New Yorkers with a severe disability that impairs mobility use this DMV application to get a local parking permit or license plates with the International Symbol of Access. Clinicians complete Part 2, the medical certification, marking a temporary disability (recovery up to six months) or one or more of nine permanent conditions. The patient takes a permit application to their city, town or village, not to DMV.
A physician, physician assistant or nurse practitioner completes Part 2; a podiatrist may certify disabilities related to the foot and an optometrist blindness. The person with the disability, or a parent or guardian, completes and signs Part 1, and the issuing agent fills in Part 3.
The person with the disability, or a parent or guardian, enters name, address, telephone, date of birth and sex, and checks whether they want license plates, a parking permit or a permit renewal. They note any existing disability plate number and, in New York City, attach a copy of their license or non-driver ID and list any prior state permit number. Signing certifies the information is true and that they will follow the conditions of use.
Check this box when the person is temporarily unable to walk without an assisting device such as a brace, cane, crutch, prosthesis, another person, wheelchair or walker. Enter the expected recovery date, the diagnosis and the assistive device needed. Temporary permits are issued for recovery periods of up to six months.
A severely disabled person has one or more permanent conditions that limit mobility. Enter the diagnosis and check each that applies: uses portable oxygen; legally blind; limited or no use of one or both legs; unable to walk 200 feet without stopping; neuromuscular dysfunction severely limiting mobility; AHA Class III or IV cardiac condition; severely limited walking from an arthritic, neurological or orthopedic condition; or lung disease with FEV1 under one liter or resting arterial oxygen tension under 60 mm Hg on room air.
The last permanent box covers a physical or mental impairment not listed that is equally disabling, imposes unusual hardship in using public transportation and prevents the person from getting around without great difficulty. When this box is checked, the certifier must explain in the space below how the disability limits functional mobility.
The certifier prints their name, professional license number, address and telephone number, then signs and dates. Signing certifies that the medical information is true and complete and that, in the certifier's opinion, the person meets the medical criteria in Part 2. A false statement on the application is a crime that can bring a fine, imprisonment or both.
The locality or DMV issuing agent completes this part: blue (permanent) or red (temporary) permit, permit number, issue and expiration dates, any second permit, the 9-digit driver license or ID number, and whether the application was denied or a permit revoked. Clinicians leave it blank.
Download the current version from the source each time; forms change without notice.
Application for a Parking Permit or License Plates, for Persons with Severe Disabilities
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.
Sources for this guide
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Part 2 must be certified by a physician, physician assistant, nurse practitioner, podiatrist (for disabilities related to the foot) or optometrist (for blindness). The certifier prints their name, professional license number, address and telephone, then signs and dates. For plates, the certifier completes the Permanent Disability section and returns the form to the patient.
Not for a parking permit. DMV does not issue parking permits; the patient takes the application to the city, town or village where they live, and New York City residents mail it to NYC DOT with a copy of their driver license or non-driver ID. Only license plate applications go to a DMV office.
Temporary permits are issued for recovery periods of up to six months. The certifier enters an expected recovery date, the diagnosis and the assistive device the person needs. The issuing locality records the permit color (red or blue) and the expiration date in Part 3.
Not for a permanent disability. Part 2 is marked as not required to renew a parking permit, and the instructions say a permanent-disability renewal needs only Part 1. A first permit application and a plate request need Part 2, unless DMV waives it for plates.