Plumsted, MT · Ocean County
Temporary Handicap Placard Application
Applicants use this application to request an initial temporary handicap placard or recertification, with a medical practitioner completing the required eligibility certification.
What this form is
This application is for requesting an initial temporary placard or recertifying an existing one. It asks for applicant and medical practitioner information, including the practitioner’s required National Provider Identification number, and requires the practitioner to certify the applicant’s eligibility. The applicant signs to agree to the terms, and the form includes a $4 fee notice.
Who needs it
A person seeking an initial temporary placard or recertification needs to complete the applicant section and have a medical practitioner certify eligibility.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This application is signed without a notary; the applicant signs and dates it, and the medical practitioner separately certifies eligibility.
How to submit this form
- 1
Download the Application
Download the Temporary Handicap Placard Application PDF.
- 2
Complete Applicant Information
Fill in the applicant information and indicate whether the request is an initial application or recertification.
- 3
Obtain Medical Certification
Have a medical practitioner complete the certification, including the required National Provider Identification number.
- 4
Sign and Submit
Sign and date the application, then submit it to the city department named on the form.
Frequently asked questions
- Do I need a notary for the Temporary Handicap Placard Application?
- No. The applicant signs and dates the application without a notary; a medical practitioner separately certifies eligibility.
- Who completes the medical practitioner section?
- A medical practitioner provides their information and certifies that the applicant was examined and meets the stated eligibility criteria.
- How do I submit the Temporary Handicap Placard Application?
- Submit it to the city department named on the form; check the city website for current contact details.
Need something notarized?
This Temporary Handicap Placard Application doesn’t need a notary — but if you have another Plumsted form that does, a commissioned online notary can help.