How do I submit the Parking Permit Application?

Take the completed application to the issuing agent in the city, town, or village where you live. The form says not to send it to the Department of Motor Vehicles.

Who can apply for a parking permit with this form?

A person with a severe disability can apply. A parent or guardian may sign for the person and must state their relationship after signing.

What information does the application ask for?

It asks for the applicant’s contact and disability information, and medical certification. The applicant and medical professional each sign and date their sections.

Lyons, NY · Wayne County

No notary required

Parking Permit Application for Persons With Severe Disabilities

This application is for people with severe disabilities who are seeking a parking permit from the local issuing agent where they live.

What this form is

Use this application to request a parking permit for a person with a severe disability; the form says parking permit applications go to the local issuing agent in the city, town, or village where the applicant lives. It asks for the applicant’s contact and disability information, medical certification, and signatures. Temporary permits are issued for six months or less, according to the form.

Who needs it

A person with a severe disability, or their parent or guardian, can use this application to request a parking permit from the local issuing agent.

How to submit it

Take the completed application to the issuing agent in the city, town, or village where you live. Do not send the application to the Department of Motor Vehicles.

About notarization

This document is signed without a notary; the applicant and medical professional sign and date their sections, with no notarized attachment or related step specified.

How to submit this form

1
Download the Application
Download the parking permit application PDF.
2
Complete the Applicant Section
Fill in the requested applicant and disability information and sign and date the applicant section.
3
Complete Medical Certification
Have the appropriate medical professional complete, sign, and date the medical section.
4
Submit to the Local Issuing Agent
Take the completed application to the issuing agent in the city, town, or village where you live; do not mail it to the Department of Motor Vehicles.

Frequently asked questions

Do I need a notary for the Parking Permit Application?: No. This application is signed without a notary. The applicant and medical professional sign and date their sections; the form does not specify a notarized attachment or related step.
How do I submit the Parking Permit Application?: Take the completed application to the issuing agent in the city, town, or village where you live. The form says not to send it to the Department of Motor Vehicles.
Who can apply for a parking permit with this form?: A person with a severe disability can apply. A parent or guardian may sign for the person and must state their relationship after signing.
What information does the application ask for?: It asks for the applicant’s contact and disability information, and medical certification. The applicant and medical professional each sign and date their sections.

Need something notarized?

This Parking Permit Application for Persons With Severe Disabilities doesn’t need a notary — but if you have another Lyons form that does, a commissioned online notary can help.