Palmyra, NY · Wayne County
Application for a Parking Permit or License Plates for Persons With Severe Disabilities
This application is for New York residents with severe disabilities seeking a parking permit or disability license plates.
At a glance
- Issued by
- City of Palmyra · Palmyra, Wayne County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- palmyrany.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Use this application to request a parking permit from your local issuing agent or license plates from a Motor Vehicles office. Complete Part 1 with the applicant’s information and choice of permit or plates; a qualified medical professional completes Part 2 when medical certification is required. License plate applicants must meet the permanent-disability requirements, and the vehicle must be registered to the person with the disability.
Who needs it
A New York resident with a severe disability may use this application to request a parking permit or, if eligible, license plates.
How to submit it
Take the completed application to the appointed issuing agent for the city, town, or village where you live. Call your local city, town, or village hall to find an agent.
About notarization
This document 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 application and read pages 1 and 2 before completing page 3.
- 2
Complete Part 1
Print the applicant’s information, choose a parking permit or license plates, and sign and date the section.
- 3
Get Medical Certification
Have a qualified medical professional complete Part 2 when certification is required for the requested permit or plates.
- 4
Gather Required Attachments
For license plates, attach a copy of the vehicle registration if you already have plates for persons with severe disabilities.
- 5
Submit to the Issuing Agent
For a parking permit, take the completed application to the appointed local issuing agent; call your local hall to find an agent.
Frequently asked questions
- Who can apply for a severe-disability parking permit?
- A New York resident with one or more severe disabilities that impair mobility may apply. The document says applicants do not need to drive or own a vehicle to receive a parking permit.
- Do I need a notary for the severe-disability parking application?
- No. This document is signed and dated without a notary; the applicant and medical professional sign their respective sections.
- 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 city, town, or village hall to find an agent.
- What medical information does the application require?
- Part 2 asks a qualified medical professional to identify the disability and provide a diagnosis. Temporary-disability applications also ask for the expected recovery date and needed assistive device.