REG 195 (REV. 4/2018) WWW 1 of 3
APPLICATION FOR DISABLED PERSON PLACARD OR PLATES
IMPORTANT INFORMATION, DISCLOSURES AND CERTIFICATIONS
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. Attention Disabled Veterans with a service-connected disability: You may be eligible for Disabled Veteran License Plates which
exempts one vehicle from the payment of registration and license fees. Documentation from the Department of Veterans Aairs, along with a completed DMV
form REG 256A is required. Visit www.dmv.ca.gov or call 1-800-777-0133 for forms and additional information.
ELIGIBILITY
You may qualify for a DP parking placard or license plates if you have impaired mobility due to having lost use of one or more lower extremities, both hands,
have a diagnosed disease that substantially impairs or interferes with mobility, or if you are unable to move without the aid of an assistive device. You may
also qualify if you have specic, documented visual problems, including lower-vision or partial-sightedness, or specic cardiovascular or respiratory illnesses.
(CVC §§295.5, 5007, 22511.55)
APPROPRIATE USE OF YOUR DP PLACARD/PLATES
With your valid DP placard or plates,
you may park:
• In parking spaces with the wheelchair symbol.
• In an area requiring a resident or merchant permit.
• Next to a blue or green curb for an unlimited period.
• In any on-street metered parking space at no charge.
You do not have to own or drive the vehicle to use the placard. You will receive a placard identication (ID) card with your placard. This ID card identies you
as the placard owner and must be kept with you at all times whenever the placard is in use. (California Vehicle Code (CVC) § 4461)
Additionally:
• You must present ID and the placard ID card upon request of a peace ocer or a person authorized to enforce parking laws. (CVC §§5007, 22511.56).
• Your DP placard cannot be loaned to anyone, including family members or friends, even if that person is also disabled. (CVC §4461)
• DP parking placard abuse and misuse can result in the conscation and cancellation of the placard. (CVC §§4461, 22511.56)
• DP plates and/or parking placard(s) must be surrendered to DMV within 60 days of the death of the disabled person. (CVC §§5007, 22511.55)
IT IS ILLEGAL - Punishable by ne, imprisonment or both ne and imprisonment (CVC §§22511.5, 22511.6, 22511.57)
• To alter, forge, or counterfeit a DP parking placard or placard ID card.
• To allow someone to use your DP parking placard if you are not in the vehicle.
• For an individual to have more than one permanent DP parking placard.
• To provide false information to obtain a DP parking placard or plates.
• To forge a medical provider’s signature.
• To possess or display a counterfeit DP parking placard.
The court may also impose a civil penalty if: a person attempts to pass, acquires, possesses, sells, or attempts to sell a genuine or counterfeit placard or
if a person displays, with fraudulent intent, or causes or permits to be displayed, a forged, counterfeit, or false placard.
PRIVACY NOTICE
DMV uses personal information only for the specied purposes, or purposes consistent with those purposes, unless DMV obtains your consent, or unless
authorized by law or regulation.
• CVC §§5007, 22511.55, 22511.58 allows any information contained in this application, including the medical provider substantiation, to be made available to
local public law enforcement or the local agencies responsible for the enforcement of parking regulations.
• CVC §1825(a) allows DMV to share information with appropriate regulatory boards to conduct audits of the DP parking placard/plates program.
DMV’s Privacy Policy is located at www.dmv.ca.gov under the “Privacy Policy” link at the bottom of the page.
SECTION 1: APPLICANT OR ORGANIZATION INFORMATION
Eective January 1, 2018, California law requires applicants for an original DP parking placard or plates to submit a copy of proof of true full name and date of bir th.
A valid driver license (DL) or identication (ID) card is acceptable, as is any document necessary to apply for a California DL or ID card. Visit www.dmv.ca.gov
or call 1-800-777-0133 for a list of acceptable documents.
SECTION 2: TYPE OF DISABLED PERSON PARKING PLACARD(S) OR LICENSE PLATES
Temporary DP parking placard:
For temporary disabilities. Valid for up to 180 days (six months) or the date noted by your qualifying licensed medical
professional, whichever timeframe is less. This placard cannot be renewed more than six times consecutively.
Permanent DP parking placard:
For permanent disabilities. Valid for two years and expires on June 30 of every odd-numbered year. You will receive two
automatic renewals, covering a 4-year period. Your third renewal will require you to reapply; a new certication is not required.
Disabled DP plates: For permanent disabilities. Can only be assigned to vehicles registered in the name of the qualied person.
DP Plate Reassignment: For existing DP plates to be reassigned to a dierent vehicle.
Travel DP parking placard:
For California residents who currently have a DP parking placard or plates, or Disabled Veteran License Plates, but not both.
For nonresidents who plan to travel in California and have a permanent disability and/or DP plates.
SECTION 3: DISABLED PERSON LICENSE PLATE APPLICANTS ONLY: VEHICLE INFORMATION
DP license plates may be issued for any vehicle or motorcycle registered to a qualied person or an organization involved in the transportation of disabled
persons if the vehicle is used solely for the purpose of transporting those persons (CVC §5007, 22511.55). One commercial vehicle with an unladen weight
of 8,001 pounds or less registered to a qualied person may be exempt from payment of weight fees (CVC §9410).
SECTIONS 5 AND 6: MEDICAL PROVIDER’S CERTIFICATION, INFORMATION, AND SIGNATURE
If the disability is related to items 4-8 in Section 6, a complete and legible description of the Illness or disability must be provided in Section 6A with
enough information to meet state law certication requirements. Descriptions that only contain abbreviations (i.e., “R60.9”) or only list symptoms (e.g., “trouble
walking”) require further explanation. A licensed physician, surgeon, physician assistant, nurse practitioner, or certied nurse midwife, may certify to items
2-8, a licensed chiropractor may certify to items 6-8 only, a licensed podiatrist may certify to a disability related to the foot or ankle, and a licensed physician
or surgeon who specializes in diseases of the eye or a licensed optometrist may only certify to item 1. The medical provider’s signature may be compared to
documentation led with the appropriate regulatory agency and the medical provider may be contacted regarding this application.
Completed applications can be submitted in person or by mail.
In person:
Take this completed form to a DMV eld oce. For faster service, please go
online at www.dmv.ca.gov or call 1-800-777-0133 for an appointment.
Mail To:
DMV Placard
P.O. Box 932345 M/S D238
Sacramento, CA 94232-3450
STATE OF CALIFORNIA
DEPARTMENT OF MOTOR VEHICLES
®
A Public Service Agency