APPLICATION FOR SPECIAL TAG

House Bill 276

2015 LEGISLATIVE SESSION
SPECIAL TAG APPLIED FOR:
MULE TRAIN
Post Office Box 386
MARKS, MS 38646
For more information, please call 662-326-4000

CUSTOMERS NAME:
MAILING ADDRESS:

___________________________________________________________________
______________________________________________________________________

CITY: ________________________________________ STATE: MISSISSIPPI

ZIP CODE:___________

TELEPHONE NUMBER(s): _________________________________ Cell:_______________________________

WHAT COUNTY YOU LIVE IN?_______________________________________________________________
WHAT IS YOUR CURRENT TAG NUMBER: ___________________________________________________

SPECIAL TAG FEE:

$31.00 (INCLUDING MAILING FEE)

DATE: __________________

SIGNATURE: __________________________________________________

PLEASE CHECK ONE

Paid by: ( ) Check
( ) Money order

) Cash

Make checks and money orders payable to QCDO TAG FUND, mail application and the
required fee to the address shown above.
PLEASE NOTE:
300 TAGS MUST BE PRESOLD BEFORE THE MISSISSIPPI STATE TAX COMMISSION WILL BEGIN
PRODUCTION ON A PARTICULAR DISTINCTIVE TAG INCLUDED IN HOUSE BILL 1482. WHEN THE
TAX COMMISSION RECEIVES THE 300 APPLICATIONS, WITH THE APPROPRIATE FEES, AND A
DESIGN PROVIDED BY THE ORGANIZATION AND APPROVED BY THE TAX COMMISSION, THE TAG
CAN BE PUT INTO PRODUCTION.
THE APPLICANT WILL BE NOTIFIED BY THE ORGANIZATION RESPONSIBLE FOR THIS PARTICULAR
TAG WHEN HIS TAG CAN BE PICKED UP AT THE OFFICE OF THE TAX COLLECTOR IN HIS COUNTY
OF RESIDENCE. THE TAX COLLECTORS OFFICES WILL HAVE A LIST PROVIDED BY THE TAX
COMMISSION OF PEOPLE WHO HAVE ALREADY PAID THEIR FEES AND ARE ENTITLED TO ONE OF
THE FIRST 300 TAGS.
THE APPLICANT SHOULD PICK UP HIS TAG AS SOON AS HE IS NOTIFIED THAT THE TAG IS
AVAILABLE AT THE TAX COLLECTORS OFFICE. THERE SHALL BE SIXTY (60) DAYS ALLOWED
FROM THE TIME THE TAXPAYER IS NOTIFIED BY THE ORGANIZATION FOR THE TAXPAYER
TO PICK UP THE LICENSE PLATE, HOWEVER, IF THE APPLICANT CHOOSES TO WAIT TO PICK
UP HIS TAG, THE SPECIAL TAG FEE SHALL BE PAID AGAIN AT THE TIME THE SPECIAL TAG IS
PICKED UP TO BE REGISTERED TO THE APPLICANTS VEHICLE.