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Get NY CP-30 2020-2024

Please visit our website at dmv.ny.gov/nav/custom-plates. If eligibility certification is required, mail it with this form. PLEASE PRINT INFORMATION BELOW Which plate are you applying for? (Refer to the list with eligibility and fee information on our website dmv.ny.gov/nav/custom-plates.) Last Name First M.I. Date of Birth (Month/Day/Year) / Address (Include Street Number and Name and/or Rural Delivery Box No.) check if new Apt. # City Signature (Sign Name in Full) State Date X Da.

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