University of Connecticut License Plate Application
SPECIAL ORDER PLATE
APPLICATION M-22 REV. 1-04
WHO MAY APPLY
1.
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SPECIAL PLATE NUMBER
DATE RESERVED
ONLY
INSTRUCTIONS:
HOW TO COMPLETE
1. For regular UConn plate orders:
Plate request must be for vehicles
CURRENTLY REGISTERED in
Connecticut (Applications for
vehicles that now have temporary
plates will NOT be accepted)
A. Complete Sections 1,2 and 3.
B. Place a checkmark next to the proper
option in the Plate Order section
indicating the style of plate
you wish to obtain.
C. Make your check or money order
payable to DMV and submit with
this application.
2. You may only acquire the same
registration type as you now
currently have on your vehicle.
(Example: If you now have a
combination plate, you can
only receive those types of plates
offered in the various combination
plate styles - you cannot transfer
a combination plate to a passenger
plate style.)
2.
REGISTRANT
INFORMATION
NAME AND
ADDRESS
NAME AS APPEARS ON REGISTRATION (Last, First, Middle Initial)
ADDRESS
(City or Town)
(Number and Street)
DAYTIME TELEPHONE NUMBER
(Zip Code)
(Please print)
Section 2
PRESENT PLATE NUMBER
DATE REGISTRATION EXPIRES
IS VEHICLE LEASED?
REGISTRATION T YPE (Passenger, Combination, etc.)
OvEs 0No
VEHICLE
YEAR
INFORMATION
MAKE
MODEL
VEHICLE IDENTIFICATION NUMBER
Section 3
MAIL
PLATES TO:
NAME (Last, First, Middle Initial)
ADDRESS
Section 4
VANITY
PLATE
REQUEST(S)
(City or Town)
(Number and Street)
(If different
from address above) (Zip Code)
UCONN PLATE ORDER
./ PRICE
REPLACE CURRENT PLATE NUMBER & CHANGE
TO NEXT NUMBER IN UCONN PLATE SERIES
For a Vanity Plate (Specific number or
MAINTAIN CURRENT PLATE NUMBER & CHANGE TO
Jetter combination):
UCONN PLATE BACKGROUND
A. Complete Sections 1,2,3, and 4.
B. Place a checkmark next to the Vanity VANITY PLATE - UCONN PLATE BACKGROUND
Plate option in the Plate Order section (Available for Passenger, Combination, Commercial, Camper, Camp Trailer)
to indicate the style of plate you wish
to obtain.
REMAKE MY EXISTING UCONN PLATE
C. Make your check or money order
WITH THE NEW HUSKY LOGO
payable to DMV and submit
with this application.
MAIL TO: DMV, Special Plate Unit, 60 State Street, Wethersfield, CT 06161-0504
Section 1
VALIDATE ABOVE
TRANSFER FEES ARE INCLUDED IN THE PRICE
DAYTIME TELEPHONE NUMBER
All letters are equally spaced. No dashes or extra
spaces between letters are allowed. Only one dot
is allowed. The dot cannot be placed at the beginning
or end of a plate number.
List plate request in order of preference. First available preference
will be ordered. THE ORDER CANNOT BE CHANGED.
1.
4_
2_
5_
3_
6_
Every attempt will be made to accommodate your request,
however, the Department of Motor Vehicles reserves the right
to deny issuance of certain requests.
$55
$75
$144
$25
HUSKY·1
UCONN HUSKIES
RIDE WITH PRIDE!
When you purchase the UConn plate, you show your pride for
UConn and help fund student scholarships and alumni services_
After the initial plate purchase, a $55 fee will be applied each
time you renew your registration, in addition to the regular OMV
fees_ A portion of your purchase is tax-deductible and will help
connect alumni, support students and strengthen UConn_
It's easy to get your UConn plates!
1 _ Mail this form, plus payment, to:
DMV
Special Plate Unit
60 State Street
Wethersfield, CT 06161-0504
2_ Once this form is processed, the DMV will mail your plates to
you_ Attach them to your car and ride with pride!
If your current vehicle registration is due to expire within the next
45 days, hold this application until after you have renewed your
registration_
For additional information about the UConn license plate program,
please visit huskiesplate_com
CANCELLATION OF THIS ORDER WILL NOT ENTITLE YOU TO A REFUND.
By signing below, I understand there will be a $55 renewal fee applied each time my registration is renewed, in addition to the regular OMV fees.
By signing this application, I expressly authorize the OMV to disclose my name and address to the UConn Foundation for use by it and all other UConn affiliates for any university-related purposes.
APPLICANT
SIGNATURE
SIGNATURE OF APPLICANT
X
DATE SIGNED
SPECIAL PLATES MAKE GREAT GIFTS FOR ALL OCCASIONS!!!
VANITY PLATE OPTIONS
A. Any combination of letters and numbers, seven characters or less, is allowed.
EARLY AMERICAN PLATE OPTIONS
A. Any combination of letters and numbers, seven characters or less, is allowed.
B. You must have a current Early American plate prior to requesting a vanity
configuration