Apply to register to vote with your driver’s license transaction. For details ask your customer agent.
Instructions:
Purpose: An individual with a disability may use this form to request placards, license plates and/or motorcycle plates that will allow a vehicle in
which he/she is riding to park in a parking space reserved for the disabled. Two types of placards are available: Temporary Placards (red), which are
valid for a period of up to 6 months; and Permanent Parking Placards (blue), which are valid until the death of the disabled individual. An applicant
may request a parking placard, license plate and motorcycle plates at the same time. See the Form Completion Instructions below.
Fee Information:
Placard: There is not a fee for the placard(s).
Plates: A request for a disability plate and/or motorcycle plate requires the assessment of the substitute/replacement tag fee. Please submit your
completed application along with the appropriate $20.00 fee. If requesting a disability plate and/or motorcycle plate(s) and it’s time to renew your
vehicle registration, the registration fee is also required.
What can I apply for?
An individual with a permanent disability may apply for:
• One placard, or
• One regular disability plate, or
• One placard and one regular disability plate, or
• Two placards
In addition, up to two motorcycle disability plates can be requested with any combination listed above.
An individual with a Temporary disability may apply for:
• One or two temporary placards
What sections should I ll out?
Parking Placard - Complete Section A. An approved medical provider needs to complete Section C.
License Plates or Motorcycle Plates - Complete Sections A & B. An approved medical provider needs to complete Section C. You may only request
a disability plate or motorcycle plate(s) if the vehicle is titled in the name of the individual with a disability.
Note:
• A doctor’s certication may not be required if the individual has a disability that meets the denition of code 6 or V.
• For a replacement placard, only complete section A. For replacement plates, complete sections A & B.
• For temporary placards, Disability Code 10 is to be used.
Permanent Disability Codes
1. Has lung disease to such an extent that forced (respiratory)
expiratory volume for one second, when measured by spirometry,
is less than one liter, or arterial oxygen tension (p02) is less than 60
mm/hg on room air at rest.
6. Has lost an arm, hand, foot or leg (See Note D)
7. Has lost the use of an arm, hand, foot or leg.
2. Has cardiovascular disease limitations classied in severity as Class
III or Class IV according to standards set by the American Heart
Association.
8. Has a permanent disability, that adversely impacts the ambulatory
ability of the applicant and which is so severe that the person
would endure a hardship or be subject to a risk of injury if the
privileges accorded a person for whom a vehicle is specially
registered were denied.
3. Is unable to walk 200 feet without stopping to rest. 9. Has a permanent impairment of both eyes so that: 1) The central
vision acuity is 20/200 or less in the better eye with corrective
glasses, or 2) There is a eld defect in which the peripheral eld
has contracted to such an extent that the widest diameter of visual
eld subtends an angular distance no greater than 20 degrees in
the better eye (See Note C)
4. Is unable to walk 200 feet without the use of, or the assistance from,
a brace, cane, crutch, another person, prosthetic device, or other
assistance device.
10. Temporary Placard - Disability is not permanent but would
substantially impair the person’s mobility or limit or impair the
person’s ability to walk for at least three weeks, and is so severe
that the person would endure a hardship or be subject to risk of
injury if the Temporary Permit was denied.
5. Requires a wheelchair for mobility
V. Reserved for use by veterans with 100% disability. The Veterans Administration has certied by letter that the applicant has a 100% service
connected disability.
Notes:
A. A licensed physician, licensed nurse practitioner or licensed physician’s assistant may certify all qualifying conditions listed.
B. A licensed chiropractor, licensed podiatrist or licensed physical therapist may certify disability codes 3 through 8, and 10.
C. A licensed optometrist may certify only qualifying conditions regarding vision.
D. The person with a disability may self-certify the conditions listed under Disability Code 6 by appearing in person with proper identication.
In this situation, only the disabled person’s name and Disability Code must be recorded. If, however, a doctor certies the loss of a limb, the
doctor must complete all of Section C.
If someone other than the applicant submits the application for Disability Plates or Placards they must provide a state issued ID. Applications
may also be mailed with the appropriate fees to the Motor Vehicle Administration, 6601 Ritchie Highway N.E., Glen Burnie, Maryland 21062 Attn:
Disability Unit.