Fillable Form MV-9W (Rev. 6-2015): Georgia Department of Revenue (Georgia.gov)

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Form MV-9W (Rev. 6-2015): Georgia Department of Revenue (Georgia.gov)

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Georgia Department of Revenue - Motor Vehicle Division
Request for Manufacture of a Special Veteran License Plate
Purpose of this Form: This form is to be used to apply for a military license plate/tag. This form should not be used to record a change of ownership, change of
address, or change of license plate classification.
Required documentation: You must provide a legible copy of your service discharge (DD-214, DD-215, or for World War II veterans, a WD form) indicating your
branch and term of service. If you are an active duty member, a copy of the approved documentation supporting your current membership in the respective
reserve or National Guard unit is required. In the case of a retired reserve member from that unit, you must furnish approved documentation supporting the
current retired membership status from that reserve unit.
Form MV-9W (Rev. 6-2015)
Web and MV Manual
Owner(s)’ Full Legal Name:
If secondary Owner(s) are listed
Zip:
Mailing Address:
City:
State: Telephone Number:
Model:Year:
Vehicle Identification Number (VIN):
Make:
Zip:
First Name Middle Initial Last Name Suffix
VEHICLE INFORMATION
Owners’ Full Legal Name:
Mailing Address:
City: State: Telephone Number:
OWNER INFORMATION
CAMPAIGN/TOUR of DUTY
LICENSE PLATES
First Name Middle Initial Last Name Suffix
Branch of Service:
______________________
SERVICE AWARD
LICENSE PLATES
World War I
(7/28/1914 – 11/11/1918)
Korean War
(6/27/50 – 1/31/55)
War in Afghanistan
(10/07/01 – Current)
Global War on Terrorism
(12/07/01 – Current)
Military Veteran
Retired from Active Duty Retirement Date: __________________
World War II
(12/07/41 – 12/31/46)
Vietnam War
(6/1/54 – 5/15/75)
Operation Desert Storm
(8/02/90 – 11/30/95)
War in Iraq
(3/20/03 – 12/18/11)
Chosin Reservior Campaign
of 1950
Bronze Star Medal
Army Distinguished
Service Cross
Air Medal
Legion of Merit
Air Force Cross
Purple Heart
Defense Superior Service
Former Prisoner of War
Medal of Honor
Silver Star Medal
Navy Cross
Distinguished Service Medal
Defense Distinguished
Service Medal
Distinguished Flying Cross
Homeland Security
Distinguished Service Medal
Gold Star Family
U.S. Reserves, National Guard,
Georgia National Guard
Branch of Service:
______________________
Retired U.S. Reserve Date: ____________________
Retired Georgia National Guard Date: ____________________
Active Duty Georgia National Guard *
Active Duty U.S. Reserve *
100% Service Connected Disabled Veteran or less than 100%
Service Connected Disabled but is compensated at 100% level due
to individual unemployabilty.*
Compensated at less than 100% level or Nonservice Connected
Disabled*
Branch of Service:
______________________
DISABLED VETERAN
LICENSE PLATE
Branch of Service:
______________________
CERTIFICATION
Passenger Vehicle Motorcycle Private Truck
* You must provide a letter from U.S. Department of Veteran Affairs indicating
disability percentage and service connection. The Georgia Department of
Veterans Services (GDVS) is available for assistance.
Veteran /Active Military Personnel Surviving Spouse
______________________________________________________________________________________
O.C.G.A. § 40-2-3. “Any person who shall make any false statement in any application for the registration of any vehicle, or in
transferring any certificate of registration, or in applying for a new certificate of registration, shall be guilty of false swearing,
whether or not an oath is actually administered to him, if such statement shall purport to be under oath. On conviction of such
offense, such person shall be punished as provided by Code Section 16-10-71.”
State of Georgia
Driver’s License Number:
_________________________
Signature
______________
Date
Have a question? Visit our website at http://dor.georgia.gov/motor-vehicles or scan the QR code above for more information.
* Active Duty members shall provide annual letter from Commanding Officer to
county tag office.
Minor Child
PRINT
CLEAR
APPLICANT INFORMATION – This form can only be submitted by a Veteran, Active Military or a surviving spouse.
Veteran/Active Military Personnel: a person who served in the active military, and who was discharged or released under honorable conditions.
Surviving Spouse: means (except for purposes of chapter 19 of this title) a person who was the spouse of a veteran at the time of the veteran's death, and who
lived with the veteran continuously from the date of marriage to the date of the veteran's death.
INSTRUCTIONS
How to complete the MV-9W Form
Complete the registrant/owner information. The mailing address block should contain the physical address of the registrant.
Complete the vehicle information for which the request for a special veteran/military license plate is being requested.
Check the category of license plate that belongs on the vehicle to which you intend to register this plate.
Check the type of license plate you would like issued. Please note that some license plates require additional documentation and/or requirements which are
noted below. Military license plates are issued only to those vehicles titled in Georgia.
COMPLETING the APPLICATION
*** MEMBERS of ACTIVE RESERVE COMPONENTS or MEMBERS of the GEORGIA NATIONAL GUARD ***
Members of active reserve components of the United States
O.C.G.A. §40-2-65
For Active Duty Members: The commanding officer of each active reserve component program unit or the adjutant general of the National Guard unit of each
neighboring state shall, upon request of any reserve member or National Guard member of that unit, respectively, furnish to that member approved
documentation supporting the member's current membership in the respective reserve or National Guard unit.
For Retired Members: The commanding officer of each active reserve component program unit shall, upon request of any retired reserve member from that unit,
furnish to that retired member approved documentation supporting the retired member's current retired membership status from that reserve unit.
Members of Georgia National Guard
O.C.G.A. §40-2-66
For Active Duty Members: The adjutant general of Georgia shall, upon request of any member of that National Guard unit, furnish to that member approved
documentation supporting the member's current membership in that National Guard unit.
For Retired Members: The adjutant general of Georgia shall, upon request of any member retired from that National Guard unit, furnish to that retired member
approved documentation supporting the member's retired membership status in that National Guard unit.
Note: Surviving Spouse - The spouse of a member of the military, National Guard or U.S. Reserves who is killed while serving in a combat arena
shall continue to be eligible to be issued a distinctive license plate as provided in this Code section so long as such spouse does not remarry.
Spouse must provide certified copy of Death Certificate accompanied by certified copy of Marriage Certificate.
FEES
All Special Veterans License plates are free for one vehicle.
Additional tags: $25 manufacturing fee (one time fee) plus $20 annual registration fee.
Ad Valorem tax exemption (either annual property or title tax): This applies to one vehicle registered to 100% Service Connected Veteran, Purple Heart,
Medal of Honor, Prisoner of War or Surviving Spouse of POW. All other tags are subject to applicable taxation.
*** CRITERIA for CAMPAIGN/TOUR of DUTY and MILITARY MEDAL AWARD LICENSE PLATES ***
CAMPAIGN/TOUR of DUTY LICENSE PLATES: To be eligible for this plate you must have had active duty service in World War I, World War II, the Korean
War, the Vietnam War, Operation Desert Storm, the Global War on Terrorism as defined by Presidential Executive Order 13289, Section 2, the War in
Afghanistan, or the War in Iraq, which includes either Operation Iraqi Freedom or Operation Enduring Freedom. The applicant must submit ONE of the seven (7)
documents listed, which must be properly completed, signed, show honorable discharge, and list the citations or decorations he or she received for serving in
the designated war or conflict.
GENERAL/RETIRED LICENSE PLATES (Including Retired National Guard): The applicant must submit a copy of his or her current military ID card, proof of
retired status,
or ONE of the seven (7) documents to show honorable discharge.
MILITARY MEDAL AWARD LICENSE PLATES: To be eligible for this plate the individual was issued a medal, decoration, or other recognition of honor for
military service awarded by a branch of the United States military.
GOLD STAR FAMILY PLATES: The applicant who has had an immediate family member die in the line of duty while serving in the United States Armed
Forces. Submit veteran’s Death Certificate accompanied by Marriage Certificate (if applicable) and DEER listing a spouse, mother, father, sibling, surviving
spouse of sibling, child or step-parent.
PURPLE HEART RECIPIENT: Active Duty Service members shall provide their original citation which will be photocopied by the county tag office.
FORMER PRISONER of WAR PLATES: The applicant must submit a copy of former POW membership card, or a statement from the United States
Department of Veterans Affairs or the United States Department of Defense, or ONE of the seven (7) documents listed.
EXAMPLES of ACCEPTABLE DOCUMENTATION
1. Enlisted Record and Report of Separation (Form WD AGO 53-55) - must
state Honorable or General Discharge, the dates of active duty service; your
commendations, award or medal.
2. General Orders;
3. Correction to Form DD214 (Form DD215);
4. Official Discharge Order from the United States Armed Forces;
5. Certificate of Release or Discharge from Active Duty (Form DD214) - must
state Honorable or General Discharge, the dates of active duty service; your
commendations, award or medal;
6. Report of Separation and Record of Service (Form NGB 22); or
7. Current Military ID Card
Have a question? Visit our website at http://dor.georgia.gov/motor-vehicles or scan the QR code for more information.
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Form MV-9W (Rev. 6-2015): Georgia Department of Revenue (Georgia.gov)

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Completed 17 June 2022

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