Apply to register to vote with your driver’s license transaction. For details ask your customer agent.
Form Completion Instructions:
Section A – Requested Service(s)
Please check the boxes as appropriate. An individual with a disability may apply for:
One placard
One regular disability plate
One placard and one regular disability plate
Two placards
In addition, up to two motorcycle disability plates can be requested with any combination listed above.
An individual with a Temporary disability may apply for:
One or two temporary placards (red)
Note: The vehicle owner must be the individual with a disability in order to qualify for issuance of a disability plate. If the individual with a disability is
not the owner or co-owner, you must apply for a disability placard.
Note: If your placard(s) have been lost or stolen, please check the appropriate box in Section A and indicate the number(s) of the lost or stolen
placard(s). If your placard(s) were stolen, you must indicate the police report number and jurisdiction reported.
Parking Placard (Blue) - Complete Sections B and C. A licensed doctor, nurse practitioner or physician’s assistant must complete Section C (see
Note below).
Temporary Parking Placard (Red) - Complete Sections B and C. A licensed doctor, nurse practitioner or physician’s assistant must complete Section
C (see Note below).
License Plates or Motorcycle Plates - Complete Sections B, C and D. A licensed doctor, nurse practitioner or physician’s assistant must complete
Section C. You may only request a disability plate or motorcycle plate(s) if the vehicle is titled in the name of the individual with a disability.
Transporters of an Individual with a disability may park in designated disability parking spaces by using the individual with disabilities parking
placard. Transporters of an individual with a disability may not obtain a disability plate.
Note:
• A doctor’s certication may not be required if the individual has a disability that meets the denition of code 6 or V.
• For a replacement placard, only complete Sections A and B. For replacement plates, complete Sections A, B and D.
• For temporary placards, Disability Code 10 is to be used.
Permanent Disability Codes 1-9
1. Has lung disease to such an extent that forced (respiratory) expira-
tory volume for one second, when measured by spirometry, is less
than one liter, or arterial oxygen tension (p02) is less than 60 mm/hg
on room air at rest.
2. Has cardiovascular disease limitations classied in severity as Class
III or Class IV according to standards set by the American Heart
Association.
3. Is unable to walk 200 feet without stopping to rest.
4. Is unable to walk 200 feet without the use of, or the assistance from,
a brace, cane, crutch, another person, prosthetic device, or other
assistance device.
5. Requires a wheelchair for mobility.
6. Has lost an arm, hand, foot, or leg. (See Note D)
7. Has lost the use of an arm, hand, foot or leg.
8. Has a permanent disability, that adversely impacts the ambulatory
ability of the applicant and which is so severe that the person would
endure a hardship or be subject to a risk of injury if the privileges
accorded a person for whom a vehicle is specially registered were
denied.
9. Has a permanent impairment of both eyes so that: 1) The central
vision acuity is 20/200 or less in the better eye, with corrective
glasses, or 2) There is a eld defect in which the peripheral eld has
contracted to such an extent that the widest diameter of visual eld
subtends an angular distance no greater than 20 degrees in the better
eye. (See Note C)
10. Temporary Placard (Red) requested
Disability is not permanent but would substantially impair the person’s
mobility or limit or impair the person’s ability to walk for at least three
weeks, and is so severe that the person would endure a hardship or
be subject to risk of injury if the Temporary Permit was denied.
V. (Reserved for use by veterans with 100% disability) The Veterans
Administration has certied by letter that the applicant has a 100%
service connected disability.
Notes:
A. A licensed physician, licensed nurse practitioner or licensed physician’s assistant may certify all qualifying conditions listed.
B. A licensed chiropractor or licensed podiatrist may certify disability codes 3 through 8 and 10.
C. A licensed optometrist may certify only qualifying conditions regarding vision.
D. The person with a disability may self-certify the conditions listed under Disability Code 6 by appearing in person with proper identication. In this
situation, only the disabled person’s name and Disability Code must be recorded. If, however, a doctor certies the loss of a limb, the doctor must
complete all of Section C.
Visit your local MVA full service ofce with the completed form. If someone other than the applicant submits the application for Disability Plates or
Placards they must provide a state issued ID. Applications may also be mailed with the appropriate fees to the Motor Vehicle Administration,
6601 Ritchie Highway, N.E., Glen Burnie, Maryland 21062. Attn: Disability Unit
Instructions:
Form Purpose: An individual with a disability may use this form to request placards, license plates and/or motorcycle plates that will allow a vehicle
in which he/she is riding to park in a parking space reserved for the disabled. Two types of placards are available: Temporary Placards (red), which
are valid for a period of up to 6 months; and Parking Placards (blue), which are valid for four years. An applicant may request a parking placard,
license plate and motorcycle plates at the same time. See the Form Completion Instructions below.
Fee Information:
There is not a fee for the placard(s). A request for a disability plate and/or motorcycle plate requires the assessment of the substitute/replacement
tag fee. Please submit your completed application along with the appropriate $20.00 fee. If requesting a disability plate and/or motorcycle plate(s)
and it’s time to renew your vehicle registration, the registration renewal fee is also required.
