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You will need information about your household income, your Vehicle Identification Number, license plate number, and the make/model of your vehicle.
Print, Sign, and Mail
All applications must be signed and mailed or faxed to our office. Visit the contact page for details. Make sure to save a copy for yourself.
Case managers are available to help. We can complete the application for you over the phone or mail you a hard copy. We also provide bilingual assistance.
Please call us at 855.483.5107 during regular business hours (9:00 am to 5:00 pm, Monday through Friday).