555 Wright Way
Carson City, NV 89711
Reno/Sparks/Carson City (775) 684-4DMV (4368)
Las Vegas area (702) 486-4DMV (4368)
Fax (775) 684-4797
dmvnv.com
SP59 (Rev 09-29-2015)
EXPEDITED SERVICE PERMIT APPLICATION
NRS426.441
Nevada law allows for issuance of an Expedited Service Permit for individuals with a permanent (irreversible) disability.
This permit entitles a person to expedited service from any officer or employee of a State agency providing public
services. The Expedited Service Permit is valid for 10 years from date of issuance.
Original and duplicate application for an Expedited Service Permit must be made in person.
Original Application Duplicate or Change Renewal
Please Print or Type
Full Legal Name
(Disabled Person)
Nevada Driver’s License or Identification Card Number
Address City State Zip Code
Address City State Zip Code
I currently have Disabled License Plate number ____________ I currently have Disabled Placard(s) number(s): __________________
I understand that it is unlawful for any individual other than myself to use or attempt to use this Expedited Service Permit and that a
person who violates this provision is guilty of a misdemeanor.
Fees for original, duplicate, or renewal: 65 years of age or older - $8.25
Under 18 years of age - $7.25
All others - $13.25
New photograph, change of name or both - $8.25
There has been a $1.00 Technology fee associated to each transaction.
A LICENSED PHYSICIAN MUST COMPLETE THIS PORTION
Do not complete this section for renewal or duplicate if you have previously provided the Nevada Department of Motor
Vehicles with a physician’s certificate indicating an irreversible condition.
As a physician for the above-named patient, I hereby certify that the applicant:
1. ________ Cannot walk two hundred feet without stopping to rest
2. ________ Cannot walk without the use of a brace, cane, crutch, wheelchair, or other device or another person
3. ________ Has a cardiac condition to the extent that functional limitations are classified as a Class III or Class IV according to
standards adopted by the American Heart Association
4. ________ Is restricted by a lung disease
5. ________ Is severely limited in his/her ability to walk because of an arthritic, neurological, or orthopedic condition
6. ________ Has a disability that affects vision
7. ________ Uses portable oxygen
I further certify that my patient’s condition is a:
Permanent Disability (irreversible, permanently disabled in his/her ability to walk, certification is valid indefinitely)
Address City State Zip Code
