Building Bright Futures Plate Application

DEPARTMENT OF MOTOR VEHICLES Agency of Transportation

dmv.

Last Name

First Name

Mailing Address

Building Bright Futures Plate Application

120 State Street Montpelier, Vermont 05603-0001

802.828.2000 Toll Free: 888-99-VERMONT

TTD: 711

Middle Initial

License #

Name & Address

City

State

ZIP Code

Email

Phone

Vehicle

Current Plate No.

Serial Number (VIN)

Make

Model

Year

Body Type

Select a Transaction Type

Convert My Existing Standard Vermont License Plates ? See instructions for fees

New "Personalized" (Building Bright Futures) Plates ? See instructions for fees

New Registration (Or Transfer) ? See instructions for fees

Convert My Existing "Low" Number Plates ? See instructions for fees

Convert My Existing "Personalized" Plates- Up to 5 spaces possible ? for Autos and Trucks. ? See instructions for fees

1st Choice

Plate Represents?

2nd Choice

Plate Represents?

3rd Choice

Plate Represents?

I hereby affirm, under penalty of perjury, that the information on this form is true to the best of my knowledge. This declaration made under penalties of 23 VSA ? 202 & ? 4110.

Signature of Applicant

X

Date Signed

DO NOT WRITE - DMV USE ONLY 455 465 490 P Veh. Type =

231 232 Date Issued:

Old Plate No.

Plate Issued

Rater #

Return #

Temp. Issued

Reg Type = 55

Exp. Date

Plate Type = R V

New BBF Plate 47 Special Plate 01 Miscellaneous 10 Total

VD-102 08/2020 MTC

Instructions

Name & Address Section:

If the address given differs from what appears on our records, this will be considered a notification of change of address for all your records. You are required to notify DMV within 30 days of any change in your mailing address, legal name or physical residence.

Vehicle Section:

The vehicle listed on the application must be registered in the name of the authorized applicant (owner, co-owner and lessee) or a Building Bright Futures plate will not be issued.

Building Bright Futures Plates can be issues on Passenger Cars, Light and Trucks registered for less than 26,001 pounds and excluding vehicles registered under the International Registration Plan.

Delivery may take up to 6 weeks from date of application for personalized or low number plate applications. A temporary plate may be issued to the applicant if required.

If the vehicle is currently registered in Vermont only, the Building Bright Futures plate fee of $24.00 is due. If the vehicle is not currently registered in Vermont, complete a Registration Application. Submit all fees for registration, in addition to the Building Bright Futures plate fee and this application. Your annual registration will be $24.00+ annual registration fee.

If you are renewing your Building Bright Futures Plate please use form VD-119 (Vermont Registration Application).

Transaction Type:

Convert my existing VT license plate - You currently have a valid VT registration and wish to exchange to a Building Bright Futures Plate. Vermont license Plates with regular number series Building Bright Futures Plates.

Enclose $24.00+ Annual Registration fee if your registration is expired. Your annual registration will be $24.00+ annual registration fee.

New "Personalized" (Building Bright Futures) Plates - You wish to apply for a personalized vanity plate application. The Plate Choice section also needs to be completed or this application will be returned to you. If you DO NOT have a Vermont Registration, please complete VD-119 (Vermont Registration Application) in addition to this application. Eligible vehicles are Passenger Cars, Light Trucks and Trucks registered for less than 26,001 pounds and excluding vehicles registered under the International Registration Plan. A combination of letters, numbers or spaces may be used. No more than two (2) numbers are allowed in combination with letters. The Department considers "O" to be a number (zero). Dots, dashes or other special characters or symbols cannot be used. The plate cannot begin with the letter "Z". A single letter plate is acceptable; however, the letter cannot be an "I", "J", "O" or "Z". Use asterisks (*) to indicate spaces where desired. If no asterisks (*) are used, the characters will be centered on the plate.

If existing standard BBF plate enclose $48.00. If standard registration enclose $72.00. Your annual registration fee will be $48.00+ annual registration fee. See form VD-017 for comprehensive instructions.

New Registration (Or Transfer) ? Issue new number series Building Bright Futures. Must also submit VD-119 (Vermont Registration Application).

Enclose $24.00 your annual registration will be $24.00+ annual registration fee.

Convert My Existing "Low" Number Plates

Enclose $24.00 your annual registration will be $24.00+ annual registration fee.

Convert My Existing "Personalized" Plates

Enclose $24.00 your annual registration will be $24.00+ annual registration fee.

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