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Arizona disability or hearing impaired plate placard application

DisabilityHearing Impaired PlatePlacard Application. DisabilityHearing Impaired PlatePlacard Application - azdot 2026

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The document is an application form for disability plates and placards in Arizona, designed for individuals with physical disabilities or hearing impairments. It outlines the eligibility criteria, required medical certification, and application process for obtaining special parking privileges. The form includes sections for personal information, vehicle details, and medical professional verification. Additionally, it provides guidelines on the use of disability plates and placards, renewal procedures, and penalties for misuse.

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Click ‘Get Form’ to open it in our editor.
Begin by entering your name, date of birth, and contact information in the designated fields. Ensure that the applicant's mailing address is complete and accurate.
Select the application type: either 'New Plate' or 'New Placard'. If you are renewing, please refer to form #40-0112 available online.
For plate applicants, provide vehicle information including Vehicle Identification Number (VIN), year, make, and current plate number. This section is crucial as it links the disability plate to a specific vehicle.
Complete the Medical Certification section. This must be filled out by an authorized health professional who can confirm your disability status. Ensure their contact details are included.
Review all entries for accuracy before signing. Individual applicants must sign and date the form, while organization applicants need an authorized officer's signature.

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Versions	Form popularity	Fillable & printable
2018	4.8 Satisfied (111 Votes)
2018	4.4 Satisfied (141 Votes)
2017	4.1 Satisfied (60 Votes)
2014	4.2 Satisfied (72 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How much does it cost to get a handicap placard in Arizona?

There is no fee for a disability placard.

What is the easiest way to get a handicap placard?

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 portion that certifies disability. Submit the application by mail or in person.

How long does it take to get a handicap placard in Arizona?

Its important to remember that the process can take time, especially if you are applying for a replacement. Renewing disabled placards may take up to four weeks, so its crucial that you keep up with it. Keep in mind that not all disabilities and conditions are visible.

Why would a handicap placard application be denied?

You go to your local tax collectors office and pick up a form for disabled parking. Take said form to one of your doctors (wouldnt be unusual to have a and specialist) and have them fill out the form. Providing the form lists a qualified disability, you will qualified and given a parking permit.

How do I apply for a disability placard in Arizona?

Typically, denials occur due to incomplete or inaccurate documentation, failure to meet eligibility criteria, or lack of sufficient medical evidence supporting your need for a handicap parking permit. Review the denial letter carefully to identify the specific reasons for the denial.

adot handicap placard

Form 96 0104 az dmv form 96-0104 AZ MVD handicap placard form Disability hearing impaired plate/placard application AZ dmv form 96-0104 printable Arizona handicap placard application online AZ handicap placard rules Adot handicap placard pdf

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What qualifies you for a handicap placard in Arizona?

Are you eligible for Handicap Parking Placards or Plates in Arizona? You cant walk 200 feet without rest. Youre restricted by lung disease, specifically with a forced expiratory volume (FEV) for 1 second, when measured by spirometry, is less than 1 liter or your arterial oxygen tension is less than 60mm/hg at rest.