Indiana handicap placard form - What are Indiana's requirements for accessible parking spaces and ticketing? In Indiana, parking is not covered by the state building code. Instead, there is a separate section of the code: Parking Facilities for Persons with Physical Disabilities - …

 
Complete Indiana State Form 42070 within a few moments by simply following the instructions listed below: Find the document template you require from the library of legal form samples. Select the Get form key to open the document and move to editing. Submit the necessary fields (they will be yellowish).. Athena grand in athens

INDIANA, Pa., Jan. 24, 2022 /PRNewswire/ -- S&T Bank, a full-service financial institution with assets of $9.4 billion and current operations in f... INDIANA, Pa., Jan. 24, 2022 /P...Sponsoring Organization for All Other Military License Plates. Indiana Department of Veterans Affairs. 777 North Meridian St., Ste. 300. Indianapolis, IN 46204-2738. 317-232-3910 or 800-400-4520.A Special Plate Application (form # 96-0143, available online) must be completed for a personalized plate. All choices are subject to approval. 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 a reserved number format beginning with the letter ...A completed Disability-Hearing Impaired Plate/Placard Application (Form 96-0104). Medical certification ON the application, completed by a licensed physician, osteopath, or chiropractor. Payment for applicable fees: Placards: Free. License plates: Free. Personalized plates: $26.96.The completed PA-3 Form; Your valid I.D. If you are applying for a: Renewal of a long term (blue) placard or special license plates; Submit by mail: The completed PA-3 Form; A copy of your valid I.D. Mail both items to: DCAB P.O. Box 3377 Honolulu, HI 96801 . If you are applying for a Disabled Paid Parking Exemption Permit (green) placard ...Online Help Form. Fill out our online help form ... Indiana Disability Rights. Contact Us. 4755 Kingsway Drive, Suite 100, Indianapolis, IN 46205. Local Phone: 317. ...Learn how to apply for a disability parking placard or license plate in Indiana. Find out the eligibility, validity, and fees for different types of disability parking options.Indiana Application for Handicap Parking Space If finding legal forms online looks like a challenge, use US Legal Forms. Choose from 85,000 state-specific document templates available for download in Word and PDF. ... Use our PS-18 form, Disability Plates/Placard application and fill out theor a disability registration plate may park in a ...ITD Form 3392. Disability License Plates and PlacardsITD 3392 (Rev. 0 7 -18) Supply # 019580141. Are You Eligible? A disabled person includes any person who is unable to walk 200 feet or more unassisted by another person or without the aid of a walker, crutches, braces, prosthetic device or a wheelchair; or without great difficulty or ...Temporary disability placards are valid for six months at which time a new certification must be completed. Apply for a Temporary Disability Placard. Deaf / Hard of Hearing. The Deaf / Hard of Hearing plate and placard alert law enforcement, emergency services and others approaching the vehicle that the driver is Deaf / Hard of Hearing.The disabled person, a family member, or a legal representative can apply for a disabled parking placard by completing the Application for Disability Parking Placard or Disability …Before you begin: Have a completed Application for Disabled Person Placard or Plates (REG 195), signed by your medical provider. You will be asked to upload it in the online application process. Have a copy of one of the following acceptable proofs of true full name and date of birth: A state-issued driver’s license (DL) or identification (ID ...The Application for Handicapped License Plates cannot be used to renew a Handicapped Parking Permit. If you need to renew your Handicapped Parking Permit, please refer to the section on Handicapped Parking Permits. Questions regarding Handicap License Plates may be addressed by email or by phone at (402) 471-3918.Complete, change and printing and indicator the attained Oregon Application for Handicap Parking Space. US Legal Forms may be the greatest local library of lawful varieties that you can see numerous record web templates. Take advantage of the company to down load skillfully-made files that adhere to state specifications.Disability license plates and placards permit vehicles to park in parking spaces marked with the international symbol of access for persons with disabilities. Learn how to obtain a disability license plate or placard from the Ohio Bureau of Motor Vehicles. Learn how to apply for a disability plate or placard.For disabled parking license plates. , submit this form, a completed License Plate Application (VSA 10) and applicable fees. For placard and/or license plates, submit forms and fees to any Customer Service Center, DMV Select or mail to DMV, Data Integrity, P.O. Box 85815, Richmond, VA 23285-5815. MED 10 (07/01/2020)Franklin Ohio Application for Handicap Parking Space is a form designed specifically for residents in Franklin, Ohio, who require accessible parking due to disabilities and physical limitations. This application is an essential document for individuals seeking the privilege of parking in designated handicap parking spaces within the city limits.The application will typically ask for the following: Your personal info, including full name, mailing address, birthdate. Driver’s license number. Vehicle ID number (VIN) Disabled person placard number. What you’re requesting (placard, license plate, etc.) If the placard was lost, stolen, not received, etc.Use this form to apply for a disabled person (DP) parking placard or license plates. Complete this form legibly in ink. Illegible, incomplete, and/or unsigned forms will be returned. Use an Application for Replacement Plates, Stickers, and Documents form (REG 156) to request replacement of a lost, stolen, or damaged placard or plates.View, download and print fillable State 42070 - Application For Disability Plate Or Parking Placard in PDF format online. Browse 10 Indiana Bmv Forms And Templates collected for any of your needs.Learn how to apply for disability parking placards and license plates in Indiana, and what disabilities qualify you for them. Find out the eligibility, validity, and availability of these …Pay any applicable fees. The fee for a permanent disability placard in Indiana is $5, while the fee for a temporary placard is $10. Wait for the BMV to review your application. If approved, the BMV will issue a …IARA: State Forms Online CatalogSection 320.0848, Florida Statutes, provides the authorization for the issuance of disabled person parking permits for both long-term and short-term mobility impairments and those certified as legally blind by an optometrist. Permits may be issued to driver license and ID card holders. Disabled person parking permits are issued in two categories:Completing the required application forms provided by the BMV. Once approved, applicants receive their handicap permits, along with instructions on proper display and usage. Types of Passes. Indiana handicap placards offers two types: permanent and temporary. Each type serves individuals with different needs:State of New HampshireProperty taxes in Indiana are paid in arrears, which means the taxes you pay this year cover the taxes owed for last year. Property taxes in Indiana cover local and county taxes as...City permits are issued to people with a permanent disability that so severely affects their ability to walk that they require the use of a private automobile. The New York City parking permit is not valid outside of NYC. For more information or to obtain an application for a NYC permit, call (718) 433-3100 or visit the NYC Department of ...The penalty for using an expired disabled parking permit varies state by state. In some states, displaying an invalid disabled permit can be charged as a civil infraction or as a misdemeanor. A civil infraction can only be punished by a fine. Fines range between $50 and $1000. Misdemeanors can be punished by a prison sentence – sentences of ...As of January 1, 2022, you may apply for a disabled parking placard and/or disabled veteran license plate at the office of your local county tax assessor-collector: 1. For a . disabled parking placard, download the Application for Persons with Disabilities Parking Placard and/or License Plate (Form VTR-214):For faster service, please go DMV Placard. online at www.dmv.ca.gov or call 1-800-777-0133 for an appointment. P.O. Box 932345 M/S D238 Sacramento, CA 94232-3450. 1. APPLICATION FOR DISABLED PERSON PLACARD OR PLATES. A Public Service Agency. Please read all the information on page one before completing this form.Eligibility Requirements for a Replacement. To be eligible for a replacement in Indiana, you must have had one issued to you previously, and it must have been lost, stolen, or damaged. Temporary ones are valid for up to 180 days, and permanent ones have a validity period of four years. Ensure your permit falls within these parameters.Different Types of Maine Application for Handicap Parking Space: 1. Temporary Handicap Parking Permit Application: This particular application is intended for individuals whose disability is expected to last for a short duration. It requires a medical professional's statement indicating the duration of the temporary disability.To obtain a permit, you must complete an application form provided by the Bureau of Motor Vehicles (BMV). How can I apply for a disability parking permit in IN? …Application for a disabled license plate must be made at your local county treasurer's motor vehicle office. A permanently disabled individual may select one of the following disabled parking choices: o One (1) disabled license plate and/or one (1) placard, or o Two (2) placards, but NO disabled license plate, or o One (1) placard and 1 ...Pay any applicable fees. The fee for a permanent disability placard in Indiana is $5, while the fee for a temporary placard is $10. Wait for the BMV to review your application. If approved, the BMV will issue a …Mail the application and payment to: Secretary of State. Disabilities License Plates/Placard Unit. 501 S. 2nd St., Rm 541. Springfield, IL 62756. NOTE: If you're a disabled veteran, you DO NOT need medical recertification to renew your placard IF your disability was originally certified as permanent.How to Apply. Applying for a Pennsylvania handicap parking placard involves: Completing the Person with Disability Parking Placard Application ( Form MV-145A) and having it notarized. Having the medical certification section completed by a medical professional, such as: A licensed physician. A chiropractor. A podiatrist. A physician’s assistant.It's also Mike Pence's hometown. It’s easy to drive past Columbus, Indiana. Judging from the road signs along the interstate, the town’s chief claim to fame is that it’s the birthp...Complete the form with your qualifying physician. Submit the form via mail or by dropping it off at the Department of Public Safety at 3600 N. Martin Luther King Ave, Building 1, Oklahoma City, Oklahoma. You can also. apply online. utilizing the following steps: Complete the online application—you’ll need your.Mayor’s Office for People with Disabilities. Disabled Parking Signs Appeal. City Hall, Room 104. 121 N. LaSalle St. Chicago, IL 60602. [email protected]. A decision regarding the appeal will be made within thirty (30) days of the request received by MOPD. Applicants will be notified by mail of the final decision.To get started on your application for an Indiana handicap parking permit, you’ll need to download or print the application form from the IN.gov website. You’ll need to fill out the …Temporary handicap placard: you will need to re-apply by submitting a new medical certification. This can only be done once. Permanent handicap placard: present your current placard, Louisiana driver’s license, and $3 fee paid in cash. Handicap license plate: you will need to renew your vehicle registration.In some states, the applications for handicap parking permits can be downloaded online. Others require you to go to your local DMV office. If you need more information, ask at your healthcare provider's office. They should be able to direct you to the proper state or county office that handles permits. Alaska.Visit the Indiana BMV website or your local BMV office to obtain the Application for Disability Parking Placard or Disability Plate (Form 42070). The form is …disability placard or disabled person license plate, but is required each time a temporary disability placard is requested. ... • the use of a “prescription pad” statement can also be used as evidence to determine eligibility for a temporary placard if it is attached to form RV-F1310301 and describes the mobility disabilities as “non ...Section 320.0848, Florida Statutes, provides the authorization for the issuance of disabled person parking permits for both long-term and short-term mobility impairments and those certified as legally blind by an optometrist. Permits may be issued to driver license and ID card holders. Disabled person parking permits are issued in two categories:Nov 1, 2023 · Application Process for a Handicap Placard in Indiana. To apply for a permit in IN, follow these steps: 1. Obtain the Application Form. Visit the Indiana BMV website or your local BMV office to obtain the Application for Disability Parking Placard or Disability Plate (Form 42070). The form is also available at certain healthcare provider ... DIVISION OF MOTOR VEHICLE LICENSING Page 1 of 1. APPLICATION FOR DISABLED LICENSE PLATE OR PARKING PLACARD. INSTRUCTIONS: Complete this form and forward to your County Clerk. SECTION 1: APPLICANT INFORMATION (to be completed by applicant before submitting to a physician) Issuance.Indiana Bmv Forms; State Form 42070 - Application For Disability Plate Or Parking Placard ... I meet the definition of “disabled” (to qualify for the placard) as outlined by Indiana Code 9-14-5-1. I am blind or visually impaired. I represent a corporation, limited liability company, partnership, or unincorporated association that provides ...Online Help Form. Fill out our online help form ... Indiana Disability Rights. Contact Us. 4755 Kingsway Drive, Suite 100, Indianapolis, IN 46205. Local Phone: 317. ...Types of Georgia Application for Handicap Parking Space: 1. Initial Application: The Initial Application is the first step for individuals who haven't previously applied for a Handicap Parking Permit in Georgia. This form requires personal information, medical certification, and documentation proving the need for a handicap parking permit. 2. Click on New Document and select the form importing option: add Indiana state form 42070 from your device, the cloud, or a protected link. Make adjustments to the sample. Take advantage of the upper and left-side panel tools to change Indiana state form 42070. Complete the form with your qualifying physician. Submit the form via mail or by dropping it off at the Department of Public Safety at 3600 N. Martin Luther King Ave, Building 1, Oklahoma City, Oklahoma. You can also. apply online. utilizing the following steps: Complete the online application—you’ll need your. Disability Placard/License Plate Application. ** See Page 2 for Instructions & Special License Plate Information ** MVD Use Only Expiration Date: Permit #: [email protected]. P.O. Box 201430 Helena MT 59620-1430 Phone (406) 444-3933 Fax (406) 444-3816. CHECK ONE: meet the eligibility requirements as listed on this application and am providing proof to that effect, or I am making application on behalf of a person with a disability as indicated in the Identification Statement above. Signature: Date: Form VTR-214 Rev. 8/2019. Form available online at www.TxDMV.gov. Page 1 of 2. You can get your Alabama Handicap Placard, by filling out the online form, providing the full details of your handicapped parking request form below ... How to obtain a permit. The applicant/legal guardian must fill out the Application for Disability Access Parking Privileges ( Form MVR 32-6-230 ). Now, creating a Indiana Handicap Placard requires no more than 5 minutes. Our state-specific online samples and clear recommendations eliminate human-prone faults. Adhere to our simple actions to get your Indiana Handicap Placard prepared rapidly: Find the template from the library. Complete all necessary information in the necessary fillable ... If DMV is unable to replace a disabled person permit, the person must apply for an original disabled person permit as set forth in OAR 735-080-0020. Statutory/ ... With a handicap parking permit, accessible parking spots near the entrances ofComplete and sign the applicant section of the form.Stephen Guilfoyle in his Market Recon column covers how the debt ceiling drama is dragging on, posts the latest rate hike odds, previews Friday's economic data deluge, highligh... Learn how to apply for, renew, or replace disability parking permits in Indiana. Find out the types, rules, and fees of handicap placards and plates, and the forms you need to submit. In order to obtain a placard, Form MV-145A (PDF), "Persons with Disability Parking Placard Application" must be completed by the person with a disability, a health care provider, or a police officer and returned to PennDOT. Permanent placards are valid for five years and renewed in March or September.Placard Renewals and Replacements. In order to obtain a placard, Form MV-145A (PDF), "Persons with Disability Parking Placard Application" must be completed by the person with a disability, a health care provider, or a police officer and returned to PennDOT. Permanent placards are valid for five years and renewed in March or September.APPLICATION FOR DISABILITY PLATE OR PARKING PLACARD. State Form 42070 (R13 / 11-13) Approved by State Board of Accounts, 2013 INDIANA BUREAU OF …INDIANA, Pa., Jan. 24, 2022 /PRNewswire/ -- S&T Bank, a full-service financial institution with assets of $9.4 billion and current operations in f... INDIANA, Pa., Jan. 24, 2022 /P...Applying for a handicap placard or license plate in Arkansas can be done by mail or in person at an Arkansas Office of Motor Vehicle location. In order to apply: A completed Application for Persons with a Disability License Plates (Form 10-366), which can be found online or at the AR OMV, must be submitted.A physician assistant with a valid and unrestricted license under Indiana Code 25-27-5. An optometrist or ophthalmologist with a valid and unrestricted license to practice optometry or ophthalmology in Indiana. Below are the fees for each type of permit: New disability plate: $9.50. Disability parking placard: $5.00.Number of placards requested: 1 placard 2 placards (Limit 1 replacement placard if lost, stolen or destroyed during the term of the original placard) I hereby make application to the Department of Public Safety for a physical disability parking placard. I understand I must display the official placard on the rearview mirror uponA Special Plate Application (form # 96-0143, available online) must be completed for a personalized plate. All choices are subject to approval. 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 a reserved number format beginning with the letter ...To apply, you will need: The Disabled Person and Physician Disability Certification (Form TC-842). For individuals: Your physician must complete the certification section on the form. For organizations: You must complete the care facility certification section. Placards: free. License plates: $20.50.document issued by the Department, such as a disabled person parking placard, or possessing, using or displaying such a document knowing it to have been altered, forged or counterfeited, is a misdemeanor of the first degree pursuant to the Vehicle Code, 75 Pa.C.S. Section 7122, punishable by a fine of not more than $10,000 or imprisonment of ...To apply for a "permanent" (blue) placard or "temporary" (red) placard, you must: Download the Application for Persons with Disabilities Parking Placard and/or License Plate (Form VTR-214) Have your doctor or health care provider complete the Disability Statement section of the application. Submit the completed application and payment (if ...How to obtain a permit. The applicant must fill out an Application For Disability Parking Placard Or Disability Plate ( State Form 42070 ), which must be certified by a physician with a valid and unrestricted licensed. The completed form can be returned to any Indiana license branch or the address on the form.Handy tips for filling out Indiana handicap placard form online. Printing and scanning is no longer the best way to manage documents. Go digital and save time with airSlate SignNow, the best solution for electronic signatures. Use its powerful functionality with a simple-to-use intuitive interface to fill out Indiana handicap placard online, e ...Application for a disabled license plate must be made at your local county treasurer's motor vehicle office. A permanently disabled individual may select one of the following disabled parking choices: o One (1) disabled license plate and/or one (1) placard, or o Two (2) placards, but NO disabled license plate, or o One (1) placard and 1 ...Impairment, Disability and Handicap. Patient offers free health information links to useful sites and leaflets for you to learn more about Impairment, Disability and Handicap. Symp...Save money, experience more. Check out our destination homepage for all discounts, tips, and planning guides for Disneyland in California! Read now Take advantage of exclusive Mick...Our Indiana retirement tax friendliness calculator can help you estimate your tax burden in retirement using your Social Security, 401(k) and IRA income. Social Security retirement...The application will typically ask for the following: Your personal info, including full name, mailing address, birthdate. Driver’s license number. Vehicle ID number (VIN) Disabled person placard number. What you’re requesting (placard, license plate, etc.) If the placard was lost, stolen, not received, etc.INSTRUCTIONS: 1. Complete in blue or black ink or print form. 2. To apply for a new disability license plate, complete Sections 1 and 2. To apply by mail, include payment of $9.50 (IC 9-18.1-11-10) in the form of a check or money order made payable to the BMV. 3. To apply for a disability parking placard, complete Sections 1 and 3.With a handicap parking permit, accessible parking spots near the entrances ofComplete and sign the applicant section of the form. Spaces for use by the Disabled Parking Permits are identified in selected lots by Disabled Parking signs.UWRF Employees must complete the application. By A Tierney · 2002 · Cited by 7 ? Disability Placard/License Plate Application. ** See Page 2 for Instructions & Special License Plate Information ** MVD Use Only Expiration Date: Permit #: [email protected]. P.O. Box 201430 Helena MT 59620-1430 Phone (406) 444-3933 Fax (406) 444-3816. CHECK ONE: The form must be completed in its entirety and mailed or faxed to: Indiana Bureau of Motor Vehicles. Attn: Driver Ability Department. 100 N Senate Ave RM 481. Indianapolis, IN 46204. Fax Number: (317) 974-1614. Once the completed form is received, the Driver Ability Department will thoroughly review the information submitted and determine if ...The replacement fee for a lost or stolen permit is $25.00. Your permit number will then be placed on a lost/stolen permit list. If the lost/stolen permit is found displayed on a vehicle on campus, Parking Enforcement will issue an unauthorized permit citation and may tow the vehicle. Disabled permits. Now, creating a Indiana Handicap Placard requires no more than 5 minutes. Our state-specific online samples and clear recommendations eliminate human-prone faults. Adhere to our simple actions to get your Indiana Handicap Placard prepared rapidly: Find the template from the library. Complete all necessary information in the necessary fillable ... Disability license plates and placards permit vehicles to park in parking spaces marked with the international symbol of access for persons with disabilities. Learn how to obtain a disability license plate or placard from the Ohio Bureau of Motor Vehicles. Learn how to apply for a disability plate or placard.1 year ago. Updated. Follow. In Indiana, parking is not covered by the state building code. Instead, there is a separate section of the code: Parking Facilities for …

Written by Tiffany Leung. Reviewed by Jessica Barrett. Updated on Sep 7, 2023. Table of Contents. Per the handicap placard regulations in. Indiana. , drivers …. Clarendon circa

indiana handicap placard form

Complete and sign the remainder of the form. Mail the completed form to the Motor Vehicle Division (PO Box 201430, Helena, MT 59620-1430). To renew: complete the three steps listed above. A new Disability Permit/License Plate Application (MV5) must be completed and signed by a licensed physician, physician’s assistant, chiropractor or ...Parking in a disability space without a valid permit or license plate is a violation of Indiana law. The penalties for this violation can vary but often include fines that range from $50 to $250. Additionally, your vehicle may be towed at your expense. 3. Forging or Altering a Handicap Placard.How to Apply for a Handicap Parking Permit. Get a handicapped parking application from the DMV office or online. Complete and sign the form. Ask your health-care provider to fill out and sign the ...To obtain a handicap parking pass in SC, you must complete the disability placard and License Plate Application ( Form RG-007A ), provide a medical certification from a licensed physician, provide a prescription from the licensed physician along with their signature, and pay the applicable fees (passes are $1; license plates are $20; disabled ...Application Process. To obtain a disabled parking badge online, visit handicapMD.com and follow the streamlined process for application. This includes. filling out the necessary forms, obtaining a digital medical certification from a licensed healthcare professional through the platform, and. submitting your application.Franklin Ohio Application for Handicap Parking Space is a form designed specifically for residents in Franklin, Ohio, who require accessible parking due to disabilities and physical limitations. This application is an essential document for individuals seeking the privilege of parking in designated handicap parking spaces within the city limits.To apply for a DP placard: Apply online using the Disabled Person Parking Placard Form Application. OR. Apply by mail or in office: Complete and sign an Application for Disabled Person Placard or Plates (REG 195). Have a licensed physician, surgeon, chiropractor, optometrist, physician assistant, nurse practitioner, or certified nurse midwife ... You may apply for a disability license plate and/or parking placard by completing an Application for Disability License Plate or Parking Placard State Form 42070. The application may be submitted to any Indiana branch or mailed to the address listed on the application. You can get the Application for Disability Plate or Parking Placard (State Form 42070) by going to your nearest Indiana Bureau of Motor Vehicles Office or printing the document online. If you're applying for a temporary disability placard, you will need to mail in a $5 fee with your application.Read on for the answer! In general, if you’ve obtained a valid handicap parking permit from your state, the placard should be valid in all 50 states. However, there are some states that do require that disabled individuals who are visiting apply for temporary travel placards. On the other hand, states like California, New York and …Age and other forms of serious illness. Vehicle Registration With a Disability Plate or Placard. The car registration process for a disabled plate or placard is fairly simple and requires a few items. You …Jeffersonville, Indiana is one of the best places to live in the U.S. in 2022 because of its low cost of living and ample things to do. Becoming a homeowner is closer than you thin...Handy tips for filling out Indiana handicap placard form online. Printing and scanning is no longer the best way to manage documents. Go digital and save time with airSlate SignNow, the best solution for electronic signatures. Use its powerful functionality with a simple-to-use intuitive interface to fill out Indiana handicap placard online, e ...If you filed your Indiana tax return electronically, wait at least three weeks before checking on the status of your refund. If you mailed your return, wait at least 12 weeks. The ... If you still need to use disabled parking once your temporary placard expires after a year, you must apply for a new one. You can do this by submitting a new medically certified application form to the BMV. You can renew your disability license plate online at myBMV.com, at any self-service terminal, by mail, or at any BMV license branch. Creepy as they may be, it turns out that snakes are pretty handy to have around. Find out what would happen if there were no snakes at HowStuffWorks. Advertisement The allegedly fe... Highest customer reviews on one of the most highly-trusted product review platforms. Complete IN State Form 42070 2018-2024 online with US Legal Forms. Easily fill out PDF blank, edit, and sign them. Save or instantly send your ready documents. Getting a Plate or Placard. Individuals must apply and qualify, as indicated in the table below. Disability placards and plates can be obtained on the same day at an NCDMV license plate agency. Completed forms may also be mailed to the address listed on the forms. Please allow three to four weeks to receive the placard or plate in the mail.INSTRUCTIONS: 1. Complete in blue or black ink or print form. 2. To apply for a new disability license plate, complete Sections 1 and 2. To apply by mail, include payment of $9.50 (IC 9-18.1-11-10) in the form of a check or money order made payable to the BMV. 3. To apply for a disability parking placard, complete Sections 1 and 3. It is a Class C misdemeanor to knowingly make false representations to obtain a disability placard. Signature. Printed Name. Date Signed (mm/dd/yyyy) APPLICATION FOR DISABILITY PLATE OR PARKING PLACARD. State Form 42070 (R13 / 11-13) Approved by State Board of Accounts, 2013. INDIANA BUREAU OF MOTOR VEHICLES. .

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