Motor Vehicle Administration
6601 Ritchie Highway, N.E.
Glen Burnie, Maryland 21062
For more information, please call: 410-768-7000 (to speak with a customer agent).
TTY for the hearing impaired: 1-800-492-4575. Visit our website at: www.MVA.Maryland.gov
Application for Military Related License Plates
VR-120 (05-16)
Owner’s Name, First Middle Last Driver’s License Number
Street Address City County State Zip Code
Co-Owner’s Name, First Middle Last Driver’s License Number
Telephone Number Email Address
Vehicle Information
Year Make Sticker No. Title No. Tag No.
Vehicle Identication Number
Insurance Co. Policy/Binder No.
Medal Recipient: (Check one) ❑ Owner ❑ Co-Owner
Check Class: ❑ Passenger Car ❑ Multi-purpose vehicle ❑ 1 ton or less ❑ Motorcycle
Fees: Military tags: $25.00
I certify, under penalty of perjury, that the above information is true and correct to the best of my knowledge.
Signature of Owner: Date:
Signature of Co-Owner: Date:
MVA Use Only:
❑ New Issue ❑ Substitute ❑ Gratis ❑ Paid
Tag Issued:
You may either...
Mail your application, proof of award, and the appropriate fees to Motor Vehicle Administration, Organizational Plates Unit
6601 Ritchie Highway N.E., Glen Burnie, MD 21062, or
Visit the Motor Vehicle Administration, Glen Burnie Full Service Ofce, and have your plates issued to you.
Proof of Award
To obtain proof of your award, contact: The National Personnel Records Center, Military Personnel Records
1 Archives Drive, St. Louis, Missouri 63138 • archives.gov
Original - MVA Copy - Customer
Instructions: Please complete the entire application (owner and/or co-owner). Submit a copy of the proof of award and the
appropriate fees along with the application.
❑ Air Force ❑ Active Duty ❑ Proudly She Served
❑ Army ❑ Veteran
❑ Coast Guard
❑ Marine Or Name of Medal or Badge:
___________________________________
❑ Navy
