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Kentucky Transportation Cabinet TC 96-15E
Division of Motor Vehicle Licensing
Application for Special License Plate
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COLORS
Horse – Black
Letters/Numbers – Kentucky Blue
Background – Ky Blue to Light Blue to White |
Please print or Type:
Name
____________________________________________________________________
Address
__________________________________________________________________
City ________________________ County__________________________ Zip
________
Pursuant to KRS 186.164 – Must be a non profit organization and in
compliance with the parameters of the Kentucky Revised Statutes.
I am applying for the following special license plate: Walking Horse
__________ Indicate the number of plates you are requesting.
$_________ Amount for plate(s) - Each plate is $25.00
$_________ Voluntary contribution to KWHA Ladies Auxiliary
(suggested is $5 for single plate; $10 for multiple plates)
$_________ Total amount enclosed – Make Check payable to
Kentucky State Treasurer
We must have 900 paid applications in order for the plate to be
produced. When the 900 applications have been received, you will be
contacted to pickup your plate at your county clerk’s office.
Mail your application and payment to: Nancy Short
KWHA Ladies Auxiliary
P O Box 568
Richmond KY 40476-0568
For Questions, call Nancy Short (859) 369-5986 (home) or (859) 625-2240
(cell)
Email: shortn@msn.com
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