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718-R-96W H
MVR AMATEUR RADIO LICENSE PLATE APPLICATION
ALL AMATEUR RADIO PLATES ARE  ISSUED  ON  A
CALENDAR YEAR BASIS.   APPLICATIONS MUST BE
SUBMITTED TO THE OKLAHOMA TAX COMMISSION AT
THE ADDRESS BELOW.

__________________________________________
NAME


__________________________________________
ADDRESS


__________________________________________
CITY, STATE, ZIP


____________________ _____________________
DAYTIME PHONE NUMBER         SOCIAL SECURITY OR FEI NUMBER

APPLICANTS FOR ORIGINAL PLATES MUST ATTACH
A PHOTOCOPY OF THEIR FCC LICENSE  TO  THIS
APPLICATION.
 
CHECK ONE:
 
ORIGINAL OR REISSUE    FEE: $4.00
 PLATES AND DECALS
  ($2.00 fee plus $2.00 mail fee.
    Allow 3 months.)
 
RENEWAL                FEE: $3.00
 PLATES AND DECALS
  ($2.00 fee plus $1.00 mail fee.
    Allow 6 weeks.)
    REMITTANCE MADE PAYABLE TO THE OKLAHOMA TAX 
    COMMISSION MUST ACCOMPANY THE  APPLICATION.
    DRIVERS LICENSE NUMBER MUST APPEAR ON  YOUR 
    CHECK OR MONEY ORDER.
PLACE AMATEUR RADIO CALL LETTERS HERE:
 

 

 
   AMATEUR RADIO LICENSE PLATES ARE TO BE DISPLAYED ON THE FRONT AND REAR OF THE 
   VEHICLE FOR WHICH IT IS ISSUED.

THE BOXES BELOW ARE REQUIRED TO BE COMPLETED.  THIS INFORMATION CAN BE FOUND ON YOUR CURRENT
VEHICLE REGISTRATION.   NOTE:  YOUR REGULAR PLATE MUST BE CURRENTLY REGISTERED AT ALL TIMES.
FAILURE TO RENEW THE REGULAR PLATE REGISTRATION IN A TIMELY MANNER WILL RESULT IN A PENALTY.
I CERTIFY THAT THE PLATE WILL BE DISPLAYED ON THE FOLLOWING VEHICLE:
         
Oklahoma Title Number            Year & Make      Regular Plate    Decal # On Regular   Regular Decal
 (Not VIN Number)                                  Number           Plate  (Example:     Expiration
                                                                            0F000000)
EXECUTED UNDER PENALTIES OF PERJURY:  Signature: ______________________________________
A special license plate may be transferred to another vechicle by completing a "REQUEST TO TRANSFER A 
SPECIAL LICENSE PLATE", form 783-A,  and mailing it to the address listed below.      These forms are 
available at your local tag office or Oklahoma Tax Commission.
OKLAHOMA TAX COMMISSION
REGISTRATION DIVISION
SPECIAL PLATE SECTION
OKLAHOMA CITY, OK 73194-0201

TELEPHONE: 405-521-2468