Phone: 785-296-3601
Fax: 785-291-3755
www.ksrevenue.gov
Division of Vehicles
915 SW Harrison, Room 162
Topeka, Kansas 66626
Nick
Nick Jordon,
Jordon, Secretary
Secretary
Donna
CarmenShelite,
Alldritt,Director
Director
Department
DepartmentofofRevenue
Revenue
MEMORANDUM
To:
County Treasurers and County Motor Vehicle Staff
From: Donna Shelite, Director of Vehicles
Date:
August 9, 2012
RE:
Friends University Educational Institutional License Plate
By this time you should have received your shipment of Friends
University educational institutional plates.
The completed Friends University Alumni Association Certificate (sample
enclosed) must be surrendered and scanned with the application when
the plate is delivered to the applicant or when the owner is renewing the
registration. The applications include: original titles, update registration
and registration renewals.
Listed below are the fees for the Friends University plate due with the
initial application. These fees are in addition to the property tax, regular
registration and title fees for a vehicle.
 A $5.00 collection fee per plate each time an Educational Institution
Plate is delivered.
 A $40.00 personalized plate reservation fee will be charged upon
delivery of each university plate.
 A 50¢ reflectorized plate fee.
 A $5.00 County Service fee.
You may contact Friends University Alumni Association at the following
toll free number 1-800-794-6945, ext. 5900, if you should have any
questions regarding the certification forms.
Thanks for your continued support and assistance. If you have any
questions, please call the Central Office Operations at 785-368-8384.
cc:
Deb Wiley
LeeAnn Phelps
DS:rw
Attachment
Friends University License Plate Certification
REGISTRATION INFORMATION:
Type of Application
________________
Current Lic. Plate No.
[
[
[
____________
Registration Year
_________
County Situs
] Renewal
] A – Auto OR T – Truck (Registered for 20,000 lbs. Or less)
] New Registration (Newly Acquired Vehicle)
Certification Expires:
__________
Month
VIN Number: ________________________
_____
Year
Owner Information:
__________________________________________
Vehicle Owner’s OR Leasee’s Printed/Typed Name
_________________________
Address







____________________
Daytime Phone Number
____________________
City
______
State
_________
Zip
Certification valid for issuance of one special license plate for the vehicle listed above.
Current Kansas registration required. Vehicle may be registered in the name of one or more owners or
leasees, but one of the owners or leasees must be properly authorized by the Alumni Association or
Endowment Association for the University or Educational Institution shown below.
The name on this certificate must also appear on the vehicle title and registration.
Requests for special plate numbers will not be honored.
Current fees, payable at the time of registration, will include a one-time specialty plate fee of $40.00,
plus a one-time reflectorized plate fee of $0.50; annual regular registration fee, including a $5.00
county transaction fee; property taxes; and sales tax, if applicable.
Proof of eligibility: Documentation of eligibility is subject to verification by the Division of Vehicles.
The following verification statement must be signed and stamped by the authorized representative of
the organization.
This certification must be presented to the County Treasurer when originally applying for an
educational institutional license plate or renewing the registration on an existing educational
institutional license plate.
Name of University or Educational Institution: FRIENDS UNIVERSITY
I certify that the applicant identified above is authorized to obtain one special educational institutional
license plate.
Signature of Authorized Representative
Date
Hervey Wright
Print or Type Name
Vice President for University Relations
Title of Authorized Representative
FOR APPLICATION ASSISTANCE, CALL: Friends University Alumni Office - 1-800-794-6945 ext. 5900
Original copy of this certification to County Treasurer