Form |
Missouri Department of Revenue |
1275 |
Special Permits Application |
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Any false statement in this application is a violation of the law and may be punished by fine or imprisonment or both.
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Validation Area |
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Applicant’s Name |
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DLN or FEIN number |
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Information |
Street Address or RFD |
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County |
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City, State, ZIP Code |
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Telephone Number |
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Applicant |
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(__ __ __) __ __ __ - __ __ __ __ |
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If applicant is a dealer, show dealer license number here: |
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If applicant is vehicle owner, complete information on next line. |
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Year |
Make |
Body Style |
Vehicle Identification Number |
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Enter the amount and type of permit desired. Use a separate application for each type of permit unless ordering books of permits. Proof of ownership must be submitted for each permit requested (except books of permits).
Information |
No. of Items Required |
Permit Type |
Price (includes $3.50 processing fee) |
Amount |
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Maintenance Permits |
$ 8.50 each |
$ |
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Documented Vessel Temporary Permit |
$ 8.50 per set or $53.50 per book of 10 |
$ |
Ordering |
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Temporary Watercraft Permit |
$ 8.50 per set or $53.50 per book of 10 |
$ |
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Temporary Outboard Motor Permit |
$ 5.50 per set or $23.50 per book of 10 |
$ |
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For Department use only: (List Permit Number(s) issued above |
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I hereby certify that the information given herein is true and complete and that the permit(s) applied for will be used in accordance with the statutes of Missouri. The signature below shall certify that I have and will maintain during the use of this permit, and period of registration, financial responsibility with respect to each motor vehicle that I own, license, or operate on the streets or highways. Any false affidavit is a crime under Section 575.050 of Missouri law.
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Signature |
Title |
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Printed Name |
Date (MM/DD/YYYY) |
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__ __ /__ __ /__ __ __ __ |
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Applies to Temporary Permits Only:
Your temporary permit expires _______________________ and you will be subject to a title penalty if you do not submit your application for title
on or before this expiration date.
Boats or Outboard Motors — A title penalty fee of $10 for each 30 days of delinquency, not to exceed $30, shall be imposed for failure to apply for a certificate of title within 60 days after purchase date of ___________________________________________.
Form 1275 (Revised 07-2013)
Instructions and Limitations
1.This form may be used to order four different types of permits. You will receive a Permit or a Registration Certificate for the purpose indicated on the application.
2.Each Permit is subject to the legal limitations outlined below:
Maintenance Permit — Individual can operate an empty vehicle currently licensed as a local commercial vehicle and its mounted equipment beyond the 50 mile licensed zone to or from a place of repair or maintenance, or place where the mounted equipment may be repaired or replaced. Permit is valid for 10 days from the date of issuance. Requires current registration receipt.
Temporary Watercraft Permit — Allows a Missouri resident or a non-resident to operate a newly purchased watercraft on the waterways of Missouri. The permit is valid for 30 days from the date of issuance. Requires proof of ownership.
Temporary Outboard Motor Permit — Allows a Missouri resident or a non-resident to operate a newly purchased outboard motor on the waterways of Missouri. The permit is valid for 30 days from the date of issuance. Requires proof of ownership.
Documented Vessel Temporary Permit — Allows a Missouri resident or a non-resident to operate a newly purchased vessel (boat) while a Certificate of Registration is being obtained from the U.S. Coast Guard. The permit is valid for 60 days from the date of issuance. Requires proof of ownership.
Note: These permits are not renewable or transferable. For watercraft, outboard motors, and documented vessels (boats), the applicant must carry the permit while the unit is in operation.
3.Checks may be accepted as payment. Make the check payable to: Missouri Department of Revenue. The check must be pre-printed with the check writer’s name and address, bank code, and account number. It must also include the following information regarding the check writer:
•Driver license or non-driver license number;
•Date of birth; and
•Daytime phone number.
The Missouri Department of Revenue may electronically resubmit checks returned for insufficient or uncollected funds. Other restrictions may apply.
Form 1275 (Revised 07-2013)
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Mail to: Motor Vehicle Bureau |
Phone: (573) 526-3669 |
Visit http://dor.mo.gov/ |
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P.O. Box 100 |
Fax: (573) 522-4197 |
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for additional information. |
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Jefferson City, MO 65105-0100 |
E-mail: dealerlic@dor.mo.gov |
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