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Get WV Application 2010-2024

WV Application Rev. 6/2010 Department Use Only West Virginia Department of Transportation Application for Duplicate Registration Card Decal or Plate Change of Address WV Division of Motor Vehicles PO Box 17110 Charleston WV 25317 1-800-642-9066 www. dmv*wv*gov Vehicle and Contact Information Names of Owner s Present Street Address City County State Phone Number Zip Model Year Make Title Number Plate/Reg* Number Weight/Length Expire Date Vehicle Identification Number Reason for Replacement Please Check Transaction s that you are applying for Change of Address only 5. 00 Duplicate Registration Card 5. 00 Duplicate Decal 5. 00 Duplicate Plate 5. 50 Reg* card included Cash by mail is at sender s risk. Any check tendered to this department which is not honored by any banking institution will result in a 10. 00 service charge. A statement of insurance must be submitted with application for a duplicate decal or plate. Required Insurance Information Effective Date of Insurance Policy From To Name of Insurance Company Name of Agent Insurance Policy Number National Association Insurance Commissioners Number NAIC A REGISTRATION CARD LICENSE PLATE OR DECAL WILL BE ISSUED IF THE COMMISSIONER IS SATISFIED THE ORIGINAL IS LOST STOLEN OR DESTROYED AND UPON CERTIFICATION TO THAT EFFECT I hereby state that there is a motor vehicle liability policy in effect on the described vehicle in accordance with the provisions of the West Virginia Motor Vehicle Laws and certify that the statements made are true and correct to the best of my knowledge and belief under penalty of false swearing. West Virginia Motor Vehicle Law 17A-9-1 Fraudulent Applications. Sign Below. If the title reads AND signature of both owners must appear below. dmv*wv*gov Vehicle and Contact Information Names of Owner s Present Street Address City County State Phone Number Zip Model Year Make Title Number Plate/Reg* Number Weight/Length Expire Date Vehicle Identification Number Reason for Replacement Please Check Transaction s that you are applying for Change of Address only 5. 00 Duplicate Registration Card 5. 00 Duplicate Decal 5. 00 Duplicate Plate 5. 50 Reg* card included Cash by mail is at sender s risk. 00 Duplicate Registration Card 5. 00 Duplicate Decal 5. 00 Duplicate Plate 5. 50 Reg* card included Cash by mail is at sender s risk. Any check tendered to this department which is not honored by any banking institution will result in a 10. Any check tendered to this department which is not honored by any banking institution will result in a 10. 00 service charge. A statement of insurance must be submitted with application for a duplicate decal or plate. 00 service charge. A statement of insurance must be submitted with application for a duplicate decal or plate. Required Insurance Information Effective Date of Insurance Policy From To Name of Insurance Company Name of Agent Insurance Policy Number National Association Insurance Commissioners Number NAIC A REGISTRATION CARD LICENSE PLATE OR DECAL WILL BE ISSUED IF THE COMMISSIONER IS SATISFIED THE ORIGINAL IS LOST STOLEN OR DESTROYED AND UPON CERTIFICATION TO THAT EFFECT I hereby state that there is a motor vehicle liability policy in effect on the described vehicle in accordance with the provisions of the West Virginia Motor Vehicle Laws and certify that the statements made are true and correct to the best of my knowledge and belief under penalty of false swearing.

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