This form is for renewal of handicap placards. 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 are 85 years of age or older and do not already have a placard, 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.

Contact Information

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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.

I accept
I Do not accept

Security Code

* denotes required entry