HTML Preview Application Passenger Fee Receipt Card Vehicles page number 1.
KENTUCKYTRANSPORTATIONCABINET
DepartmentofVehicleRegulation
DIVISIONOFMOTORCARRIERS
TC95‐39
Rev.07/2015
Page1of2
APPLICATIONFORKENTUCKYPASSENGERFEERECEIPTCARDFORYEAR AddOn Renewal
MAILTO:POBOX2007,Frankfort,KY40602‐2007 Phone:(502)564‐1257Fax:(502)564‐4138
Walk‐ins:8:00am–4:00pmEST
http://transportation.ky.gov/motor‐carriers
OfficeUseOnly
BUSCERTIFICATE#
BUS PlateFee 39 Cert 41 $250.00
TRANSPORTATIONNETWORKCOMPANY#
TNC PlateFee 42 Cert 43 $250.00
DISABLEDVEHICLECERTIFICATE#
DPV PlateFee 42 Cert 43 $250.00
LIMOUSINECERTIFICATE#
LIMO PlateFee 42 Cert 43 $250.00
TAXICABCERTIFICATE#
TAXI PlateFee 42 Cert 43 $250.00
SECTION1:COMPANYINFORMATION
LegalName: DBAName:
Street:
City: State: Zip:
Phone: Fax: Email:(required)
SECTION2:VEHICLEINFORMATION
UNIT#
VEHICLEIDENTIFICATION#
(Serial#)
MAKE YEAR PLATESTATE PLATE#
FEEPER
VEHICLE
SEATING
CAPATICY
MCPLATE/DECAL
(OfficeUseOnly)
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TOTALFEESSUBMITTED $