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New Emblem No. New Plate No. <br /> COUNTY OF HAWAII,DEPARTMENT OF FINANCE <br /> VEHICLE REGISTRATION&LICENSING DIVISION <br /> 101 PAUAHI ST.SUITE NO.5 <br /> HILO HI 96720 <br /> APPLICATION FOR REPLACEMENT OF LICENSE PLATE AND/OR DECAL <br /> I hereby certify that the motor vehicle license plate <br /> No. and/or decal no. <br /> for <br /> (make&type) Serial No. <br /> has been: E] lost ❑ mutilated ❑ stolen ❑ stored ❑ destroyed <br /> In accordance with Section 249-8, Hawaii Revised Statues as amended, I hereby make <br /> application for the replacement of: <br /> 0 plate ❑ decal expiring <br /> (month/year--mm/yyyy) <br /> 0 mutilated plates and/or remaining plate return for cancellation <br /> converted to: E— passenger commercial veterans <br /> ❑ other: <br /> Date Signature of Registered Owner <br /> FEE: Emblem Only$.50 Plate Only$5.00 Plate and Emblem$5.50 <br /> (This application to be submitted with the current year's registration and valid safety inspection <br /> certificate) <br /> Hawai'i County is an Equal Opportunity Provider and Employer <br />