Indiana handicap placard form - Learn how to apply for, renew, or replace disability parking permits in Indiana. Find out the types, rules, and fees of handicap placards and plates, and the forms you …

 
 Obtaining Plates or Placards. You may apply for a disabled person’s plate or placard at your local Motor Vehicle office, or by mail: Division of Motor Vehicles Mail and Correspondence PO Box 30412 Salt Lake City, UT 84130. There is an additional $4 postage fee for plates obtained through the mail. . Amiibo nfc app android

State Form 32584 (R13 / 7-20) INDIANA DEPARTMENT OF VETERANS AFFAIRS 777 North Meridian Street, Suite 300 Indianapolis, Indiana 46204-1421 Telephone: (317) 232-3910 * This agency is requesting disclosure of your Social Security Number in accordance with IC 4-1-8-1; disclosure is mandatory and this record cannot be processed without it. Complete, change and printing and indicator the attained Oregon Application for Handicap Parking Space. US Legal Forms may be the greatest local library of lawful varieties that you can see numerous record web templates. Take advantage of the company to down load skillfully-made files that adhere to state specifications.To apply for a "permanent" (blue) placard or "temporary" (red) placard, you must: Download the Application for Persons with Disabilities Parking Placard and/or License Plate (Form VTR-214) Have your doctor or health care provider complete the Disability Statement section of the application. Submit the completed application and payment (if ...A disabled parking permit is designed for people who experience temporary difficulties locating parking spaces. If you have a family member who struggles with this regularly, they can apply for a disabled parking permit on your behalf. Here’s more information about the process. A disabled parking permit will allow provisional use of ...There are no exceptions to this rule. They are the only people eligible to prescribe a disability parking permit to you. Your physician will have to have a valid and unrestricted license to practice medicine in the state of Indiana. The proper form you must fill out is the Application For Disability Parking Placard Or Disability Plate (State ...Online Help Form. Fill out our online help form ... Indiana Disability Rights. Contact Us. 4755 Kingsway Drive, Suite 100, Indianapolis, IN 46205. Local Phone: 317. ...When it comes to fighting disease, your body’s defense system doesn’t like enlisting outside help. Overcoming this ”locals only” attitude has been a huge handicap for scientists tr...A completed Disability-Hearing Impaired Plate/Placard Application (Form 96-0104). Medical certification ON the application, completed by a licensed physician, osteopath, or chiropractor. Payment for applicable fees: Placards: Free. License plates: Free. Personalized plates: $26.96.Pick up an application at your local license branch or you can print/download a copy of this and other helpful forms from the Bureau of Motor Vehicles web site at: …View, download and print fillable State 42070 - Application For Disability Plate Or Parking Placard in PDF format online. Browse 10 Indiana Bmv Forms And Templates collected for any of your needs.Complete and sign the remainder of the form. Mail the completed form to the Motor Vehicle Division (PO Box 201430, Helena, MT 59620-1430). To renew: complete the three steps listed above. A new Disability Permit/License Plate Application (MV5) must be completed and signed by a licensed physician, physician’s assistant, chiropractor or ...State Form 32584 (R13 / 7-20) INDIANA DEPARTMENT OF VETERANS AFFAIRS 777 North Meridian Street, Suite 300 Indianapolis, Indiana 46204-1421 Telephone: (317) 232-3910 * This agency is requesting disclosure of your Social Security Number in accordance with IC 4-1-8-1; disclosure is mandatory and this record cannot be processed without it. There are no exceptions to this rule. They are the only people eligible to prescribe a disability parking permit to you. Your physician will have to have a valid and unrestricted license to practice medicine in the state of Indiana. The proper form you must fill out is the Application For Disability Parking Placard Or Disability Plate (State ... How to fill out Indiana handicap placard: 01. Obtain the Indiana handicap placard application form from the Indiana Bureau of Motor Vehicles (BMV) website or your local BMV office. 02. Fill out the application form with accurate and complete information, including your personal details, contact information, and disability information. 03.Complete the form with your qualifying physician. Submit the form via mail or by dropping it off at the Department of Public Safety at 3600 N. Martin Luther King Ave, Building 1, Oklahoma City, Oklahoma. You can also. apply online. utilizing the following steps: Complete the online application—you’ll need your.So here's the trick. If you're trying to get a handicap placard for your vehicle. If you do through the mail process, it will take at least a month, maybe six weeks to get it, but if you take that same application form in the $5 placard feed, any license plate agency, they'll hand you a placard at that visit for the most cases.IARA: State Forms Online CatalogIC 9-14-5 Chapter 5. Parking Placards for Persons With Physical Disabilities IC 9-14-5-1 Qualification for issuance of placard Sec. 1. The bureau shall issue a placard to the following: (1) An individual of any age who: (A) has a temporary or permanent physical disability that requires the use of a wheelchair, a walker, braces, or crutches as certified by a health care provider listed in ...Florida Disabled Placards. If you are a disabled driver or passenger in Florida, you can apply for: A permanent disabled parking placard, valid for up to 4 years. A temporary placard, valid for up to 6 months. Placards are available to: Disabled people who meet the application requirements. Organizations that transport people with disabilities.A disabled parking permit is designed for people who experience temporary difficulties locating parking spaces. If you have a family member who struggles with this regularly, they can apply for a disabled parking permit on your behalf. Here’s more information about the process. A disabled parking permit will allow provisional use of ...Creepy as they may be, it turns out that snakes are pretty handy to have around. Find out what would happen if there were no snakes at HowStuffWorks. Advertisement The allegedly fe... Obtaining Plates or Placards. You may apply for a disabled person’s plate or placard at your local Motor Vehicle office, or by mail: Division of Motor Vehicles Mail and Correspondence PO Box 30412 Salt Lake City, UT 84130. There is an additional $4 postage fee for plates obtained through the mail. Learn how to apply for disability parking placards and license plates in Indiana, and what disabilities qualify you for them. Find out the eligibility, validity, and availability of these placards and plates. Completed forms may be processed at any BMV branch office or mailed/faxed to: Bureau of Motor Vehicles Disability Clerk 29 State House Station Augusta, ME 04333-0029. TTY Users call Maine Relay 711. FAX: (207) 624-9204. Phone: (207) 624-9000 Ext. 52149. BMV Use Only. Placard#_________________. There are no exceptions to this rule. They are the only people eligible to prescribe a disability parking permit to you. Your physician will have to have a valid and unrestricted license to practice medicine in the state of Indiana. The proper form you must fill out is the Application For Disability Parking Placard Or Disability Plate (State ...Our guide outlines the 7 best moving companies in Indiana and everything you need to know from pricing to services offered. Expert Advice On Improving Your Home Videos Latest View ...The disability privilege allows a qualifying individual to park in any space marked with the International Symbol of Access. The State of Colorado offers identifying license plates and placards for persons with disabilities to park in reserved parking spaces. House Bill 18-1285 Remuneration-Exempt Disability Parking Placard is effective January ...Nov 1, 2023 · Application Process for a Handicap Placard in Indiana. To apply for a permit in IN, follow these steps: 1. Obtain the Application Form. Visit the Indiana BMV website or your local BMV office to obtain the Application for Disability Parking Placard or Disability Plate (Form 42070). The form is also available at certain healthcare provider ... One very important part of making your busines accessible to customers who are handicapped is signage. Below are the best handicapped parking signs we found on Amazon. If you buy s...Pick up an application at your local license branch or you can print/download a copy of this and other helpful forms from the Bureau of Motor Vehicles web site at: …One very important part of making your busines accessible to customers who are handicapped is signage. Below are the best handicapped parking signs we found on Amazon. If you buy s...Pick up an application at your local license branch or you can print/download a copy of this and other helpful forms from the Bureau of Motor Vehicles web site at: https://www.in.gov/bmv/ under vehicle services. The Indiana code governing accessible placards and plates is IC 9-14-5-1.To apply for a DP placard: Apply online using the Disabled Person Parking Placard Form Application. OR. Apply by mail or in office: Complete and sign an Application for Disabled Person Placard or Plates (REG 195). Have a licensed physician, surgeon, chiropractor, optometrist, physician assistant, nurse practitioner, or certified nurse midwife ...You can get the Application for Disability Plate or Parking Placard (State Form 42070) by going to your nearest Indiana Bureau of Motor Vehicles Office or printing the document …It is a Class C misdemeanor to knowingly make false representations to obtain a disability placard. Signature. Printed Name. Date Signed (mm/dd/yyyy) APPLICATION FOR DISABILITY PLATE OR PARKING PLACARD. State Form 42070 (R13 / 11-13) Approved by State Board of Accounts, 2013. INDIANA BUREAU OF MOTOR VEHICLES.You may apply for a disability license plate and/or parking placard by completing an Application for Disability License Plate or Parking Placard State Form 42070. The application may be submitted to any Indiana branch or mailed to the address listed on the application. State Form 32584 (R13 / 7-20) INDIANA DEPARTMENT OF VETERANS AFFAIRS 777 North Meridian Street, Suite 300 Indianapolis, Indiana 46204-1421 Telephone: (317) 232-3910 * This agency is requesting disclosure of your Social Security Number in accordance with IC 4-1-8-1; disclosure is mandatory and this record cannot be processed without it. Jeffersonville, Indiana is one of the best places to live in the U.S. in 2022 because of its low cost of living and ample things to do. Becoming a homeowner is closer than you thin...To apply for a "permanent" (blue) placard or "temporary" (red) placard, you must: Download the Application for Persons with Disabilities Parking Placard and/or License Plate (Form VTR-214) Have your doctor or health care provider complete the Disability Statement section of the application. Submit the completed application and payment (if ...General Public Cost: There is no fee for a placard issued to a person with a permanent disability, and a $5 fee (per placard) if issued to a person with a temporary disability. 272a The fee for Disabled License Plates is the regular registration fee for the vehicle as prescribed by law.Application Process for a Handicap Placard in Indiana. To apply for a permit in IN, follow these steps: 1. Obtain the Application Form. Visit the Indiana BMV website or your local BMV office to obtain the Application for Disability Parking Placard or Disability Plate (Form 42070). The form is also available at certain healthcare provider ...Our guide outlines the 7 best moving companies in Indiana and everything you need to know from pricing to services offered. Expert Advice On Improving Your Home Videos Latest View ...Highest customer reviews on one of the most highly-trusted product review platforms. Complete IN State Form 42070 2018-2024 online with US Legal Forms. Easily fill out PDF blank, edit, and sign them. Save or instantly send your ready documents.Temporary Disabled Parking Placard Applications — May be taken to any Secretary of State facility or mailed in. Permanent Disabled Parking Placard Applications — MUST be mailed to the following address: Secretary of State, Persons with Disabilities Placard Unit, 501 S. 2nd Street, Room 532, Springfield, IL 62756.Fill out and download the Application for Disability License Plate or Parking Placard (Form 42070) for Indiana online. Get a blank PDF or Word version for free.IARA: State Forms Online CatalogLearn how to apply for disability parking placards and license plates in Indiana, and what disabilities qualify you for them. Find out the eligibility, validity, and availability of these placards and plates.Burry has called bitcoin a "speculative bubble" fueled by debt and has said it has questionable long-term prospects. Jump to Bitcoin could be sidelined by governments that consider...How to fill out Indiana handicap placard: 01. Obtain the Indiana handicap placard application form from the Indiana Bureau of Motor Vehicles …With a handicap parking permit, accessible parking spots near the entrances ofComplete and sign the applicant section of the form. Spaces for use by the Disabled Parking Permits are identified in selected lots by Disabled Parking signs.UWRF Employees must complete the application. By A Tierney · 2002 · Cited by 7 ?The Indiana Bureau of Motor Vehicles (BMV) provides an online platform where you can easily renew your handicap parking placard. Access the BMV website using a reliable internet connection and navigate to the handicap parking placard renewal section. 4. Complete the Online Renewal Form.Learn how to apply for, renew, or replace disability parking permits in Indiana. Find out the types, rules, and fees of handicap placards and plates, and the forms you need to submit.For disabled parking license plates. , submit this form, a completed License Plate Application (VSA 10) and applicable fees. For placard and/or license plates, submit forms and fees to any Customer Service Center, DMV Select or mail to DMV, Data Integrity, P.O. Box 85815, Richmond, VA 23285-5815. MED 10 (07/01/2020) 6. The Motor Vehicle Commission requires that a person’s disability be recertified by a qualified medical practitioner and their qualification for license plates/placard as provided under N.J.A.C. 13:20-9.1(a) 4. 7. The persons with a Disability placard and/or license plates are to be used exclusively for a person with a disability named on the To obtain a handicap parking pass in SC, you must complete the disability placard and License Plate Application ( Form RG-007A ), provide a medical certification from a licensed physician, provide a prescription from the licensed physician along with their signature, and pay the applicable fees (passes are $1; license plates are $20; disabled ... There are no exceptions to this rule. They are the only people eligible to prescribe a disability parking permit to you. Your physician will have to have a valid and unrestricted license to practice medicine in the state of Indiana. The proper form you must fill out is the Application For Disability Parking Placard Or Disability Plate (State ... According to Deborah Spurlock of Indiana University Southeast, “the yellow stains on skin caused by nitric acid are the result of a xanthoprotein reaction.” Xanthoproteic acid form...Disabled. Permits for Accessible Parking Accommodations. IU Bloomington faculty, staff, or students who demonstrate a need for disabled parking may purchase a Disabled permit that allows access to disabled parking on campus. If you already have a Disabled permit, you may be able to renew it online.Picketing & Scabs - The picket line draws attention to the cause the workers are fighting for. Learn about picket lines and find out where the term 'scab' originated. Advertisement...A valid email address or mobile phone number. Completed and signed placard application ( Permanent Placard Application Form or Temporary Placard Application Form) Certification from a medical professional or qualifying veteran exemption documentation. Additionally, if you are a guardian applying for a placard for transport of a disabled person ...To obtain a disability stickers in PA, disabled residents can apply through the Pennsylvania Department of Transportation. The process involves completing the Person with Disability Parking placard Application (Form MV-145A) and having it notarized. Additionally, the medical certification section of the form must be completed by a medical ...The process for renewing a handicap placard in Indiana depends on whether the pass is temporary or permanent: Temporary Pass: A new Application for Disability Parking Pass or Disability Plate (Form 42070) must be completed. A new certification from a licensed physician, chiropractor, or podiatrist must be obtained.Pick up an application at your local license branch or you can print/download a copy of this and other helpful forms from the Bureau of Motor Vehicles web site at: …The Importance of Disabled Placards. There's a broad spectrum of reasons why individuals might need a disabled placard. From mobility issues to chronic conditions, these placards can be a lifeline. Benefits to the Disabled Community. Every time a placard is used, it ensures that an individual has safer, easier access to buildings, stores, and ...Indiana just joined other states by passing what's known as a "slowpoke" law, which permits police enforcement to ticket drivers in the left lane who are holding up faster-moving t...Handy tips for filling out Indiana handicap placard form online. Printing and scanning is no longer the best way to manage documents. Go digital and save time with airSlate SignNow, the best solution for electronic signatures. Use its powerful functionality with a simple-to-use intuitive interface to fill out Indiana handicap placard online, e ...How to Apply for a Handicap Parking Permit. Get a handicapped parking application from the DMV office or online. Complete and sign the form. Ask your health-care provider to fill out and sign the ...Age and other forms of serious illness. Vehicle Registration With a Disability Plate or Placard. The car registration process for a disabled plate or placard is fairly simple and requires a few items. You …The application process involves: Completing the Disabled Placard and License Plate Application (Form RG-007A) Providing a medical certification from a licensed physician. Providing a prescription from the license …The process for renewing a handicap placard in Indiana depends on whether the pass is temporary or permanent: Temporary Pass: A new Application for Disability Parking Pass or Disability Plate (Form 42070) must be completed. A new certification from a licensed physician, chiropractor, or podiatrist must be obtained. You can get the Application for Disabled Person Placard or Plates (Form REF 195) by going to your local California Department of Motor Vehicles (DMV) Office or printing the document online. There is no fee for a permanent parking placards and license plates, but there is a $6 fee for a temporary parking placards. Indices Commodities Currencies StocksITD Form 3392. Disability License Plates and PlacardsITD 3392 (Rev. 0 7 -18) Supply # 019580141. Are You Eligible? A disabled person includes any person who is unable to walk 200 feet or more unassisted by another person or without the aid of a walker, crutches, braces, prosthetic device or a wheelchair; or without great difficulty or ...The Application for Handicapped License Plates cannot be used to renew a Handicapped Parking Permit. If you need to renew your Handicapped Parking Permit, please refer to the section on Handicapped Parking Permits. Questions regarding Handicap License Plates may be addressed by email or by phone at (402) 471-3918.Completed forms may be processed at any BMV branch office or mailed/faxed to: Bureau of Motor Vehicles . Disability Clerk . 29 State House Station . Augusta, ME 04333-0029 . TTY Users call Maine Relay 711 . FAX: (207) 624-9204 . Phone: (207) 624-9000 . Ext. 52149 . Applicant Name: iling Driver’s License or ID # and Expiration Date: Phone ... To apply for a DP placard: Apply online using the Disabled Person Parking Placard Form Application. OR. Apply by mail or in office: Complete and sign an Application for Disabled Person Placard or Plates (REG 195). Have a licensed physician, surgeon, chiropractor, optometrist, physician assistant, nurse practitioner, or certified nurse midwife ... Anyone abusing or misusing their handicap placard is considered to be committing a Class C misdemeanor in Indiana, which can come with a punishment of up to 60 days in jail (!) or a fine of up to $500. If you’re not sure about the specific handicap parking rules in your area, you can always contact the Bureau of Motor Vehicles at (888) 692 ... Step 3: Return the placard application to your local DMV. Once you’ve filled out an application for a handicap parking placard, return it to your local DMV. You can return your application in-person or by mail. If you return your application by mail, you may need to pay a fee and wait until your parking placard is mailed to you.DMV > Vehicle Services > Persons with Disabilities Information. Persons with Disabilities Information. Eligibility Requirements. Placard Online Services. Registration Plates. Parking Placards. Josh Shapiro, Governor Michael Carroll, Secretary.Written by Tiffany Leung. Reviewed by Jessica Barrett. Updated on Sep 7, 2023. Table of Contents. Per the handicap placard regulations in. Indiana. , drivers …You may apply for a disability license plate and/or parking placard by completing an Application for Disability License Plate or Parking Placard State Form 42070. The application may be submitted to any Indiana branch or mailed to the address listed on the application.Please review our list below to find your state and its corresponding DMV handicap parking form. If you need assistance, don’t hesitate to give us a call at 1-844-386-7463. You can send an email to our support team as well using the address [email protected], and our team of knowledgeable professionals will walk you through the process ... Learn how to apply for, renew, or replace disability parking permits in Indiana. Find out the types, rules, and fees of handicap placards and plates, and the forms you need to submit. disability must be due to a condition listed in (2‐8) on the reverse side of this form in the "Physician/Certifying Practitioner's Statement of Certification" section. Section 320.0848(1)(d), Florida Statutes, provides that the department shall renew the disabled parking permit of any person certified How to Apply. You can apply for your handicap license plate or parking placard in Indiana by mail or in person at any Indiana Bureau of Motor Vehicles office. A completed application includes: A filled out Application For Disability Parking Placard Or Disability Plate (Form 42070) Certification from a licensed physician to verify your disability. In some states, the applications for handicap parking permits can be downloaded online. Others require you to go to your local DMV office. If you need more information, ask at your healthcare provider's office. They should be able to direct you to the proper state or county office that handles permits. Alaska. IC 9-14-5 Chapter 5. Parking Placards for Persons With Physical Disabilities IC 9-14-5-1 Qualification for issuance of placard Sec. 1. The bureau shall issue a placard to the following: (1) An individual of any age who: (A) has a temporary or permanent physical disability that requires the use of a wheelchair, a walker, braces, or crutches as certified by a health care provider listed in ... Click on New Document and select the form importing option: add Indiana state form 42070 from your device, the cloud, or a protected link. Make adjustments to the sample. Take advantage of the upper and left-side panel tools to change Indiana state form 42070.State Form 32584 (R13 / 7-20) INDIANA DEPARTMENT OF VETERANS AFFAIRS 777 North Meridian Street, Suite 300 Indianapolis, Indiana 46204-1421 ... (You may also request a Purple Heart handicapped plate at your license branch if you are eligible for a handicapped placard in Indiana.)How to fill out Indiana handicap placard: 01. Obtain the Indiana handicap placard application form from the Indiana Bureau of Motor Vehicles (BMV) website or your local BMV office. 02. Fill out the application form with accurate and complete information, including your personal details, contact information, and disability information. 03.

In some states, the applications for handicap parking permits can be downloaded online. Others require you to go to your local DMV office. If you need more information, ask at your healthcare provider's office. They should be able to direct you to the proper state or county office that handles permits. Alaska.. Live pull tabs

indiana handicap placard form

Indices Commodities Currencies StocksWhat are Indiana's requirements for accessible parking spaces and ticketing? In Indiana, parking is not covered by the state building code. Instead, there is a separate section of the code: Parking Facilities for Persons with Physical Disabilities - IC 5-16-9-1.The Application for Handicapped License Plates cannot be used to renew a Handicapped Parking Permit. If you need to renew your Handicapped Parking Permit, please refer to the section on Handicapped Parking Permits. Questions regarding Handicap License Plates may be addressed by email or by phone at (402) 471-3918.To apply for a new disability license plate, complete Sections 1 and 2. To apply by mail, include payment of $9.50 (IC 9-18.1-11-10) in the form of a check or money order made payable to the BMV. To apply for a disability parking placard, complete Sections 1 and 3. The fee for a temporary parking placard is $5.00 (IC 9-18.5-8-7(c)).Section 320.0848, Florida Statutes, provides the authorization for the issuance of disabled person parking permits for both long-term and short-term mobility impairments and those certified as legally blind by an optometrist. Permits may be issued to driver license and ID card holders. Disabled person parking permits are issued in two categories:Temporary disability placards are valid for six months at which time a new certification must be completed. Apply for a Temporary Disability Placard. Deaf / Hard of Hearing. The Deaf / Hard of Hearing plate and placard alert law enforcement, emergency services and others approaching the vehicle that the driver is Deaf / Hard of Hearing.The disabled person, a family member, or a legal representative can apply for a disabled parking placard by completing the Application for Disability Parking Placard or Disability …INSTRUCTIONS: 1. Complete in blue or black ink or print form. 2. To apply for a new disability license plate, complete Sections 1 and 2. To apply by mail, include payment of $9.50 (IC 9-18.1-11-10) in the form of a check or money order made payable to the BMV. 3. To apply for a disability parking placard, complete Sections 1 and 3.Learn how to apply for, renew, or replace disability parking permits in Indiana. Find out the types, rules, and fees of handicap placards and plates, and the forms you need to submit.New Handicap Placard. This form is for the request of a new handicap placard when age 85 is reached. If you do not already have a placard and need one for a medical condition, you will need to apply in person at your local DMV branch. If you already have a handicap placard and wish to renew, please use this form to apply.In this comprehensive guide, we will explore the advantages of having a handicap placard in Indiana, how to obtain one, and answer frequently asked questions about the topic. ... Your medical professional will need to complete and sign the medical certification section of the application form, verifying your disability. Submit the …Replace Disability Placards & Plates. If your handicap placard has been lost, damaged, or stolen, you must complete a new Application for Persons With Disabilities Parking Permit for Iowa Residents (Form 411055). Be sure to: Complete the appropriate section for lost, stolen, destroyed, or damaged placards. Include your permit number.A healthcare professional with a valid and unrestricted driver's license must complete the bottom half of the application. NOTE: Temporary, moderate, and permanent disability placards are free. Submit your application: By mail to the address on the form. By fax to (775) 684-4992. OR. In person at a Nevada DMV office.Placard Renewals and Replacements. In order to obtain a placard, Form MV-145A (PDF), "Persons with Disability Parking Placard Application" must be completed by the person with a disability, a health care provider, or a police officer and returned to PennDOT. Permanent placards are valid for five years and renewed in March or September.State Form 32584 (R13 / 7-20) INDIANA DEPARTMENT OF VETERANS AFFAIRS 777 North Meridian Street, Suite 300 Indianapolis, Indiana 46204-1421 Telephone: (317) 232-3910 * This agency is requesting disclosure of your Social Security Number in accordance with IC 4-1-8-1; disclosure is mandatory and this record cannot be processed without it.Written by Tiffany Leung. Reviewed by Jessica Barrett. Updated on Sep 7, 2023. Table of Contents. Per the handicap placard regulations in. Indiana. , drivers …You may apply for a disability license plate and/or parking placard by completing an Application for Disability License Plate or Parking Placard State Form 42070. The application may be submitted to any Indiana branch or mailed to the address listed on the application.How to Apply. Anyone having a qualifying disability can apply for a handicap placard. If you own or lease a vehicle, you can also apply for a handicap license plate. To complete the application process, you must: Fill out and submit the Disability-Hearing Impaired Plate/Placard Application (Form 96-0104), which can be obtained online or in person..

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