The Illinois Placard form serves as an essential tool for individuals with disabilities, facilitating their access to designated parking spaces. It ensures that persons who meet specific medical criteria can obtain either a temporary or permanent placard, based on their physician's certification. By streamlining the application process for parking placards and license plates for drivers with disabilities, the form seeks to improve mobility and quality of life for these individuals. If you are in need of such a placard, consider filling out the form by clicking the button below.
In the State of Illinois, the Secretary of State oversees the issuance of parking placards for persons with disabilities, a critical resource for enhancing mobility and accessibility. The Illinois Placard form, designed for both new applicants and those seeking renewals, encompasses a comprehensive procedure aimed at verifying the eligibility of individuals based on medical criteria. It necessitates detailed input from the applicant, a healthcare professional's certification, and, in cases involving minors, a guardian's acknowledgment. Besides aiding in the application for temporary and permanent disability parking placards, the form cater to those applying for meter-exempt parking, thereby accommodating a wider range of disabilities and needs. Importantly, the form underscores the legal implications of misuse or falsification of information, highlighting fines and potential revocation of driving privileges as deterrents. Furthermore, the form addresses veterans by offering them an avenue to submit proof of service. This structured approach reflects a blend of regulatory thoroughness and sensitivity to the varied needs of individuals with disabilities, ensuring that the benefits are reserved for those genuinely in need. The prescribed process, which includes mailing the application for permanent placards and the possibility of in-person submissions for temporary ones, showcases the state's commitment to accessibility while maintaining integrity and oversight in the issuance of such critical aids.
State of Illinois Secretary of State 501 S. 2nd Street Springfield, IL 62756
NNEW APPLICANT
NRENEWAL
*If your valid placard was lost/stolen/damaged,
use replacement form VSD 415,
available online at cyberdriveillinois.com or visit your local Secretary of State facility.
Persons with Disabilities Certification for Parking Placard
*This form is valid for three months from your physician’s signature date for a Temporary Placard and six months for a Permanent Placard.
NOTE TO DISABILITY LICENSE PLATE OWNERS: If you have a disability license plate, you MUST complete the form and renew your placard.
DIRECTIONS: Both sides of this document must be signed and completed fully. All fields are required.
Applicants complete Part 1. If the applicant is a MINOR, then Parent/Guardian(s) MUST also complete Part 2. The applicant’s medical profes- sional MUST complete Part 3. If the applicant is applying for meter-exempt parking, his/her medical professional MUST also complete Part 4.
Part 1: Applicant Information (MUST have a valid Illinois driver’s license and/or ID card)
I hereby certify that I meet the definition of a person with a disability as provided in 625 ILCS 5/1-159.1, and I certify that my physical condition entitles me to the issuance of a Persons with Disabilities Parking Placard. By affixing my signature below, I understand that the parking placard may not be used unless I am the driver or passenger of the vehicle.
*If a military veteran, please provide a copy of your DD214 showing proof of service.
Disability Parking Placard # (if any)
Full Name of Person with Disability (If Minor, complete Part 2 also.)
Male/Female
Date of Birth
Valid Illinois Driver’s License or ID Card # of Applicant
Illinois Address
Apt/Unit #
City
IL
ZIP
Mailing Address if Different from Above
Telephone Number
Email Address
Military Veteran? Yes / No
Signature of Person with Disability
Today’s Date
Part 2: For Parent or Legal Guardian (MUST have a valid Illinois driver’s license and/or ID card)
I hereby certify that the above applicant is a minor and I have primary responsibility for his/her transportation. By affixing my signature below, I understand that the disability placard is issued to the person with disability and may not be used unless I am transporting the disabled person in the vehicle.
Name of Parent or Legal Guardian
Relationship to Person with Disability
Valid Illinois Driver’s License or ID Card #
Signature of Parent or Legal Guardian
Warning: Any misuse of the disability parking placard/plates or making a false application may result in the revocation of the placard, a 12- month suspension or revocation of your driver’s license, and a fine of up to $1,000.
Temporary Disabled Parking Placard Applications — May be taken to any Secretary of State facility or mailed in. Permanent Disabled Parking Placard Applications — MUST be mailed to the following address:
Secretary of State, Persons with Disabilities Placard Unit, 501 S. 2nd Street, Room 541, Springfield, IL 62756.
*If you have a permanent disability placard and would like a Persons with Disabilities License Plate, please visit your local Secretary of State facility to apply. You will need your permanent placard number and current plate number or VIN.
Please complete Page 2 to ensure timely processing.
Printed by authority of the State of Illinois. July 2021 — 1 — VSD 62.28
Part 3: Medical Eligibility Standards and Medical Professional Certification
As the medical professional(s) executing this document and verifying the nature of the applicant’s disability, I understand that making a false representation of a person’s disability for the purposes of obtaining any type of disabled parking placard may result in suspension or revocation of my license and a fine of up to $1,000. As a licensed physician, advanced practiced nurse, optometrist, chiropractor or physician’s assistant, I certify the applicant has a condition that constitutes him/her as a person with disabilities.
Length of Disability: (Check one)
NTemporary Disability; the duration of this disability is ________________________(maximum 6 months)
NPermanent Disability
NMeter-Exempt Disability (Must complete and sign Part 4 also.)
Check all that apply: (MUST check at least one):
NIs restricted by a lung disease to such a degree that the person’s forced (respiratory) expiratory volume (FEV) for 1 second, when measured by spirometry, is less than 1 liter.
NUses a portable oxygen device.
NHas Class III or Class IV cardiac condition according to the standards set by the American Heart Association.
NCannot walk without the use of or assistance from a wheelchair, a walker, a crutch, a brace, a prosthetic device, or another person.
NIs severely limited in the ability to walk due to an arthritic, neurological, oncological, or orthopedic condition.
NCannot walk 200 feet without stopping to rest because of one of the above five conditions.
Check all that apply: (MUST check at least one diagnosis):
N Amputation of extremity(s) _________________________
N Arthritis of the ______________________________________
N Spina Bifida
N Osteoarthritis of the
_________________________________
N Multiple Sclerosis
N Chronic Pain due to
N Quadriplegia/Paraplegia
N Legally Blind with limited mobility
NCerebral Palsy
NOther Diagnosis: _________________________________________________________________________________________
If none of the above conditions apply, list the medical condition that impacts the person’s mobility.
Medical Professional’s Printed Name
Specialty
Office Address
City, State, ZIP
Medical Professional’s Signature
State Professional License Number (NOT NPI#)
Signature of Collaborating/ Supervising Physician (if signed above by resident/assistant)
Supervising State Professional License Number
Part 4: Medical Eligibility for Meter-Exempt Parking
The meter-exempt parking certification must be completed only when the applicant qualifies. To qualify, the applicant MUST have a VALID Illinois driver’s license, have an ambulatory disability described in Part 3, and also have one of the following conditions listed below.
Economic need is not a consideration for meter-exempt parking.
The applicant is eligible for meter-exempt parking as provided by statue due to the following PERMANENT medical condition or disability:
Check all that apply:
NCannot manage, manipulate or insert coins, or obtain tickets in parking meters/ticket machines due to lack of fine motor control of BOTH hands.
NCannot reach above his/her head to a height of 42 inches from the ground due to a lack of finger, hand or upper-extremity strength or mobility.
NCannot approach a parking meter due to his/her use of a wheelchair or other device for mobility.
NCannot walk more than 20 feet due to an orthopedic, neurological, cardiovascular or lung condition in which the degree of debilitation is so severe that it almost completely impedes the ability to walk.
NMissing a hand(s) or arm(s) or has permanently lost the use of a hand or arm.
NPatient is under 18 years of age and incapable of driving.
FOR SECRETARY OF STATE OFFICE USE ONLY
Parking Placard Number: ________________________________
Expiration Date: ______________________________________
Issued By: ___________________________________________
Issue Date: __________________________________________
Filling out the Illinois Placard form is a straightforward process aimed at ensuring that individuals who meet the necessary criteria are provided with the accessibility they require. This procedure assists in making mobility and parking more manageable for those with disabilities. Careful attention to detail when completing this form will help in avoiding delays. Here's how to correctly fill out the form:
After submission, the application will be reviewed, and if approved, the placard will be issued. It's essential to keep a copy of the form for records and follow up if necessary. Accuracy and completeness are crucial to facilitate a smooth processing experience.
Who is eligible to apply for a Persons with Disabilities Parking Placard in Illinois?
Eligibility for a Persons with Disabilities Parking Placard in Illinois includes individuals who meet one of the medical eligibility criteria outlined by state law. This includes persons who cannot walk 200 feet without stopping to rest, use a portable oxygen device, have a Class III or IV cardiac condition, are severely limited in their ability to walk due to a neurological, orthopedic, arthritic, or oncological condition, or have another listed disability that affects their mobility. Both temporary and permanent disabilities are considered.
How does one apply for a parking placard?
To apply, complete the Persons with Disabilities Certification for Parking Placard form, ensuring both sides are fully completed. The applicant must fill out Section 1, and if the applicant is a minor, a parent or guardian must complete Section 2. A medical professional has to certify the disability in Section 3, and if meter-exempt parking is needed, Section 4 must also be completed. For a temporary disabled parking placard, you can either visit any Secretary of State facility or mail your application in. However, applications for permanent disabled parking placards must be mailed to the designated address.
What must be included with the parking placard application?
Accompanying the application must be certification from a licensed medical professional verifying the nature and extent of the applicant's disability. If the applicant is a military veteran, a copy of their DD214 showing proof of service should be included if applicable. Ensure all personal identification information is correctly provided, along with a valid Illinois driver's license or ID card number.
Can someone with a disability license plate also need a placard?
Yes, individuals who have a disability license plate are still required to apply for and renew their parking placard by completing the necessary form. This ensures their right to use designated parking spaces even when not driving a vehicle with the disability license plate.
Is there a fee for the parking placard?
The information provided does not specify a fee for applying for or renewing a parking placard. Typically, such programs are provided free of charge, but it is advisable to check the latest updates on the Secretary of State's website or contact their office directly for the most accurate information.
How long is the parking placard valid?
A temporary parking placard is valid for up to six months from the physician's signature date. A permanent parking placard validity period is not explicitly mentioned but will generally have a longer validity period, subject to renewal requirements.
What are the consequences of misuse or false application?
Misuse of the disability parking placard or plates, or making a false application, can lead to severe penalties, including the revocation of the placard, a 12-month suspension or revocation of the driver's license, and a fine of up to $1,000.
Are there special provisions for meter-exempt parking?
Yes, individuals with specific permanent medical conditions or disabilities that severely limit their mobility and ability to use parking meters are eligible for meter-exempt parking. This requires separate certification by a medical professional that the individual meets one of the specific conditions listed in the application form.
What should be done if a valid placard is lost, stolen, or damaged?
If a valid parking placard is lost, stolen, or damaged, one must use the replacement form VSD 415. This form is available online at cyberdriveillinois.com or at a local Secretary of State facility. Completing this form as soon as possible will ensure the continued right to use designated parking spaces.
Filling out the Illinois Placard form might seem straightforward, but there are common missteps that can lead to delays or even rejection of your application. By being aware of these errors, applicants can ensure a smoother process.
Not completing both sides of the document: The form requires thorough completion, including the signatures on both sides. Many applicants miss filling out the back side which includes crucial medical professional certification.
Incomplete or missing information: Every field on the form needs to be filled out. This includes selecting the type of disability and the medical professional providing a comprehensive diagnosis. Leaving fields blank or providing incomplete details can stall the application process.
Overlooking the meter-exempt parking section: For those who qualify for meter-exempt parking due to their disability, missing the completion of Part 4 is a common error. This section is crucial for those who need this accommodation, and not filling it out can mean missing out on necessary benefits.
Forgetting to include necessary documentation: If you're a military veteran, the application requires a copy of your DD214 as proof of service. Omitting this document can delay the processing of your placard application.
By avoiding these common mistakes, applicants can help ensure their application is completed accurately, which in turn, helps expedite the issuing process. Detailed attention to every part of the form and providing all required documentation upfront will significantly smooth the path to receiving your Illinois Disability Placard.
When applying for an Illinois Disabled Parking Placard, individuals may find themselves navigating through a variety of documents and forms, either as prerequisites or as part of supplemental processes. These documents often are crucial for confirming eligibility, ensuring that all legal and procedural requirements are appropriately met. Understanding each document’s purpose can simplify the application process.
Each of these documents plays a unique role in the application process for an Illinois Disabled Parking Placard. From establishing eligibility and identity to verifying the specific needs based on disability, they collectively ensure that the process is thorough and accessible. Understanding the importance of each can help applicants efficiently navigate the process, ultimately aiding in securing the necessary accommodations to improve their quality of life.
The Replacement for Lost, Stolen, or Damaged Parking Placard Form (VSD 415) shares similar features to the Illinois Placard form in its purpose of addressing the needs of individuals with disabilities. While the VSD 415 form specifically caters to the replacement of already issued placards, it complements the initial application or renewal process outlined in the standard placard form by ensuring continuity in the provision of parking privileges to people with disabilities.
The Application for Disability License Plates bears resemblance to the Illinois Placard form, as both entail the provision of parking accommodations based on medical certifications of disability. The primary variance rests in the type of accommodation sought – one applies for a placard to be displayed in a vehicle, while the other is for the issuance of special license plates. Both, however, necessitate a verification of disability status by a healthcare provider.
The Medical Certification for Persons with Disabilities closely aligns with the Illinois Placard form, especially in the sections requiring medical professional input. This document underscores the necessity for a medical authority to certify the nature and extent of one's disability, a process pivotal in both applications to ensure that only eligible individuals receive the intended benefits.
Similar in its administrative process, the Temporary Disabled Parking Placard Application, a component explicitly mentioned within the broader Illinois Placard form, serves individuals with temporary disabilities. The similarity lies in the submission procedure and the requirement for medical certification, albeit this document is targeted at a specific duration and category of disability, emphasizing the temporary nature of the applicants’ conditions.
The Meter-Exempt Parking Application, akin to the Illinois Placard form, especially part 4, offers a distinctive accommodation by focusing on individuals who cannot feasibly use parking meters due to their disabilities. This document parallels the meter-exempt section of the placard form, both necessitating certification from a medical professional regarding the applicant's inability to operate or access standard parking meter mechanisms due to physical impairments.
When dealing with the Illinois Placard form, particular steps should be followed to ensure that the application process is smooth and free from errors. The form is an essential document for individuals with disabilities seeking parking accommodations, so careful attention to detail is crucial. Here are six dos and don'ts to consider:
Taking these do's and don'ts into account will aid in the hassle-free completion and submission of the Illinois Placard form, facilitating a smoother process for obtaining the necessary parking accommodations for persons with disabilities.
The Illinois Placard form is a crucial document for persons with disabilities seeking parking accommodations in Illinois. However, several misconceptions surrounding the form and its application process can lead to confusion. Here's a look at 10 common misunderstandings:
It's often believed that the form is only for permanent disabilities. In reality, both temporary and permanent disability placards are available, catering to the varying needs of individuals with disabilities.
Many think that renewing a placard is automatic. However, renewal requires completing the form again to ensure all information is current and accurate.
A common misconception is that you can use someone else's placard if they are not in the car. The law clearly states that the placard can only be used if the person with the disability is driving or being transported in the vehicle.
Some believe all disabilities qualify for meter-exempt parking. The truth is, meter-exempt eligibility is strict and based on specific criteria, such as severe mobility limitations or the inability to operate parking meters due to lack of fine motor control.
There's a false idea that any medical professional can sign the form. Only licensed physicians, advanced practice nurses, optometrists, chiropractors, or physician’s assistants can certify the disability and the need for a parking placard.
A prevalent misunderstanding is that the application process is long and cumbersome. While thorough, the process is designed to be as straightforward as possible, especially with the clear directions provided on the form itself.
Some assume that temporary placards are valid for an arbitrary time period. The form specifies that temporary placards are valid for a maximum of six months, based on the medical professional’s certification of the disability's expected duration.
There's also a misconception that having a disability license plate negates the need for a placard. In fact, individuals with a disability license plate must still complete the form to obtain a placard, providing flexibility for using different vehicles.
Another false belief is that applicants need to visit a Secretary of State facility in person. While this is true for temporary placards, permanent placard applications can be mailed to the address provided on the form.
Lastly, many think the form only asks for basic personal and disability information. However, it also includes provisions for meter-exempt parking and requires detailed certification from a medical professional, ensuring a comprehensive evaluation of the applicant's needs.
Understanding these common misconceptions helps in demystifying the process of obtaining a parking placard in Illinois, making it more accessible for those who truly need it.
When filling out and utilizing the Illinois Placard form for Persons with Disabilities Certification for Parking, it's crucial to be aware of several key aspects to ensure the process is completed accurately and efficiently. Here are ten essential takeaways:
Understanding these key points can help applicants navigate the process seamlessly, ensuring they receive the support and resources entitled to them under the law.
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