1-800-642-9066
dmv.wv.gov
DMV-54-TR
REV 07/17
West Virginia Department of Transportation
Division of Motor Vehicles
Application for a Penn State Alumni Association License Plate
Insurance Company
Eective Dates of Policy From: To:
NAIC Number
Insurance Agent
B) Vehicle Information
C) Insurance Information
Policy No.
/ / / /
Name(s) on Registration
Applicant’s Name
Street Address
A) Applicant/Owner(s) Information
PLATE SAMPLE
CITY
STATE ZIP
B) Vehicle Information
Make
VIN No.
Current Plate No.
Year Title No.
D) Applicant Certication
SIGNATURE OF APPLICANT DATE
/
(X)
/
PLEASE SEE REVERSE SIDE FOR INSTRUCTIONS
PENN STATE UNIVERSITY OFFICE USE ONLY BELOW THIS LINE
OFFICE STAFF INSTRUCTIONS:
Insert the plate numbers on the plate
diagram to the left and submit this form
to the WV DMV for recording and
processing. Be sure to retain a copy for
your records.
Phone No.
( )
I certify that all information on this application is true and correct and if I cease to be in good standing with the above organization, I will immediately
return the special license plate to the Division of Motor Vehicles.
Instructions
To qualify for a Penn State Alumni Association license plate you must be a member of the Penn State Alumni Association.
The vehicle must have a West Virginia title and license plate in the name of the applicant before a special plate can be issued.
The current license plate must be returned to the Division of Motor Vehicles after the special plate is received. After issuance of the
special plate, the exchanged plate is canceled and cannot be transferred to another vehicle. There are no refunds.
Send the application and correct fees (as outlined below) via check or money order, payable to Penn State License Plate, to the
address listed below. Please include your personal property tax receipt or an adavit from the assessor, if your registration is expiring
within 60 days of your application.
James Weimer
304-345-5479
1210 Johnson Road
Charleston, WV 25314
Present Plate Detail Total Fee
Plate Begins with 5, 6, or 7
of Current Year
Plate Begins with 8
Plate Begins with 9
Plate Begins with O
Plate Begins with N
Plate Begins with D
Plate Begins with 1
Personalized Plate
Plate Begins with 2
Plate Begins with 3
Plate Begins with 4
Plate Begins with 5
Plate Begins with 6
All Expirations beyond the 6th month of next year
$75.50
$77.13
$74.75
$72.38
$70.00
$67.63
$65.25
$65.25
$62.88
$60.50
$58.13
$55.75
$53.38
$51.00
PLEASE ALLOW ( 60 ) DAYS FOR DELIVERY
1.
2.
3.
4.
Your fee is based on the expiration of your present license plate.
Use the first letter or number of your license plate to calculate the total fee from the chart above.
Your Penn State University license plate will expire every July 1st.
The renewal fee is $66.50 per year.