Van Etten, NY · Chemung County
Application for License Plates or Parking Permit for Persons with Disabilities
New York residents with qualifying disabilities use this application to request a parking permit from their local issuing agent or disability license plates from the Motor Vehicles office.
What this form is
This application requests a parking permit or license plates for a person with a severe disability that impairs mobility. The instructions say to take a parking permit application to the appointed issuing agent in the applicant’s city, town, or village; license plate applications go to a Motor Vehicles office. The form asks for the applicant’s information, disability details, and medical certification when required.
Who needs it
A New York resident with a qualifying disability may use this application to request a parking permit or, for a permanent disability, license plates.
How to submit it
For a parking permit, take the completed application to the appointed issuing agent for the city, town, or village where you live; call your local hall to find the nearest agent. For license plates, bring the completed application to a Motor Vehicles office.
About notarization
This application is signed without a notary; the signer just signs and dates it, and the form does not specify a notarized or sworn attachment.
How to submit this form
- 1
Download The Application
Download the application and read pages 1 and 2 before completing the form on page 3.
- 2
Complete The Application
Fill out Part 1 with the applicant’s information and indicate whether you want a parking permit or license plates.
- 3
Gather Medical Information
Complete the applicable medical certification section in Part 2 and gather any documents required for the type of application.
- 4
Submit The Application
Take a parking permit application to the local issuing agent. Bring a license plate application to a Motor Vehicles office.
Frequently asked questions
- Do I need a notary for the disability parking permit application?
- No. The application is signed without a notary. The signer just signs and dates it; the form does not specify a notarized or sworn attachment.
- How do I submit the parking permit application?
- Take the completed application to the appointed issuing agent for the city, town, or village where you live. The instructions say to call your local hall to find the nearest agent.
- Who can apply for a parking permit?
- The instructions say New York residents with one or more severe disabilities that impair mobility may be eligible. Applicants do not have to drive or own a vehicle.
- What medical certification does the application require?
- The form includes medical certification sections for permanent and temporary disabilities. It lists which medical professionals may certify each type and notes circumstances when certification may be waived.