Dunkirk, NY · Chautauqua County
Application for a Parking Permit or License Plates for Persons with Severe Disabilities
People with severe disabilities use this application to request a parking permit or license plates and provide personal and medical information.
What this form is
This application lets a person with a severe disability apply for a parking permit or license plates. The applicant completes Part 1, and a medical doctor, doctor of osteopathy, or doctor of podiatric medicine completes the medical certification in Part 2. Take the completed application to the issuing agent in the area where you live; the form directs license plate applicants to apply to the DMV.
Who needs it
A person with a severe disability applying for a parking permit or license plates, with medical certification completed by an eligible medical professional, needs this form.
How to submit it
Take the completed application to the issuing agent in the area where you live. If you have a New York State driver license or DMV-issued ID card, bring it when you apply.
About notarization
This application is signed and dated without a notary; the applicant and medical professional sign their respective sections.
How to submit this form
- 1
Download the Application
Download the parking permit or license plates application.
- 2
Complete Applicant Information
Fill in Part 1 and sign and date the application.
- 3
Get Medical Certification
Have an eligible medical professional complete and sign Part 2.
- 4
Bring Identification
If you have a New York State driver license or DMV-issued ID card, bring it with you.
- 5
Take It to the Issuing Agent
Take the completed application to the issuing agent in the area where you live.
Frequently asked questions
- Do I need a notary for this parking permit application?
- No. This application is signed and dated without a notary; the applicant and medical professional sign their respective sections.
- How do I submit the application?
- Take the completed application to the issuing agent in the area where you live. Bring your New York State driver license or DMV-issued ID card if you have one.
- Who completes the medical certification?
- Part 2 must be completed by a medical doctor, doctor of osteopathy, or doctor of podiatric medicine.
- Can I use this form to apply for license plates?
- Yes. The application offers a choice between license plates and a parking permit. It directs license plate applicants to apply to the DMV.