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OHIO BUREAU OF MOTOR VEHICLES

BMV OR DEPUTY USE ONLY OHIO DEPARTMENT OF PUBLIC SAFETY. BUREAU OF MOTOR VEHICLES NOTE: A PRESCRIPTION. PLACARD NUMBER FROM YOUR HEALTH CARE. PROVIDER MUST BE. application for disability PLACARDS SUBMITTED WITH THIS. ISSUE DATE Ohio Revised Code ( ) APPLICATION. (Instructions are listed below.). SEE REVERSE SIDE FOR INSTRUCTIONS. allows an applicant to obtain one disability placard. A person with a disability that limits or impairs the ability to walk is entitled to request one additional placard that may be issued at the discretion of the Registrar. Consideration will be given only if the person applies separately for an additional placard and states the reason why the additional placard is necessary. Second placards are issued for an additional fee of $ Please allow 10-15 business days for processing if mailed. INDICATE TYPE OF PLACARD REQUESTED.

bmv 4826 7/18 [760-0616] page 1 of 2 restricted bmv or deputy use only ohio department of public safety bureau of motor vehicles note: from application for disability placards ohio revised codeissue date (r.c.) 4503.44

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