Request Assistance With License Plates or Sales Tax

2. First Name*

3. Last Name*

5. Phone Number*

   Provide the number where you can be reached during the day.

6. Alternate Phone Number

   Provide the number where we can leave a message.

8. Email Address

10. Mailing Address*

    Please provide your mailing address or PO Box.

12. Physical Address

    Please provide your physical address.

14. City*

    Mailing City

15. State*

16. Zip*

18. License Plate Number

20. I need help with:*

    1. An online access code
    2. Paying sales tax

    1. Online renewal
    2. Missing postcard

    1. Paying with cash
    2. Other

22. Type in a brief description of your request:*

Leave This Blank:


24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

* indicates a required field