Printed by authority of the State of Illinois. January 2007 — 25M — VSD 612.4
Bass License Plate
Deer License Plate
Duck License Plate
Goose License Plate
Pheasant License Plate
Turkey License Plate
JESSE WHITE • SECRETARY OF STATE
Vehicle Owner’s Name
City State ZIP
Daytime Telephone Number (8 a.m. - 4:30 p.m.)
Current License Plate # Expiration Date
If your exact 1st, 2nd and 3rd choices are not available, would you like the next plate number available in that series? Yes No
If you want a space between letters, please indicate with a slash mark. An automatic space is required between letters and numbers.
Note: Spacing will vary with the type of plate requested.
Proper completion of this form is the customer’s responsibility.
OFFICE USE ONLY
1st choice 2nd choice
A B C D A B C 1 Vanity Sporting Series Plates
1, 2, 3 or 4 letters
Personalized Sporting Series Plates
1 or 2 letters plus 1-99
3 letters plus 1-9
Sporting Series Vanity & Personalized Plates Request Form
Bass Deer Duck Goose Pheasant Turkey
• No refund or adjustment will be made for a change of choice or
spacing after a plate has been ordered or if the request form is
• The Secretary of State’s office is authorized to recall a plate
determined to be obscene or offensive.
• All request forms should indicate whether or not you want the
Secretary of State to assign one of your choices with the next
available number if your exact request is unavailable.
• If you wish to submit more than three requests, attach additional
selections to the request form.
• Plates may be requested and ordered at www.cyberdriveillinois.com
• Intermix letters and numbers
• Use a space between numbers
• Use lower-case letters
• Use characters, symbols, foreign words or symbols of punctuation,
such as dashes or periods
• Select obscene or offensive combinations
• Money must accompany request forms on all first-time registrations.
• A leased vehicle is eligible for vanity or personalized plates.
Vanity/Personalized Plates SPORTING
S E R I E S