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STATE OF FLORIDA
DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES – DIVISION OF MOTORIST SERVICES
SUBMIT THIS FORM TO YOUR LOCAL TAX COLLECTOR OR LICENSE PLATE AGENT OFFICE
www.flhsmv.gov/locations/
APPLICATION FOR PERSONALIZED LICENSE PLATE
INSTRUCTIONS ARE INDICATED ON REVERSE SIDE Date of Application
PLEASE CONTACT YOUR LOCAL COUNTY TAX COLLECTOR'S OFFICE, LICENSE PLATE AGENT
OR REFER TO THE REVERSE SIDE OF THIS FORM FOR FEE INFORMATION.
OWNER / APPLICANT IDENTIFICATION
Owner’s / Lessee’s Name: Sex: Date of Birth:
Street Address: City: State: Zip:
Owner’s / Lessee’s D/L Number: Owner’s / Lessee’s E-mail Address:
FEID#:
Co-Owner’s / Co-Lessee’s Name: Sex: Date of Birth:
Street Address: City: State: Zip:
Co-Owner’s / Co-Lessee’s D/L Number: Co-Owner’s / Co-Lessee’s E-mail Address:
FEID#:
VEHICLE INFORMATION
Current Decal Number: Current License Plate Number: Vehicle Type:
Title Number: Vehicle Identification Number:
Vehicle Make: Year: Color: Vehicle Weight:
CERTIFICATION
This is to certify that I am/we are the registered owner/lessee or co-owner/co-lessee of the motor vehicle referenced above.
I/we authorize my/our name, address, and renewal date to be provided to the organization sponsoring the specialty license plate selected.
Under penalties of perjury, I/we declare that I/we have read the foregoing document and that the facts stated in it are true.
Signature(s):
LICENSE PLATE SELECTION (see reverse side for plate choices)
Enter the type of license plate requested: (see reverse
side of this form for types of plates and fees)
Specify the intended meaning/explanation for your
personalized license plate configuration choice
(nickname, initials, etc.):
Please Note:
•
Use no more than the number of characters authorized for the type of license plate you have requested
(including a space or hyphen, see reverse side).
•
For license plates with center graphic, allow two spaces for the logo or characters will cover the graphic design.
Centered Graphic
Left Graphic
Specialty Motorcycle
(7 characters, may also have an additional space or hyphen.
(5 characters)
(6 characters)
A regular motorcycle may have a Florida graphic.)
LOGO
A
B
C
D
1
1ST CHOICE
2ND CHOICE
3RD CHOICE
4TH CHOICE
INSTRUCTIONS
1. Carefully read all information on the front and back of this application before completing the application.
2. Complete the application form and submit it to your local county tax collector's office or license plate agent with the following items:
a. PROOF OF FLORIDA INSURANCE: Proof of personal injury protection (PIP) and property damage liability insurance (PDL) must be submitted in the form
of a card, policy, binder, certificate of insurance or affidavit.
b. A copy of your current registration certificate or renewal notice.
c. Remittance fees (payable to your county tax collector/license plate agent).
3. Please allow six to eight weeks for the manufacture and delivery of the license plate. The license plate will be delivered to your county tax collector's office or
license plate agent.
HSMV 83043 (Rev. 02/24) S www.flhsmv.gov
5
IMPORTANTINFORMATION ABOUTYOUR CHOICE
You may check personalized plate availability at the department’s websitelocated at https://services.flhsmv.gov/MVCheckPersonalPlate/
Your local county tax collector's office or license plate agent may assist you in determining if a specific type of license plate is available, as well
as the choice for personalization and the total cost of the license plate you desire, including trucks (with a net weight of more than 5,000 pounds),
"for-hire" vehicles and trailers.
•
Yourchoicemayincludeletters,numbers,aspaceorahyphenascharacters.
Licenseplatesthathave7charactersmayhavean
additionalspaceorhyphen.However,licenseplatesthathave5characters, may NOThaveanadditionalspaceorhyphen.
•
Requests with obscene or objectionable words will be rejected. If a personalized license plate has been issued and later determined to be
obscene or objectionable, the department will recall the license plate.
TYPEOF LICENSE PLATES
Personalized license plates for motorcycles are only available as a "Florida Graphic" or "Motorcycle Specialty" license plate.
TYPES OF LICENSE PLATES
(See https://www.flhsmv.gov/dmv/specialtytags/ for more information)
FEES
AIR FORCE **
MARINE CORPS **
SALUTES VETERANS **
ARMY **
NAVY **
SHARE THE ROAD **
COAST GUARD **
OLYMPIC SPIRIT **
TAMPA BAY ESTUARY **
INDIAN RIVER LAGOON **
5 $71.40
CHOOSE LIFE **
SUPPORT EDUCATION **
EVERGLADES RIVER OF GRASS **
SALUTES FIREFIGHTERS **
POLICE ATHLETIC LEAGUE **
SUPPORT LAW ENFORCEMENT **
PROTECT WILD DOLPHINS **
5 $76.40
FISH FLORIDA**
5
$78.40
A STATE OF VISION **
FALLEN LAW ENFORCEMENT
PLAY TENNIS **
AGRICULTURE EDUCATION **
OFFICERS**
PROTECT FLORIDA WHALES **
AMERICA THE BEAUTIFUL **
FLORIDA SHERRIFFS ASSOC **
PROTECT MARINE WILDLIFE **
ANIMAL FRIEND **
FLORIDA SHERIFF'S YOUTH RANCHES **
PROTECT OUR OCEANS**
BEST BUDDIES **
FRATERNALORDER OF POLICE**
PROTECT OUR REEFS **
BIG BROTHERS BIG SISTERS **
FREEMASONRY **
(***) SAVE OUR SEAS **
BLUE ANGELS**
GADSDEN FLAG **
SAVE WILD FLORIDA**
CHALLENGER/COLUMBIA **
GO FISHING **
STOP CHILD ABUSE **
CONSERVE WILDLIFE **
HORSE COUNTRY **
SUPPORT AUTISM PROGRAMS **
DISCOVER FLORIDA HORSES**
HOSPICE EVERYDAY IS A GIFT **
SUPPORT HOMEOWNERSHIP FOR ALL**
DISCOVER FLORIDA OCEANS **
IN GOD WE TRUST **
SUPPORT OUR TROOPS **
DUCKS UNLIMITED **
KEEP KIDS DRUG FREE **
TREES ARE COOL **
END BREAST CANCER **
LAUREN’S KIDS **
VISIT OUR LIGHTS **
ENDLESS SUMMER**
NASCAR **
WALT DISNEY WORLD**
EXPLORE OFF ROAD FLORIDA **
WILDLIFE FOUNDATION OF FLORIDA **
5 $81.40
MOTORCYCLE SPECIALTY **
$73.40
FLORIDA GRAPHIC * FLORIDA STATE MOTTO *
$51.40
SPECIAL OLYMPICS FLORIDA * STATE WILDFLOWER *
$71.40
AGRICULTURE *
SCOUTING TEACHES VALUES *
INVEST IN CHILDREN *
STATE OF THE ARTS*
7 $76.40
(***)AQUACULTURE *
FAMILY VALUES *
PROTECT FLORIDA SPRINGS*
CONSERVE FLORIDA’S FISHERIES *
GOLF CAPITAL OF THE WORLD *
SAVE THE MANATEE*
DIVINE NINE *
IMAGINE*
STOP HEART DISEASE*
EXPLORE STATE PARKS *
LIVE THE DREAM*
UNITED WE STAND*
FAMILY FIRST *
PROTECT THE PANTHER *
7 $81.40
HELPING SEA TURTLES SURVIVE *
7
$79.40
COLLEGIATE:
ADVENT HEALTH UNIVERSITY ICUF **
FLORIDA GULF COAST UNIVERSITY *
ROLLINS COLLEGE ICUF **
AVE MARIA UNIVERSITY ICUF **
SAINT LEO UNIVERSITY ICUF**
FLORIDA INSTITUTE OF TECHNOLOGY ICUF **
SAINT THOMAS UNIVERSITY ICUF **
BARRY UNIVERSITY **
FLORIDA INTERNATIONAL UNIVERSITY **
SOUTHEASTERN UNIVERSITY ICUF **
BEACON COLLEGE ICUF **
FLORIDA MEMORIAL UNIVERSITY ICUF**
STETSON UNIVERSITY ICUF **
BETHUNE-COOKMAN UNIVERSITY **
FLORIDA SOUTHERN COLLEGE ICUF **
UNIVERSITY OF CENTRAL FLORIDA **
ECKERD COLLEGE ICUF **
FLORIDA STATE UNIVERSITY **
UNIVERSITY OF FLORIDA **
EDWARD WATERS COLLEGE ICUF **
JACKSONVILLE UNIVERSITY ICUF **
UNIVERSITY OF GEORGIA **
EMBRY-RIDDLE AERONAUTICAL U ICUF **
KEISER UNIVERSITY ICUF **
*
UNIVERSITY OF MIAMI **
EVERGLADES UNIVERSITY ICUF **
UNIVERSITY OF SOUTH FLORIDA **
LYNN UNIVERSITY ICUF **
UNIVERSITY OF TAMPA ICUF**
FLAGLER COLLEGE ICUF **
NOVA SOUTHEASTERN U ICUF**
UNIVERSITY OF WEST FLORIDA **
FLORIDA A & M UNIVERSITY **
PALM BEACH ATLANTIC U ICUF**
WARNER SOUTHERN COLL ICUF **
FLORIDA ATLANTIC UNIVERSITY **
RINGLING SCHOF ART & DESIGN ICUF **
WEBBER INTERNATIONAL U ICUF **
FLORIDA COLLEGE ICUF **
5
$81.40
FLORIDA PROFESSIONAL SPORTS
MIAMI HEAT **
TAMPA BAY LIGHTNING **
TEAM:
ORLANDO MAGIC **
TAMPA BAY RAYS**
FLORIDA MARLINS **
TAMPA BAY BUCCANEERS **
JACKSONVILLE JAGUARS **
MIAMI DOLPHINS **
5
$81.40
BLUE ANGLES MOTORCYCLE **
4
$81.40
FLORIDA PANTHERS *
ORLANDO CITY SOCCER *
6 $81.40
Amount Includes All Fees (SEE "FEE EXCEPTIONS" BELOW).
*Graphic design is centered on the plate
**Graphic design is on the far left/right side of the plate.
***If applying for more than 10 license plates for the same owner the fee is $67.55 per license plate.
FEE EXCEPTIONS:
An additional branch fee of $.50 may be required by some county agencies.
An additional license plate mail fee of $5.45 is required if a license plate is mailed to the applicant.
The annual or biennial registration fee is due in addition to these fees shown.
Visitthefollowingwebsiteforcurrentmailingaddresses:https://www.flhsmv.gov/locations/
HSMV 83043 (Rev. 2/24) S www.flhsmv.gov