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APPLICANT INFORMATION (person with disability)

MED 10 (02/10/2018) DISABLED PARKING PLACARD OR LICENSE PLATES APPLICATION HP PLATESPERMANENT PLACARD (5 years)RENEWAL (No medical professional certification required.)ORIGINAL (Medical professional certification required.)REISSUE Lost StolenDestroyed/MutilatedORIGINAL PLATES submit completed form VSA 10 DUPLICATE PLATES Destroyed LostREISSUE PLATES Plates never received Unreadable (letters/numbers unclear) I understand that misuse, counterfeiting, or alteration of disabled placards may result in fines up to $ and up to 6 months in jail and/or revocation of disabled parking privileges.

DISABLED PARKING PLACARD MED 10 (07/01/2020) . OR LICENSE PLATES APPLICATION . HP PLATES PERMANENT PLACARD (5 years) RENEWAL (No …

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