Form hsmv 83039 2013-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the name of the disabled person as printed on their Florida Driver License or ID Card, followed by their date of birth and sex.
3. If applicable, provide the current disabled parking permit number and the disabled person's email address. Fill in their address, city, state, and zip code.
4. The disabled person or their guardian must sign and date the application. Include a phone number for contact purposes.
5. In the 'Physician/Certifying Practitioner’s Statement of Certification' section, ensure that a certifying authority completes this part accurately, specifying whether it's a temporary or permanent permit.
6. Check any applicable boxes regarding frequent travel or quadriplegia. Ensure all required fields are filled before submission.

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