MV-95
| | | |
| |South Carolina Department of Motor Vehicles |MV-95 |
| | |(Rev. 10/12) |
| |APPLICATION FOR SPECIAL LICENSE PLATE | |
| | |Page 1 of 3 |
To Apply:
Indicate the plate desired and complete the application information.
Provide required certification. (See pages 2 and 3 of this form for a complete list of requirements.)
Mail completed application and required fees to S.C. Department of Motor Vehicles, P.O. Box 1498, Blythewood, S.C. 29016-0008.
• Visit to view available specialty plates.
• Special plates are issued to cars or light trucks with an empty weight of 9,000 pounds or less and a gross vehicle weight of 11,000 pounds or less.
• Depending on your present expiration date, an updated tax receipt and additional fees may be required. If your current tag is within three months of expiring, you should pay your property taxes and renew your plate BEFORE you submit an application for a specialty plate.
• Some applications for special plates must be mailed to the Department.
• If you no longer meet the requirements for the special plate, you must return it to your local DMV office.
• Registration Fees:
Passenger Cars - $24.00
Light Trucks GVW Fees:
0001-4000 $30.00 7001-8000 $80.00
4001-5000 $40.00 8001-9000 $90.00
5001-6000 $60.00 9001-10,000 $100.00
6001-7000 $70.00 10,001-11,000 $110.00
• Senior Citizen Fees: Cars - $20.00 (age 65) $22.00 (age 64)
Light trucks with a GVW of no more than 6,000 lbs. fees are $30.00
|REQUIRED INFORMATION |
|Type of plate requested: | |
|If applying for the following plates: |
|College or University Plate, specify School | |
|Rotary International Plate, specify Club Name | |
|Education Apple Plate, specify School | |
| |
|APPLICANT INFORMATION |
|Last Name |First Name |M.I. |
| | | |
|Street Address | |
| |
|Mailing Address | |Email Address (optional) |
| | |
|City |State |Zip Code |(Area Code) |Telephone Number |
| | | | | |
|Vehicle Identification Number |Make |Year |Vehicle Plate Number |
| | | | |
|Yes, I wish to donate $5.00, more or less, to Donate Life SC. Amount of donation: | |
INSURANCE INFORMATION
|Under penalties of perjury, I declare this vehicle is insured with the company named below and I will maintain liability insurance throughout the |
|registration period. |
|Name of Insurance Company | |
CERTIFICATION
|I certify all information provided in this application is true and correct. |
|Signature of Applicant: | |
|DMV USE ONLY |
|Check No. | | |
|$30.00 + Registration Fee | Endangered Species | |
| |Greenville Children’s Hospital*** | |
|Boy Scouts of America |Marine Corps League | |
|Boykin Spaniel Foundation |National Multiple Sclerosis Society |Secular Humanist of the Low Country |
|Beaufort Water Festival |Parrothead |Share the Road (Palmetto Cycling) |
|Cattlemen’s Association |Penn Center |Support Our Troops |
|Donate Life |Reduce Reuse Recycle*** |University of Tennessee*** |
|Elks Association | |US Air Force Academy*** |
|Emergency Medical Services | |Wildlife (Bird)*** |
| | |Wildlife (Deer)*** |
|$35.00 + Registration Fee |$40.00 + Registration Fee |$46.00 + Registration Fee |
| | | |
|Choose Life SC | |Nurses Foundation |
| | | |
| | | |
| |Palmetto Health Children’s Hospital*** The Ohio State | |
| |University*** | |
|$50.00 + Registration Fee | | |
| | | |
|Ducks Unlimited | | |
|Hunting Island State Park | |Special Olympics |
|MUSC Children’s Hospital |Ronald McDonald House Charities*** |Square Dance |
| |Rotary International | |
| |Shag | |
|$54.00 |$54.00 + Registration Fee |
| | |
|Education (Apple) |Keep IT Beautiful |
|School: | |
|District: | |
|County: | |
|$60.00 + Registration Fee |$65.00 + Registration Fee |
| | |
|Earth Echo International |Surfrider Foundation |
|$70.00 + Registration Fee |
| | | |
|Auburn University |First in Golf |Our Farms Our Future*** |
|Breast Cancer Awareness*** |Florida State University*** |University of Florida*** |
|Camp Sertoma |Georgia Tech Foundation |University of Georgia*** |
|Carolina Panthers |NC State University*** |Working For the Wild Turkey |
|Driven By the Arts |No More Homeless Pets | |
|NASCAR $70.00 + Registration Fee |
| Dale Earnhardt #3 | Jeff Burton #99 | NASCAR |
|Dale Earnhardt, Jr. #8 |Jeff Gordon #24 |Rusty Wallace #2 |
|$75.00 + Registration Fee |
| Gone Fishing | Heritage Classic Foundation |
|$100.00 + Registration Fee |
| | |
|H.L. Hunley |Morris Island Lighthouse |
|Homeownership: The American Dream |Technology Alliance |
| |
| |
|College and University $70.00 + Registration Fee |
| | | |
|Anderson College |Converse College |SC State University |
|Benedict College |Erskine College |Southern Wesleyan University |
|Bob Jones University |Francis Marion University |The Citadel |
|Charleston Southern University |Furman University |The University of South Carolina*** |
|Claflin College |Lander University |Voorhees College |
|Clemson University |Limestone College |Winthrop University |
|Coastal Carolina University |Morris College |Wofford College |
|Coker College |Newberry College | |
|College of Charleston |North Greenville University*** | |
|Columbia College |Presbyterian College | |
The following plates require Proof of Membership or Certification.
|Regular Registration Fee |
| |
|SC Aviation Association |
|(Induction Letter from the SC Aviation Association’s Director) |
| |
|SC Troopers Association*** |
|(Letter of Authorization from SC Troopers Association) |
|$30.00 + Registration Fee |
| EMT – Emergency Medical Technician | SC Grand Lodge of Ancient Free and Accepted Masons |
|(EMT Certification) |Shriner’s |
|Fraternal Order of Police |Sons of Confederate Veterans |
|Kiwanis |US Naval Academy*** |
|Lions International |West Point Association of Graduates |
|Prince Hall Masons |Prince Hall Order of the Eastern Star*** |
|SC Chiropractic Association | |
|SC Grand Lodge of Ancient Free Masons | |
|(Current dues card from Grand Lodge) | |
|Fraternities & Sororities $70.00 + Registration Fee |
| Alpha Kappa Alpha | Delta Sigma Theta | Omega Psi Phi | Zeta Phi Beta |
|Alpha Phi Alpha |Kappa Alpha Psi |Phi Beta Sigma*** | |
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Revised 10/12 SOUTH CAROLINA SPECIAL PLATES Page 3 of 3
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