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Get Wv Ems License Plate Form 2013-2024

COMPLETED BY THE APPLICANT (Instructions on the back of form.) PLATE SAMPLE A) Owner(s) Information Use Name(s) of Owner(s) as shown exactly on current Registration card that you wish to register the license plate. Daytime Phone ( Name Address ) STREET ADDRESS STATE CITY WV EMS Personnel Certification# ZIP Exp. B) Vehicle Information B) Vehicle Information Year Make Title No. Current Plate No. VIN No. C) Insurance Information Effective Dates of Policy From: / / To: / / P.

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