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*ANY FALSE STATEMENT ON THIS APPLICATION IS A VIOLATION OF THE LAW AND MAY BE PUNISHED BY FINE, IMPRISONMENT, OR BOTH.* (301.420 RSMo.) VALIDATION AREA DEALERSHIP NAME DEALER NUMBER STREET ADDRESS COUNTY TELEPHONE NUMBER CITY STATE ZIP CODE TYPE PLATE SIZE REPLACEMENT PLATES ($12.00 PER PLATE) MV ADDITIONAL PLATES (QUANTITY) (SEE FEES BELOW) BOAT 12 11 10 9 8 7 6 5 4 3 2 1 MONTHS MONTHS MONTHS MONTHS MONTHS MONTHS MONTHS MONTHS MONTHS MONTHS MONTHS MONTH January .

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