Fillable Printable Vtr 423 Application For Gold Star License Plates
Fillable Printable Vtr 423 Application For Gold Star License Plates
Vtr 423 Application For Gold Star License Plates
Application for
Gold Star
Licen se Plate s
Page 1 of 2
Form VTR-423 Rev 10/17
Online form at www.TxDMV.gov
Affidavit
State law makes falsifying information on this application a third-degree felony.
I meet the eligibility requirements as listed on this form, and am providing proof to that effect.
Signature of Applicant Date
Eligibility Requirements
• Gold Star Family: Proof that you are an immediate family member (parent, child or sibling) of a person who died while serving in
the U.S. Armed Forces.
• Gold Star Fath er: Proof that you are the father of a person who died while serving in the U.S. Armed Forces.
• Gold Star Mother: Proof that you are the mother of a person who died while serving in the U.S. Armed Forces.
•
Gol
d Star
Spouse: Proof that you are the surviving spouse of a person who died while serving in the U.S. Armed Forces.
Plate Type
Note: All plates below are available for passenger cars, trucks (up to 18,000 lbs.), and motorcycles/mopeds.
Gold Star Famil y Gold Star Father Gold Star Mother Gold Star Spouse
Vehicle Information
Specialty plates are available for the vehicle types listed.
Vehicle Identification Number
Current TX Plate
Year
Make
Bod y Style
Empty Weight (lbs.)
Vehicle Type:
Passenger Car Truck Motorcycle/Moped
Appli cant Information
Type or print only
First Name
Middle Initial
Last Name
Suffix
County
Mailing Address
City
State
Zip Code
E-mail
Day Phone
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. Do not mail cash. There is no specialty plate fee. Plate may be
personalized for an additional $40 fee, make your selection on page 2. There is a limit of one Gold Star specialty plate per applicant.
Your annual registration fee must be paid to your local county tax assessor-collector when your plates are issued. NOTE: When the
specialty plates are issued, additional fees may be collected to establish a single expiration date for both the specialty plate and the
vehicle registration.
If you place your order by mail, please contact your county tax assessor-collector’s office in three weeks to verify your plates are ready
for issuance. Personalization fees will not be refunded once application is submitted. Contact your county tax assessor-collec t o r if yo u
have any questions.
For County Use Only
License Number
Mo/Yr of Exp
Date Issued
Appli cation for Gold Star License Plates
Page 2 of 2
Form VTR-423 Rev 10/17
Online form at www.TxDMV.gov
International Symbol of Access
To display the International Symbol of Access on your license plate, attach a signed Form VTR-214 to this form to show your eligibility.
Contact your county tax assessor-collector if you have questions.
Personalize Your Plate
If you would like to perso nal ize your spec ia lty plate, ther e wil l be a $40 fee per year, in
addition to the annual registration fee and the Specialty Plate Fee.
• Show selections exactly as you wish them to appear on your license plates. 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 (*)), a heart (use an “at” mark (@)) and a star (use
an ampersand (&)).
• Passenger car and truck plates are limited to five (5) characters total.
• Motor cycle/mo ped plates are limite d to four (4) characters total.
• You are not required to use all the spaces provided.
• 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 application is submitted.
1st Selection 2nd Selection 3rd Selection
General Requir eme nts
• Texas title and vehicle registration must be in your name.
• 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.
• If the vehicle is leased, attach a photocopy of the lease agreement.
• Vehicle is for personal use only.
