Form
1576
Missouri Department of Revenue
Application for Replacement
Plate(s) and Tab(s)
Ofce Validation
Pursuant to 301.420 RSMo, any false statement in this application is a violation of the law and may be punished by ne, imprisonment, or both.
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Vehicle Information
Year Make Vehicle Identication Number
Title Number Body Style Kind of Vehicle - If Truck or Bus License Number Tab Number New Tab Number
(Zone, Gr.Wt., Seat)
Expiration Month Expiration Year Replacement Permit Number Total Fees
Notary Information
Subscribed and sworn before me, this
day of year
State County (or City of St. Louis) My Commission Expires (MM/DD/YYYY)
Notary Public Signature
Notary Public Name (Typed or Printed)
Embosser or black ink rubber stamp seal
__ __ /__ __ /__ __ __ __
Signature Title
Printed Name Date (MM/DD/YYYY)
Signature
Under penalties of perjury, I declare that the above information and any attached supplement is true, complete, and correct.
__ __ /__ __ /__ __ __ __
Office Use Only
Applicant last renewed this registration on __ __ /__ __ /__ __ __ __ at the _____________________________________________ ofce.
Applicant presented documented proof that the above vehicle is currently registered and the registration is current for this period as
witnessed by ___________________________________________________________________________________________________.
Agent’s Signature Date (MM/DD/YYYY)
Remarks
__ __ /__ __ /__ __ __ __
Owner
Information
Owner’s Name (Last, First, Middle) Telephone Number
Street, Rural Route, or P.O. Box City State Zip Code County
(__ __ __) __ __ __ - __ __ __ __
Form 1576 (Revised 10-2013)
Replacement Plate
Information
Do not use this form if plates are being issued from stock. Use an Application for License (Form 184) instead.
Number of Plates Needed r One r Two r Tabs Only r Bronze Star Placard r Change of Address
Reason Required r Lost r Stolen r Mutilated r Destroyed r Never Received r Seized by Law Enforcement
r Requesting Enhanced Security Tabs (I certify that the tabs displayed on my plates
will be destroyed upon receipt of the requested replacement tab(s).
r Second Plate Only (see reverse)
No notarization required
Reset Form
Print Form
If plate(s) or tab(s) are lost or stolen, notify local law enforcement authorities or the Missouri State Highway Patrol.
Vehicle owners can obtain replacement plate(s) or tab(s) in instances when the original has been lost, stolen, mutilated, destroyed, or
never received.
Note warning at the top of form. (301.420 RSMo)
Be absolutely sure that the replacement plate(s) or tab(s) are needed. There will be no refund granted after the manufacture of the
replacement plates.
If the original is found after application is made, the original becomes null and void and must be surrendered immediately to the Missouri
Department of Revenue.
1. Your name must match the name as it appears on your certicate of title or registration receipt, otherwise this application will be
rejected.
2. Show your present address and telephone number where you may be reached during normal working hours.
3. Complete all vehicle information blocks.
4. If you have truck or bus plates, show zone and weight, or seating capacity.
5. Show current license plate(s) or tab(s) number and expiration month and year.
6. If applying for replacement plates or tabs, indicate the number of plate(s) you need to replace. If replacing tabs only, mark the
“Tabs Only” block.
7. Indicate the reason required.
8 The application must be signed in the presence of a Notary Public. Not required to be notarized if applicant is applying for an
optional second plate CMV.
Form 1576 (Revised 10-2013)
Mail to: Motor Vehicle Bureau Phone: (573) 526-3669
P.O. Box 100 E-mail: mvbmail@dor.mo.gov
Jefferson City, MO 65105-0100
Visit http://dor.mo.gov/motorv/
for additional information.
Applicant Instructions - Please Read Carefully
When application is made for replacement plate(s), you will be issued one Replacement Plate Permit. This permit serves as proof of valid
registration until you receive the replacement plate(s). The permit is to be displayed on the back windshield of your motor vehicle unless it
is a motorcycle, motortricycle, or trailer. Please carry the validated application receipt with you as proof of valid registration until you receive
your replacement plate(s) or tab(s).
If only one plate is replaced, it must be attached to the rear of the vehicle. A replacement plate for a commercial motor vehicle must be
attached to the front of the vehicle.
Replacement and Processing Fees
$8.50 per plate or $17.00 per set of plates and a $3.50 processing fee
$8.50 per tab or set of tabs and a $3.50 processing fee
Any person replacing stolen license plates or tabs may receive up to two sets of license plates or tabs per year at no cost.
Second Plate Only - Any owner of a commercial motor vehicle whose vehicle is licensed as farm, local or beyond local in excess of 12,000
lbs., or an owner of a commercial bus may be issued a second license plate. The second license plate will bear the same conguration as the
initial license plate and contain a number “2” sticker in the upper right hand corner. The rst plate must be attached to the front of the vehicle
and the second plate, with the “2” sticker, must be placed on the rear of the vehicle. No notarization is required for optional second plate CMV.
Second Plate and Processing Fee
$8.50 for second plate and a $3.50 processing fee
Checks may be accepted as payment. Make checks payable to: Missouri Department of Revenue. The check must be pre-printed with the
check writer’s name, address, bank code and account number. It must also include the following information regarding the check writer:
1. Driver’s license or non-driver’s license number;
2. Date of birth; and
3. Daytime telephone number.
Note: The Missouri Department of Revenue may electronically resubmit checks returned for insufcient or uncollected funds. Other
restrictions may apply.
Replacement Plate(s) and Tab(s) - Special Instructions