Form Mvd-355-Town/city Requisition Form
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1NEW HAMPSHIRE DEPARTMENT OF SAFETY
41 HAZEN DRIVE, CONCORD, NH 03305
FAX ALL REQUESTS
ATTN.: SUPPLY WAREHOUSE
Shipped UPS Within Ten (10)
TELEPHONE INQUIRY: (603) 223-8000, Option #4, then Option #3
Workdays
FAX: (603) 271-6678
EXCEPT FOR DECALS & PLATES
PLATEROOM ORDERS CALL 271-3757
TOWN/CITY REQUISITION FORM
CONTACT
TOWN/CITY: ___________________________________ NAME:__________________________ AGENT #: _____________
STREET & ZIP: ____________________________________________PHONE: _________________ DATE: _____________
FORM#
DESCRIPTION
PACKAGING
ORDER AMT.
DSAD 3
Greenies – MA
50/pad
DSMV 30
Record Change Request
100/pack
DSMV 38
Parent or Guardian Authorization Certification
100/pad
DSMV 181S
Blank Registration (“old style”)
2400/case
DSMV 255
Revenue Memo
100/pack
DSMV 505
Release of Motor Vehicle Records
50/pad
RDMV 110
Application for Certified Copy of Registration
100/pad
RDMV 120
Application for Initial Plates
100/pad
RDMV 125
Application for Replacement Plates / Decals
50/pad
RDMV 130
Application for Walking Disability Privileges
50/pad
RDMV 306
Administrative Complaint (town check ret’d by bank)
50/pad
RDMV 312
Batch Cards
50/pack
RDMV 344
Blank Registration – 3-Up. State Seal Only
250/pack
RDMV 354
Permit to Operate Uninsp. MV (Vehicle out of state)
100/pad
RDMV 356
Short-Term Permit to Operate Uninspected MV
100/pad
S/N 7300
Envelopes – Green Municipal Agent
50/pack
PLATES
Passenger
50/crate
PLATES
Motorcycle
25/bndl.
PLATES
Trailer
25/bndl.
PLATES
Other
each
DECALS
Trailer Vehicle Identification Numbers
25 each
DECALS
Double Decals Year
What Year? ____________
100/book
DECALS
Single Decals Year
What Year? _____________
100/book
DECALS
Monthly Decals
WHAT MONTH(S)? _____________________
100/book
TDMV23
Title Applications
100/pack
TDMV23B
Title Applications for Lexmark printers
RDMV372 (Rev 01/15)
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Parent category: Business