This form is not valid for more than 12 months from the date of the certifying ...
specific disability(ties) checked below (2-8), the disabled person parking permit ...
Travel Parking Placards are issued to applicants with permanent disabilities. ...
WHITEoUT WILL VoID THIS foRm (INcLUDINg cHANgES WITH INITIALS) AND ...
Form VTR-214 (rev. 05/14) ... making application on behalf of a person with a
disability. DL or ID # and state ... Disabilities Parking Placard and/or. License
Permanent disabled parking choices (choose only one) ... Return this form and
your signed authorization to the applicant. ... A parking permit for a person with
disabilities may be issued only for a medical necessity that severely affects
I am applying for a disability parking placard as provided in Public Act 300 of
1949. ... I am subject to the penalties described on the reverse side of this form.
Please read instructions on back carefully before completing form. ... park in any
parking space designated for a person with a disability, other than an individual ...
To apply for any disability placard in Georgia, you will need a Disabled Person's
Parking Affidavit (Form ...
Physical Disability — International Symbol of Access, for parking in specially
marked ... I have read the front and back of this form and I fully understand and
... provide form HSMV 83039, Application For Disabled Person Parking Permit, ...
provide regular transportation service to disabled persons having disabilities ...
May 25, 2016 ... APPLICANT INFORMATION (person with disability) ... Persons with disabilities
use this form to apply for a disabled parking placard or disabled ...