Do I need a notary for the Parking Permit or License Plates Application?

No. This document is signed without a notary. A medical professional completes the disability certification when required, and the applicant signs and dates Part 1.

How do I submit the parking permit application?

Take the completed application to the appointed issuing agent for the municipality where you live. The instructions say to call your local city, town, or village hall to locate an agent.

Can I use this application to request license plates?

Yes. The form covers both parking permits and license plates. License plates require a permanent disability and are requested through a Motor Vehicles office.

Does a medical professional need to complete the form?

The form includes a medical certification section. Certification requirements depend on the request and disability; the instructions specify which medical professionals may certify permanent and temporary disabilities.

Attica, NY · Wyoming County

No notary required

Parking Permit or License Plates Application for Persons with Severe Disabilities

This application lets eligible residents request a disability parking permit or license plates and is completed by the person with the disability and a medical professional.

What this form is

Use this application to request a parking permit through your local issuing agent or disability license plates through a Motor Vehicles office. The form asks for the applicant’s contact and identifying information, the requested option, and information about the disability; a medical professional completes the certification when required. For a parking permit, take the completed application to the appointed agent for the municipality where you live.

Who needs it

A New York State resident with a severe mobility-related 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.

About notarization

This document is signed without a notary; the medical professional completes the required disability certification, and the applicant signs and dates Part 1.

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 Part 1
Fill in the information about the person with the disability, select a parking permit or license plates, and sign and date the application.
3
Get Medical Certification
When required, have an eligible medical professional complete the applicable disability certification section in Part 2.
4
Submit The Application
For a parking permit, take the completed application to the appointed issuing agent for the municipality where you live.

Frequently asked questions

Do I need a notary for the Parking Permit or License Plates Application?: No. This document is signed without a notary. A medical professional completes the disability certification when required, and the applicant signs and dates Part 1.
How do I submit the parking permit application?: Take the completed application to the appointed issuing agent for the municipality where you live. The instructions say to call your local city, town, or village hall to locate an agent.
Can I use this application to request license plates?: Yes. The form covers both parking permits and license plates. License plates require a permanent disability and are requested through a Motor Vehicles office.
Does a medical professional need to complete the form?: The form includes a medical certification section. Certification requirements depend on the request and disability; the instructions specify which medical professionals may certify permanent and temporary disabilities.

Need something notarized?

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