Form CP-62.1 - Order Form for Personalized Plates - New York
NASCAR Plates
FEE: Standard - $60.00, Personalized - $91.25
For details, call 518-402-4838 or visit www.dmv.ny.gov/cplates.htm
o NY Knicks - NBA
o Brooklyn Nets - NBA
CP-62.1 (8/15)
REGIONAL, CAUSE AND SPORTS PICTURE PLATE CHOICES (Please Check One)
Regional Plates
FEE: Standard - $60.00, Personalized - $91.25
Other Sports Plates
FEE: Standard - $60.00, Personalized - $91.25
Organization, College, University, Fraternity & Sorority Plates FEE: Varies
Please check our web site or call us for available choices and ordering instructions before sending this form.
Plate Choice :_________________________________________________________
Cause Plates
FEE: Standard - $53.75, Personalized - $85.00
o Saratoga/Cortez o Schenectady/Proctor’s Theater o Shelter Island o Tech Valley o Washington County
o Adirondacks
o Capital - Saratoga
o Catskills
o Central - Leatherstocking
o Chautauqua - Allegheny
o Finger Lakes
o Hudson Valley
o Long Island
o New York City
o Niagara Frontier
o 1000 Islands - Seaway
o Buffalo Bills - NFL
o NY Giants - NFL
o NY Jets - NFL
o NASCAR Driver
(EXAMPLE)
o New York Mets
o New York Yankees
o Birthplace of Baseball
FEE: Standard - $53.75, Personalized - $85.00
Major League Baseball Plates
FEE: Standard - $60.00, Personalized - $91.25
o Buffalo Bandits - Lacrosse
o Rochester Americans - Hockey
o Rochester Raging Rhinos-Soccer
o Buffalo Sabres - NHL
o NY Islanders - NHL
o NY Rangers - NHL
What county name (within the region selected above) do you want printed on this plate? _________________________
Current NY State Vehicle Plate Number _________________________
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NASCAR Driver’s Name______________________________________
NASCAR Driver’s Number ___________________________
o NASCAR Fan
For a complete listing, visit
www.dmv.ny.gov/cplates.htm or call 518-402-4838.
Payment Method:
o Check o Money Order o MasterCard o Visa o Discover o American
Express
Name (as it appears on credit card)_______________________________________________
Credit Card Number _______________________________________________ Expiration Date ________________________________
Authorized Signature -_____________________________________ Daytime Phone No: ____________________________
Please do not send cash! Make check or money order payable to the “Commissioner of Motor Vehicles”. Please allow 4 to 6 weeks for
delivery. When renewing, the additional custom plate fee will be added to your vehicle registration renewal fee.
IMPORTANT: Making a false statement in any registration application or in any proof or statements in connection with it, or deceiving
or substituting in connection with this application, is a misdemeanor under Section 392 of the Vehicle and Traffic Law, and may also result
in the revocation or suspension of the registration and/or the applicant’s license pursuant to regulations established by the Commissioner.
Return completed form and payment to: DMV Custom Plates Unit, PO Box 2775, Albany NY 12220
Amount Enclosed
$_____________
o Drive Out Diabetes
o Erie Canal
o Keep Kids Drug Free
o Life Pass It On
o Love Your Library
o Marine & Coastal District
o National Multiple Sclerosis Society
o New York State Cultural Institutions
and Museums
o Our Best Friends
o Peace At Home
o State of the Arts
o Agriculture in the Classroom
o Autism Society of America
o Bluebird Environmental
o Conserve Habitat
o Discover Queens
o Drive for the Cure
o New York Yankees 2009 World Series Champions
o Brooklyn Dodgers
o NY Giants Super Bowl Champs - NFL
o NYS Fair
Standard - $43.75
Personalized - $75.00
o I♥NEW YORK
Standard - $43.75
Personalized - $75.00
o Olympic Spirit
Standard - $48.75
Personalized - $80.00
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