South Carolina Department of Motor Vehicles
Application to Replace or Surrender Plate, Decal, or
Registration
Applications are accepted at SCDMV branches or can be mailed to: SCDMV, 10311 Wilson Blvd., Building C, Blythewood, SC 29016-0019
SECTION I - Name and Address of Registered Owner/Plate Information:
Full Name ____________________________________________________________________ Phone Number __________________________________
Residence Address________________________________________ City _____________________________________ State_____ Zip Code _________
Mailing Address _________________________________________ City ______________________________________ State _____ Zip Code _________
License Plate No.Vehicle Identification Number
*For multiple plates, you must complete Section VI Golf Cart Permit # __________________________
Update Voter Unless you indicate otherwise, the addresses above will be used by the State Election Commission to update your voter registration:
Registration |
Do not update my residence address. |
Do not update my mailing address. |
SECTION II - Turn In/Report (check one) |
License Plate |
Golf Cart Permit |
Suspended |
Exchanged for Special Plate |
|
Relinquished Special Plate |
Found |
Voluntary Turn In |
Voluntary Turn In (owner retained plate) |
Lost |
Other (state reason) |
Vehicle Sold Date: |
______ To: _________________ |
|
Address: |
|
|
|
|
|
|
|
|
|
Please check if you wish to obtain a receipt.
SECTION III - I wish to replace (check one) Expiration Year Decal Plate Registration
(Required) I attest that I have not requested or received a refund for vehicle property tax or registration fees for this license plate.
If your license plate was turned in on a prior date or ”other” is marked, additional requirements may be necessary for replacement.
|
|
|
|
|
|
|
I certify the plate, expiration year decal, or registration was: (check one) |
Turned In |
Other (state reason) |
|
Lost |
Stolen |
Destroyed |
Never Received |
Defective |
Damaged in Mail |
INSURANCE CERTIFICATION (Required if replacing decal or plate.)
Under penalties of perjury, I declare this vehicle is insured with the following company named below and I will maintain liability insurance throughout the registration period.
Insurance Company Name:
SECTION IV - Authorized individual making report or obtaining replacement (If different from registered owner)
|
|
|
|
|
|
|
|
|
|
Name |
|
|
Street Address |
|
|
|
City |
|
State |
|
|
Zip Code |
|
Signature of Authorized Individual |
|
|
|
|
|
|
|
SECTION V - I certify all information provided in this application is true and correct. (Required)
Registered Owner’s Printed Name |
Registered Owner’s Signature |
Date |
South Carolina Department of Motor Vehicles
Application to Replace or Surrender Plate, Decal, or
Registration
SECTION VI - Only required for multiple plate turn in requests.
License Plate Number |
Year/Make |
Vehicle Identification Number |
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
DMV USE ONLY: Do not write below this line
New Plate |
|
I ID Presented |
|
Office/Clerk |
|
Date |
DMV Registration Refund Initiated
VISIT OUR WEBSITE AT WWW.SCDMVONLINE.COM