached to an airborne unit, the Airborne Department of the U.S.
Army Infantry School, or participated in at least one combat parachute jump.
Woman Veteran: You are a female active or former member with honorable discharge from the U.S. Armed Forces,
Texas National Guard, or Texas State Guard (use Form VTR-139 for Texas Army National Guard, Texas Air National Guard,
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Infantry Guard, or Texas State Guard plates).
Form VTR-420 Rev. 9/2017 Form available online at www.TxDMV.gov
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