Military & Veterans' Registry Application

Applicants must submit a DD-214 or NGB-22 indicating length and character of services.

If the name of the DD-214 is different than the veteran's current legal name, documentation of name change is required.
If you are currently on active duty, please provide a military ID card. This does not include retirement ID cards or VA service cards.
If applying for a DAV license plate, submission of a benefit summary showing 100% Permanent and Total rating is required.
Please allow at least 24 hours for information to be electronically transferred to the DMV's database.
An email message will be sent to confirm receipt.
If you are missing documentation or have questions about this form, please use our DD-214 Online Request or contact us at ndva@nebraska.gov or 402-471-2458.

A paper application is available if you prefer to mail in your application. Download Paper Application

First Name

Last Name

Suffix

Address 1

Address 2 (suite, apt #, etc.)

City/Town

State

Zip Code

Phone Number

Birthday

Social Security Number (last 4 digits)

Driver License State Issued

Driver License/State ID Number

Military Component

Email Address

Confirm Email Address

Comments

STATEMENT OF CONFIDENTIALITY:

By submitting this form, I understand failure to provide the requested information or access thereto may result in a denial letter. I understand that the Department of Veterans' Affairs may certify me for the military honor license plate and/or the veterans' identifier on my state issued ID. Nebraska Department of Veterans' Affairs may contact you regarding other benefits but will not disclose or sell your information.