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License Plate Replacement Application
To apply for a replacement license plate(s), take or mail this completed application, with a photocopy of your
current registration and fees to any vehicle licensing oce. Replacement of Disabled American Veteran
or Prisoner of War plates must be processed in Olympia. Keep a copy of this completed form in your
vehicle as proof that you have submitted an application for replacement license plates.
Applicant
PRINT OR TYPE Name of registered owner Driver license number
Mailing address
City State ZIP code (Area code) Daytime phone number
License plate number Tab expiration date Vehicle Identication Number (VIN) Year Make
Plate(s)
I am applying for a replacement plate because the current plate(s) has been: Lost Stolen Mutilated
Plate type ............................ Automobile Motorcycle Trailer, large Trailer, small
Background design (example: Keep Kids Safe)
Date Signature of registered owner
To keep your standard or special plate number*
Check if you want replacement plates with the same number as your current plates. Be sure to include the
additional fee with this application. If the additional fee is not paid, the replacement plates will be the next
available number/letter, letter/number combination, or Special Plate background design.
Replacement HAM and MARS plates will be issued with the original number, indicating your FCC license number.
Armed forces collection plates: Check the box next to the decal you had on your existing plates:
Veteran Retired Active duty Reserves Disabled veteran
Army guard Air guard Army, retired Air, retired Fallen hero
Personalized plate*
Your replacement plates will be the same number/letter, letter/number or Special Plate background design format
as your current plates. Fill in the information below to insure the exact format of your personalized plates.
Please print exactly the way the plate should look, including hyphens and spaces, if used.
Sample:
*If the license plate has been reported stolen or our records indicate the vehicle has been stolen,
the same number/letter combination will not be used. This is a law enforcement issue and is for the
protection of the public.
TD-420-504 (R/8/16)WA
When you have completed this form, please print it out and sign here.
