Rush Notary

Rushville, NY · Yates County

No notary required

Application for a Parking Permit or License Plates for Persons With Severe Disabilities

This application lets eligible residents with severe disabilities request a parking permit or license plates and includes sections for the applicant and a medical professional.

At a glance

Issued by
City of Rushville · Rushville, Yates County, New York
Notarization
Not required: file this form without a notary.
Official source
villageofrushville.com
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 for a permanent or temporary disability, or license plates for a permanent disability. The form asks for the applicant’s contact and identifying information, the type of request, and disability details. A medical professional completes the applicable certification section unless the stated exceptions apply. Parking permit applications go to the appointed local issuing agent; license plate applications go to a Motor Vehicles office.

Who needs it

A resident with a mobility-limiting disability who is applying for a parking permit or disability license plates needs this application.

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. For license plates, bring it to any Motor Vehicles office.

About notarization

This application is signed and dated without a notary; the medical professional also signs and dates the medical certification section.

How to submit this form

  1. 1

    Download The Application

    Download the application and read pages 1 and 2 before completing page 3.

  2. 2

    Complete The Applicant Section

    Fill out Part 1, select whether you are applying for a parking permit or license plates, and sign and date the application.

  3. 3

    Get Medical Certification

    Have an eligible medical professional complete the applicable certification in Part 2, unless a stated exception applies.

  4. 4

    Submit The Application

    Take a parking permit application to the appointed local issuing agent, or bring a license plate application to any Motor Vehicles office.

Frequently asked questions

Do I need a notary for the severe disability parking application?
No. The applicant signs the form without a notary, and the medical professional signs and dates the medical certification section.
How do I submit a parking permit application?
Take the completed application to the appointed issuing agent for the city, town, or village where you live. The form says to contact your local hall to find the nearest agent.
Where do I apply for disability license plates?
Bring the completed application to any Motor Vehicles office. The form says the disability must be permanent and the vehicle must be registered to the person with the disability.
Who may qualify for a parking permit?
The form says eligible applicants are residents with one or more severe disabilities that impair mobility. Parking permits may be issued for permanent or temporary disabilities.

Need something notarized?

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