Deerpark, NY · Orange County
Application for a Parking Permit for Persons With Severe Disabilities
This application lets a person with a severe disability request a temporary or permanent parking permit from the issuing agent for their city, town, or village.
What this form is
Use this application to request a parking permit for a person with a severe disability; the packet says to apply through the local issuing agent, not the Department of Motor Vehicles. The applicant completes Part 1, and a qualified medical professional generally completes the medical certification in Part 2. The application asks for personal and contact details, disability information, diagnosis, and signatures.
Who needs it
A person with a temporary or permanent disability affecting mobility may use this application to request a parking permit from their local issuing agent.
How to submit it
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 city, town, or village hall to find the nearest permit issuing agent.
About notarization
This document is signed and dated without a notary; the applicant and medical professional sign their respective sections, and no notarized or sworn attachment is specified.
How to submit this form
- 1
Download The Application
Download the parking permit application packet.
- 2
Complete Part 1
Fill in the applicant’s information and sign Part 1.
- 3
Get Medical Certification
Have a qualified medical professional complete the applicable medical certification in Part 2, unless the instructions allow it to be waived.
- 4
Submit To The Issuing Agent
Take the completed application to the appointed issuing agent for the city, town, or village where you live.
Frequently asked questions
- Do I need a notary for the disability parking permit application?
- No. The applicant and medical professional sign their sections; the document 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. Call your local hall to find the nearest agent.
- Who completes the medical certification?
- A qualified medical professional completes Part 2. The packet lists different eligible professionals for permanent and temporary disabilities.
Need something notarized?
This Application for a Parking Permit for Persons With Severe Disabilities doesn’t need a notary — but if you have another Deerpark form that does, a commissioned online notary can help.