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Get NC MVR-33A 2019-2024

North Carolina Division of Motor Vehicles 3155 Mail Service Center Raleigh NC 27699-3155 MVR-33A Rev 7/2015 VA FILE NUMBER Military/Veteran s Registration Plate Application Application must be submitted with supporting documents to NC Division of Veterans Affairs prior to submitting to NCDMV Section 1 I would like to apply for the following license plate Please select only one 1 plate for each application Afghanistan Veteran suffix AV none Air Medal Recipient suffix AM 10. 00 Bronze Star Combat Recipient Suffix V Free Bronze Star Recipient suffix BS none Congressional Medal of Honor Free Desert Storm Veteran suffix GV none Disabled Veteran suffix DV Free Distinguished Flying Cross suffix FC 10. 00 Ex Prisoner of War Free Gold Star Lapel Button suffix GS none Iraq Veteran suffix IV none Korean Conflict suffix KV none Legion of Merit suffix LM none Legion of Valor Free Partially Disabled Veteran prefix PD none Pearl Harbor Survivor none Purple Heart Recipient Motorcycle suffix PV none Silver Star Disabled Veteran prefix SD Free Silver Star Recipient suffix SS Free Vietnam Era suffix VV none War on Terror suffix WT none World War ll Veteran suffix WV none One free plate per person No special fee license fee is due First in Flight Background First in Freedom Background When applying for a personalized Military/Veteran license plate please remember the prefix/suffix representing the plate will be the first/last letters on the plate. Personalized special plate choice must contain at least one alpha character. The personalized plate choice cannot be numbers only. Please note the prefix/suffix for the plate. If you choose to personalize the plate the cost will be an additional 30. 00 personalized fee. You are allowed four 4 spaces for a personalized message THE SPECIAL/PERSONALIZED FEE IS AN ANNUAL FEE DUE IN ADDITION TO LICENSE FEE Section 2 CONTACT INFORMATION Name To agree with certificate of Title HOME PHONE OFFICE PHONE First Middle Last CELL PHONE Address VEHICLE INFORMATION City State Zip Code VEHICLE IDENTIFICATION NUMBER Driver License State Current NC Plate Number YEAR MAKE BODY STYLE Owner s Certificate of 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 Policy Number Authorized in N*C. Not Agency or Group SIGNATURE OF OWNER DATE OF CERTIFICATION Section 3 North Carolina Division of Veterans Affairs To be completed by the NC Division of Veterans Affairs prior to submitting to NC Department of Motor Vehicles The records of the U*S* Department of Veterans Affairs indicates that the above applicant qualifies for a special license plate.

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