New Jersey residents with a temporary mobility limitation use SP-68 to get a temporary disability placard from their municipal police department. A medical practitioner certifies in Section B, after personally examining the patient, that the person has temporarily lost the use of a limb, needs an assisting device to walk, or is otherwise temporarily limited in mobility.
The applicant completes Section A and signs Section C, the terms and conditions. A medical practitioner completes and signs Section B, Medical Practitioner's Certification, including a required National Provider Identification number.
Download the current version from the source each time; forms change without notice.
Application for Temporary Placard
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.
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With the police department of the municipality where they live. Temporary placards are issued by the police chief, not at Motor Vehicle Commission offices. The fee is attached to the application, payable to the NJ MVC.
No longer than six months from the date of issue. The placard can be recertified one time by a qualified medical practitioner, for a period not exceeding six months, so the maximum total is about one year.
A medical practitioner, who certifies under penalty of law that they personally examined the patient and that the patient meets the temporary eligibility criteria. The practitioner gives a name, address, phone and a required National Provider Identification number.