Disability-Hearing Impaired Plate/placard Application Page 2
Download a blank fillable Disability-Hearing Impaired Plate/placard Application in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Disability-Hearing Impaired Plate/placard Application with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Requirements and Additional Information
• The disability plate or placard provides the person with a disability the privilege of parking in specially marked
parking spaces provided for the exclusive use of persons with a disability. The person with a disability must be
the driver or a passenger in the vehicle when the disability parking space is used.
• If the person with a disability is under the age of 18 and not capable of signing, a legal guardian may sign and
indicate relationship to the applicant. If the applicant is over the age of 18 and not capable of signing, a copy of a
power-of-attorney form is required before the application can be accepted.
• Disability plates are assigned to, and may only be displayed on, a specific vehicle registered or leased in the person
with a disability’s name. If leased, but not registered in the applicant’s name, a document showing the disabled
applicant as a lessee is required. A disability plate may be transferred to another qualifying vehicle by visiting the
nearest MVD or Authorized Third Party Office. Disability plates are available to individuals and organizations, but may
not be issued to trailers.
• Disability plates may be personalized for an additional fee of $25 per year for standard personalized plates or $50
per year for specialty personalized plates. A Special Plate Application (form # 96-0143, available online) must be
completed for a personalized plate. All choices must be approved. The fee for a remake of a lost, stolen or
mutilated personalized disability plate is $5 plus postage/handling, if mailed.
• The Hearing Impaired plate is in a special, reserved number format beginning with the letter “H”. Hearing
Impaired plates and placards alert law enforcement, emergency services and others approaching the vehicle that
the driver is hearing impaired. Hearing Impaired plates/placards are not valid for special parking privileges.
Hearing Impaired plates may not be personalized. Hearing Impaired plates may not be issued to trailers.
• Disability placards are issued to the person with a disability and may not be duplicated, transferred to, or used by,
another person. Permanent placards are valid for five years (provided the medical certification remains valid) and may
be renewed. Temporary placards are valid for six months. At the end of six months, if the medical condition continues,
a new application/certification is required.
• Placard replacements: if the current record cannot be located and the original application is unavailable for verification,
a new application will be required. Both Permanent and Temporary placards will be issued with the same expiration
date that appeared on the lost, stolen or mutilated placard. There is no fee for replacement placards.
• If an organization, a signed statement by an authorized officer of the organization affirming that the registered
vehicle that is owned or leased by the organization and that will display the placard or the international symbol of
access special plate primarily transports physically disabled.
• If a nonprofit organization, a signed statement by an authorized officer of the organization affirming that the
nonprofit organization provides assistance to senior citizens and will maintain records of each volunteer who uses
placards to transport persons with a temporary or permanent.
• Most other states and the provinces of Canada have agreed to honor Arizona disability plates and placards.
When traveling by vehicle in other states, provinces or foreign countries, it is a good idea to contact the
appropriate motor vehicle authorities.
• Use of plates or placards in violation of Arizona law may result in fines and penalties charged to the operator, to
the person in charge or to the owner of the vehicle, and the plate or placard may be recalled.
For more information, forms, or office hours and locations, visit ,
or call: Phoenix 602-255-0072, Tucson 520-629-9808, elsewhere in Arizona 800-251-5866,
(Hearing/Speech Impaired–TDD systems only: Phoenix 602-712-3222, elsewhere 800-324-5425).
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal