ARMED FORCES RENEWAL

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ARMED FORCES RENEWAL

Active duty military personnel qualifies for a reduced rate renewal. To request a renewal at the reduced rate we will need a completed armed forces affidavit signed by an officer. You may attach copies of your orders in leu of an officer signature, but the form is still required. If you have out of state insurance we will also need a copy of that.

ARMED FORCES FORM 779-17

ARMED FORCES RENEWAL

"*" indicates required fields

Date*

VIN# OR TAG #*

Name*

First Last

Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone

UPLOAD ARMED FORCES AFFIDAVIT 797-17*

Drop files here or

Max. file size: 100 MB.

upload insurance verification*

Drop files here or

Max. file size: 100 MB.

CARD NUMBER*

CARD EXPIRATION DATE*

CVV CODE*

BILLING ZIP CODE FOR CARD*

ELECTRONIC PAYMENT ADDTIONAL FEE*

I understand that there will be an additional fee for paying with card. The fee is 2.25% of the total + $2. This is not a fee charged by this agency, it is a result of the vendor fee’s being passed to the customer because in this case the vendor is the state.