Sleepy Hollow, NY · Westchester County
Application for License Plates or Parking Permits for Persons With Severe Disabilities
This application lets a person with a severe disability request disability parking plates or a parking permit, with medical certification completed by a qualified doctor.
What this form is
Use this application to request license plates for persons with disabilities from the DMV or a parking permit from a local issuing agent. The applicant completes Part 1, and an MD, DO, or DPM completes Part 2 with medical information and certification. The issuing agent completes Part 3, which records permit details and the decision.
Who needs it
A person requesting disability plates or a parking permit needs this application, with Part 2 completed by an MD, DO, or DPM.
How to submit it
For license plates, apply to the DMV; for a parking permit, apply to the local issuing agent. The form does not provide an address or other contact details.
About notarization
This application is signed and dated without a notary; the applicant certifies the information is true, and the doctor certifies the medical information.
How to submit this form
- 1
Download the Application
Download the disability plates or parking permit application.
- 2
Complete Part 1
Enter the applicant’s information, select plates or a permit, and sign and date Part 1.
- 3
Get Medical Certification
Have an MD, DO, or DPM complete and sign Part 2 with the required medical information.
- 4
Submit the Application
Apply to the DMV for license plates or to the local issuing agent for a parking permit.
Frequently asked questions
- Who completes the disability parking application?
- The person with the disability completes Part 1. An MD, DO, or DPM must complete the medical certification in Part 2.
- How do I submit the application?
- Apply to the DMV for license plates or to the local issuing agent for a parking permit. The form does not list an address or contact details.
- Do I need a notary for the disability parking application?
- No. The application is signed and dated without a notary; the applicant certifies the information, and the doctor certifies the medical information.
- What information does the application ask for?
- It asks for the applicant’s contact and personal information, the requested plates or permit, medical details and diagnosis, and information for the issuing agent.
Need something notarized?
This Application for License Plates or Parking Permits for Persons With Severe Disabilities doesn’t need a notary — but if you have another Sleepy Hollow form that does, a commissioned online notary can help.