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End Hunger ‘Imagine’ Specialty                 License Plate
An organization that seeks to establish a new specialty license plate for which an annual use fee is to be charged, must submit the results of a scientific sample survey of at least 15,000 registered vehicle owners or registrants who support the idea.

The additional cost of this specialty tag will be $25.00 plus a $2 processing fee required by the state.

The specialty license plate will create a dedicated funding source for The Florida Association of Food Banks.

The purpose of the license plate is to highlight the problems with respect to hunger in this state and the money will be used for programs directed at ending hunger in Florida.

Based on the State’s administrative requirements, the ‘Imagine’ Specialty Tag will be submitted to the Florida Legislature in March 2004 and will be available for sale in the Fall of 2004.

Thank you for your support.
Questions?
Email: info@imagineplate.com

NOTE: Participating in this official survey IN NO WAY OBLIGATES YOU TO PURCHASE A SPECIALTY LICENSE TAG FOR THIS OR ANY OTHER ORGANIZATION. This is not a legally binding contract, only a survey. SURVEY AVAILABLE FOR FLORIDA REGISTERED VEHICLE OWNERS ONLY


YES, I want to help establish a license tag honoring IMAGINE: Please complete this survey. In order for this survey to count, we must have a YES response to all four questions and your current automobile tag number.

1. Do you certify that you are the legal owner/lessee of a motor vehicle registered in the state of Florida with Florida License plate number: OR Driver's License Number and that your vehicle is eligible for a specialty license plate? YES NO

2. Do you agree that you intend to purchase an ‘Imagine’ type of specialty plate for an additional cost of $25 plus a $2.00 processing fee, if the proposed plate is approved by the Florida Legislature and offered by the Department of Highway Safety and Motor vehicles?
YES NO

3. Do you agree that your name, address, zip code, telephone number, county of residence and Florida license plate number can be provided to the Department of Highway Safety and Motor Vehicles with the results of the survey? YES NO

4. Do you authorize the organization that is proposing the specialty license plate to contact you if such license plate becomes available for
purchase? YES NO

Name:
Address:
City: Zip:
Phone#:
County:
Email:



This survey is being conducted by Foundation Consultants Corporation, who is authorized by the State of Florida, Division of Motor Vehicles to conduct this survey. For further information concerning this survey please contact FCC at:
One South Ocean Boulevard, Suite 303, Boca Raton, FL 33432
Telephone: (561) 347-9773; Fax: (561) 210-8040


Thank you for your participation.
You can also mail the survey to: Foundation Consultants Corporation, One South Ocean Boulevard, Suite 303, Boca Raton, FL 33432;
OR send by fax to: (561) 210-8040

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