Handicapped Application
New York State Department of Motor Vehicles
HOW TO APPLY FOR A PARKING PERMIT OR LICENSE PLATES
FOR PERSONS WITH SEVERE DISABILITIES
www.nysdmv.com
GENERAL INSTRUCTIONS
You are eligible for a special parking permit or license plates if you are a New York State resident who has one or more severe disabilities
that impair your mobility. See Part 2 of the MV-664.1 (Application for a Parking Permit or License Plates, for Persons With Severe
Disabilities) for a description of qualifying disabilities.
1) If you are applying for the oarkinQ oermit:
NOTE: DO NOT SEND YOUR APPLICATION TO THE DEPARTMENT OF MOTOR VEHICLES. DMV does NOT issue oarkina oermits.
(a) A parking permit may be issued for either a permanent or temporary disability.
(b) You do not have to be a driver, or the registered owner of a vehicle, to get a parking permit. Children who have a qualifYing disability are
eligible for permits at any age, as are persons who are legally blind. Permits are issued in the name of the person with the disability.
(c) Fill out Part I of the application (MV-664.1). Have your physician, podiatrist or nurse practitioner complete Part 2 of the application
and return it to you. NOTE: The need for medical certification may be waived by the issuing agent if you have an obvious, visually-
identifiable disability (such as the loss of a leg) QB. if you alreadv have license plates for persons with severe disabilities. Fill out
Part 1 of the application and attach a copy of your registration to your application. If you have custom plates for persons with severe
disabilities, bring a photo of your plate showing the wheelchair symbol.
(d) You must take your completed application to the issuina aaent in the area where vou live. Also. if you have a NYS driver
license or an 10 card issued bv NYS OMV. bring it with you when you apply for the permit.
I MOST NEW YORK STATE RESIDENTS I - Call your local city, town or village hall to find out where the nearest permit issuing
agent is located. Most city, town or village clerks, and some police departments, issue permits. Although most agents
accept the MV-664.1, some have their own application form, and not all agents issue permits for temporary disabilities.
I NASSAU COUNTY I residents should call (516) 227-7399 (the Nassau County Office of the Physically Challenged) to find out
where to apply for a permit.
I NEW YORK CITY I residents must send the MV-664.1 application to the NYC Department of Transportation, 28-11 Queens Plaza
North, 8th Floor, Long Island City, NY 11101-4008, or call (718) 433-3100. If you already have plates for persons with severe
disabilities, complete Part I and attach a copy of your registration. If you have custom plates for persons with severe disabilities,
attach a photo of your plate showing the ISA. Please read important information about "PARKING IN NEW YORK CITY" on page 2.
2) If you are applying for license olates:
(a) Your disability must be permanent.
(b) The vehicle on which the special plates will be used must be registered to the person with the disability, whether or not
that person drives. You must be at least 16 years old to have a vehicle registered in your name.
(c) Fill out Part I of the MV-664.1 application. Have your physician, podiatrist or nurse practitioner complete Part 2 of that application
and return it to you. NOTE: The need for a medical certification may be waived by the Motor Vehicles office if you are permanently
disabled and if you have an obvious, visually-identifiable disability (such as the loss of a leg) OR if you received a parking permit
for the disabled within the past year. Fill out Part I of the application and attach a copy of your permit application showing the
medical certification, or doctor's statement, and bring your permit with you.
(d) You can obtain the plates at any Motor Vehicles office. Bring the completed application with you.
If you are registering your vehicle for the first time, you must provide all of the items required for an original registration,
including the proof of disability.
If you already have plates on your car, bring them with you to exchange them for plates for persons with severe disabilities. You
will have to fill out a registration application (MV-82) and pay $15.00 for the new plates that show the International Symbol of
Access (ISA). If this transaction is done at any time other than when you renew the vehicle registration, a $3.00 transaction fee
will be charged.
Personalized plates with up to six characters and the ISA are available from DMV's Custom Plates office. Call (518) 402-4838.
MV-664.3 (9/07)
PAGE 1 OF 2
USING LICENSE PLATES AND PARKING PERMITS
· The plates and permits may be used to park in reserved parking spaces only when the person with the disability is
driving or riding in the vehicle. People who are not disabled cannot use your parking permit and/or plates to park in a
reserved space. Persons parking illegally in these spaces violate Section 1203-c(4) of the NYS Vehicle and Traffic Law and
can be fined $50 to $75 for a first offense, and $75 to $150 for a second offense within two years. Municipalities can impose
higher fines. Any person who abuses or misuses any parking permit or license plates for the disabled may have them revoked.
. Parking pemlits should be hung from the rear-view mirror when parked, but should be removed from the mirror when driving.
. Generally, the plates and permits are valid everywhere in New York State where parking spaces are reserved for persons with
disabilities. However, use of the plates or permit does not exempt you from state or local parking regulations or fees or the
requirement to obtain permission to park in a designated area. They are also valid in most other states, territories and foreign
countries. If you are traveling outside of New York, check with the police or Motor Vehicles agency where you are traveling,
to be sure your permit or plate will be accepted.
. Parking spaces reserved for people with disabilities must be marked with conspicuous and permanently installed above-
grade signs displaying the wheelchair symbol. These signs are positioned at a height of five to seven feet above the parking
space surface. Designation of reserved spaces may include the use of blue painted lines or markings. Do not park in the
striped access aisle next to spaces reserved for people with disabilities even if you have a permit or plates.
Access aisles provide room for people with wheelchairs and other specially equipped vehicles to transfer safely to and from
their vehicles.
. Localities designate parking spaces for persons with disabilities by local law or ordinance. If you have a question about
parking for the disabled on a particular street, find out if it is a county, city, town, village or state road, and contact the
authorities responsible for maintaining the road. If you have a question about reserved parking at any facility with off-street
parking, contact the facility manager or the local building inspector.
. PARKING IN NEW YORK CITY
New York City docs l1Q! set aside reserved spaces on its streets for persons with disabilities. Reserved parking spaces are
only available off-street, in parking lots for shopping centers/malls, office/apartment buildings and college campuses. You
can use the state plates and pennits to park in designated spaces in those off-street lots.
The NYC Department of Transportation also issues a City permit (a rectangular dashboard permit) that allows persons with
severe disabilities to park at most curbsides on NYC streets. City permits are issued to New York City residents and to people
who work or attend school in NYC, and who have a permanent disability that so severely affects their ability to walk that they
require the use of a private automobile. The New York City parkin!: permit is not valid outside ofNYC. To obtain an
application for a NYC permit, call (718) 433-3100.
. METERED PARKING WAIVERS
If you have a certain severe disability that limits your ability to access or put payment into a parking meter, in addition to a
mobility-related disability, you may be eligible for a metered parking waiver. The metered parking waiver allows the holder to
park in a metered parking space in any city, town or village of New York State (except New York City) without paying the fee.
For more information, see forms MV-664.1MP (Application for a Metered Parking Waiver for Persons with Severe
Disabilities) and MV-664.2MP (Metered Parking Waiver Information). These forms are available through your local issuing
agent and are also available at the DMV website: www.nysdmv.com
MV-664.1 (9109)
PAGE 2 OF 4
Please
TEAR at the PERF
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for your mformatlon.
New York State Department of Motor Vehicles
APPLICATION FOR A PARKING PERMIT OR LICENSE PLATES,
FOR PERSONS WITH SEVERE DISABILITIES
Please read pages] and 2 of this packet before completing this application. If applying for a Parking Permit, take the completed application to
the issuing agent (local municipality) in the city, town or village where you live. Do not send your application to the Department of
Motor Vehicles. DMV does not issue Darkina Dermits.
Part 1 INFORMATION ABOUT PERSON WITH DISABILITY - (Please print and sign by the arrow.)
Last Name First M.1. I Telephone No.
I. )
Address: No. and Street Apt. No. City State Zip Code
Date of Birth I D Male D Female II am applying for D License Plates (Apply to OM V.) D Parking Permit (Apply to local issuing agent.)
Do you have license plates for persons with disabilities? DYes - My license plate number is: DNo
Read Note on Page 4 Before Signing
-+
(Signature of Person with Disability or Signature of Parent or Guardian) -Ij"signed by a parent or gllardian, (Date)
/Jlease state l'Ollr relationshi/J to the /JerSOll with the disabilitl' afier l'Ollr sienatllre.
Part 2 MEDICAL CERTIFICATION
NOTE: PERMANENT DISABILITIES may be certified by a Medical Doctor (MD), Doctor of Osteopathy (DO), Physician Assistant (PA),
Nurse Practitioner (NP), a Doctor of Podiatric Medicine (DPM, for disabilities related to the foot) or Optometrist (OD, for blindness).
TEMPORARY DISABILITIES, however, may be certified only by a Medical Doctor or Doctor of Osteopathy.
Check the box(es) that describe the disability, and fill in the diagnosis:
D TEMPORARY DISABILITY: A person with a temporary disability is any person who is temporarily unable to ambulate without the aid of an
assisting device. Examples of an assisting device include, but are not limited to, a brace, cane, crutch, prosthetic device, another person,
wheelchair or walker. IMPORTANT: Temporary permits are issued for six months or less regardless of expected recovery date.
Expected Recovery Date: Diagnosis:
What assistive device is needed?
D PERMANENT DISABILITY: A "severely disabled" person is any person with one or more of the PERMANENT impairments,
disabilities or conditions listed below, which limit mobility.
Diagnosis: Please check the conditions that apply:
D Uses portable oxygen D Legally blind D Limited or no use of one or both legs D Unable to walk 200 ft. without stopping
0 Neuromuscular dysfunction that severely limits mobility 0 Class III or IV cardiac condition. (American Heart Assoc. standards)
0 Severely limited in ability to walk due to an arthritic, neurological or orthopedic condition
0 Restricted by lung disease to such an extent that forced (respiratory) expiratory volume for one second, when measured by
spirometry, is less than one liter, or the arterial oxygen tension is less than sixty mm/hg of room air at rest
0 Has a physical or mental impairment or condition not listed above which constitutes an equal degree of disability, and which imposes
unusual hardship in the use of public transportation and prevents the person from getting around without great difficulty.
EXPLAIN BELOW HOW THIS DISABILITY LIMITS FUNCTIONAL MOB!L1TY.
MDIDO/DPM/NP/PNOD Name Professional License No.
MDIDO/DPM/NP/PNOD Address Telephone No.
( )
Read Note on Page 4 Before Signing
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(MD/DO/DPM/NP/PAlOD Signature) (Date)
Part 3 FILE INFORMATION (For Issuing Agent Use Only)
o Blue D Red Parking Permit No. Date Issued: Date Expires:
o First D Second 9-digit number from NYS Driver License/lD Card
o Denied o Revoked Reason:
(Date)
-+
(Issuing Agent) (Locality)
MV-664.1 (8/12)
PAGE 3 OF 4
NOTE TO CUSTOMERS AND MEDICAL PROFESSIONALS
Making a false statement or providing false information on an application for a parking permit or
license plates for persons with severe disabilities is a crime (a felony or a misdemeanor) under
the Vehicle and Traffic Law and the Penal Law, and is punishable by a fine, imprisonment or
both, and --regarding applications for parking permits--may also result in liability for payment of
a civil penalty of $250-$1 ,000.
Customers Reauestina license Plates. or a Parkin9 Permit. for Persons with a Disabilitv
By signing Part I of this application, you are certifying:
. that the information you provide on this application is true;
. that you have read and understand the conditions for "Using License Plates and Parking Permits" stated
on page 2; and
. that you agree to comply with those conditions.
Medical Professionals Providina Medical Information in Suooort of an Aoolication for license
Plates. or a Parkina Permit. for Persons with a Disabilitv
By signing Part 2 of this application, you are certifying:
. that the medical information you are providing is true and complete; and
. that, in your opinion, the person named in Part I of the application is medically qualified to receive
license plates, or a parking permit, for persons with a disability, according to the medical criteria
specified in Part 2.
MV-664.1 (8/12)
www.dmv.ny.gov
PAGE 4 OF 4
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