PLATE CANCELLATION REQUEST
State of Maine
Bureau of Motor Vehicles Once this form is signed and dated by
29 State House Station BMV staff, it serves also as a
Augusta, ME 04330-0029 Plate Cancellation Order Per MSRA
Title 29A, Section 463.
Fill in the information in this block and have this form Notarized. Take the form to a BMV branch office or mail it to the address
above, ATTN: Registrations. Please attach a copy of your current registration if it is available to you.
Registration Data:
Class Code: _____ Registration Number: _______________________ Vehicle Identification Number: _____________________________
All persons listed on the registration must sign below: Request Date: _________________________
First Registrant Printed Name: ____________________________________ Signature: _______________________________
Second Registrant Printed Name: ____________________________________ Signature: _______________________________
THIS FORM MUST BE NOTARIZED
Before me personally appeared _______________________________________________________________ who by me being duly sworn
upon oath, says that the statement set forth above is true and correct.
Subscribed and sworn to before me this ________________ day of _____________________________, 20____. Notary Public for
_______________________________________ County, State of _______________________________.
_____________________________________________________
Signature of Notary or Attorney
BMV USE ONLY:
Date Cancelled: Branch Supervisor Signature: Main Office Processed:
MVR 60, Rev. 1-2013
