Application for Original or Replacement Title Validation Decal for an Off-Highway Vehicle

Title validation for an off-highway vehicle requires the use of the following application by that vehicle’s owner.

Extracted Text for Proper Search

S	

TATE OF FLORIDA  	
DEPARTMENT OF HIGHWAY SAFETY & MOTOR VEHICLES  
SUBMIT THIS FORM TO YOUR LOCAL TAX COLLECTOR OFFICE  	
www.flhsmv.gov/offices/	 	
APPLICATION FOR ORIGINAL OR REPLACEMENT TITLE VALIDATION 
DECAL FOR  AN OFF-HIGHWAY VEHICLE  	
(SEE APPLICATION INSTRUCTIONS ON SECOND PAGE )  VALIDATION DECAL 
FEE ( $9.25) 
BRANCH FEE, I F APPLICAB	
LE ($ .50) 
MAIL  FEE, IF APPLICABLE ( $	
 .7	5) 	
DAT	

E:	
  	
I (We) hereby make application for the following off- highway vehicle title validation decal: 	
ORIGINAL                            	 	 REPLACEMENT 	
(1) 	OWNER/CO	-OWNER INFORMATION	 	 OWNER 'S NAME  	 CO-OWNER 'S NAME, IF APPLICABLE  	
 OWNER’S EMAIL ADDRESS  	 CO-OWNER’S EMAIL ADDRESS  	
 MAILING ADDRESS  (FOR TITLE VALIDATION DECAL)  
 C ITY 	 STATE  	 ZIP 	
 (2)	 	OFF	- HIGHWAY VEHICLE INFORMATION	 	 TITLE NUMBERW  	 VEHIC LE	 IDENTIFICATION	 NUMBERW 	
 MODEL YEARW  	 MAKE OF VEHICLE:  	
 (3)	 	REASON FOR REPLACEMENT OF TITLE VALIDATION 	DECAL	 (see reverse side of form)	 	
The original title valida tion decal to the above described vehicle was:  	
 Damaged             	 Defaced           	  Lost             	 Lost -In -Transit	 (applied for and never received)	 Stolen  	
ATTESTMENT  	 	
(CHECK WHEN APPLICABLE)  	
My title validation decal was reported as stolen to  the:      	 Police Department      or      	 Sheriff's Office 	
UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING 
DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE.  
SIGNATURE OF CO -OWNER (IF APPLICABLE)   SIGNATURE OF OWNER      
HSMV 82054 (0	
4/14)  	 www.flhsmv.gov

INSTRUCTIONS TO APPLY FOR AN ORIGINAL OR REPLACEMENT 	
TITLE VALIDATION DECAL	 	
Submit this completed form with applicable fees to your local county tax collector's office or 
license plate agency . 
A.  I

f applying for an original title validation  decal, complete Sections 1, 2 and 4 on the reverse side of this 
form.  
B.  I

f applying for a replacement title validation  decal, complete all sections on the reverse side of this form. 	
Replacement Types For Title Validation Decals	 	
Damaged:	 	
A damaged decal  is when the decal has sustained physical damage. 
Example:  Someone has peeled half of the letters/numbers off of the decal or the customer has waxed the 
letters/numbers off of the decal, etc.  
R

eplacement fees are required,  unless law enforcement has issued a citation to the customer.  If a citation has 
been issued, the owner must surrender the damaged decal  to a local county tax collector's office or license plate 
agency (along with a copy of the citation) to obtain a replacement at no fee.  
Defaced:	 	
A defaced decal is when the decal  has not sustained physical damage, but is unreadable for some other 
reason.  
Example:  The sun has faded the letters or numbers on the decal . 
R

eplacement fees are required,  unless law enforcement has issued a citation for the defaced decal .  The owner 
must surrender the defaced decal  to a local county tax collector's office or license plate agency (along with a 
copy of the citation) to obtain a replacement at no fee.  
Lost (not stolen)	 	
Replacement fees are required.  
Lost in Transit:	 	
Titles validation decals lost in the mail may be replaced at no fee, if the application is made within 180 days 
from the date of issuance.  
Stolen (not lost):	 	
The applicant must certify in Section 4,  on the reverse side of this form, that the item was reported to law 
enforcement as being stolen.  The replacement will be issued at no charge.  
Check your local phone book government pages or visit the following website for current mailing 
addresses: http://www.flhsmv.gov/offices/.   
 
  HSMV 82054 (04/14) 	
 www.flhsmv.gov