Fillable Application For Replacement Plates Or Decals (Town of Hampton, NH)

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Application For Replacement Plates Or Decals (Town of Hampton, NH)

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Robert L. Quinn
Commissioner of Safety
Department of Safety
Division of Motor Vehicles
23 Hazen Drive, Concord, NH 03305
(603) 227-4030
Elizabeth A. Bielecki
Director of Motor Vehicles
APPLICATION FOR REPLACEMENT PLATES AND/OR DECALS
N.H. Plate Number
Type:
Phone #:
Please check replacement needed: DO NOT MAIL CASH
1 plate (Includes decal fee): $4.00
Decals Only: $1.00
REASON:
LOST
STOLEN
DESTROYED
PLATE CHANGE
NOTE: A set of plates with the same number can only be ordered if one or both plates are surrendered with this application.
If the plates were stolen, a new number must be issued.
OWNER’S NAME:
DOB:
ADDRESS:
Street
City
State
Zip Code
DESCRIPTION OF VEHICLE:
Yr.:
Make:
Model:
VIN:
Vehicle Identification Number:
I certify that the above replacements are needed for the reason indicated and that the loss was reported to the
, N.H. Police Department.
Owner’s Signature
Signed under penalty of unsworn falsification pursuant to RSA 641:3
RDMV125 (Rev 3/2020)
Vehicle Identification Number:
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Application For Replacement Plates Or Decals (Town of Hampton, NH)

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Completed 3 August 2020

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