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.

Click here for information on the Accessible Parking Etiquette.

NOTE: Please have your drivers license or ID handy before you begin. Fields denoted by an asterisk (*) are required.

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Identification Information

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Self Certification Information

I certify, under penalty of law, that the above information is true and correct. I also understand that false representation by me can lead to penalties as provided by law as follows: Any person who has not reached the age of 85, and who intentionally and falsely represents that such person has the qualifications to obtain such a parking ID placard in an attempt to obtain such placard shall for the first offense be fined $100. For each subsequent like offense, the person shall be fined $200, or imprisoned not less than 10 nor more than 30 days, or both.

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