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Get Disability Hearing Impaired Plate/placard Application - Arizona ... - Azdot
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How to fill out the Disability Hearing Impaired Plate/Placard Application - Arizona online
This guide provides clear and supportive instructions for individuals applying for the Disability Hearing Impaired Plate or Placard in Arizona. By following these steps, you can ensure that your application is completed accurately and efficiently.
Follow the steps to complete your application online.
- Press the ‘Get Form’ button to access the application form in the online editor.
- Begin by providing your applicant name, whether you are a person with a disability or representing an organization. Ensure to use clear and accurate information.
- Select the application type, either New Plate or New Placard. If you are renewing, remember to use form # 40-0112 instead.
- Fill in your mailing address, including your city, state, and zip code. Ensure that this information is current to avoid any delays.
- Enter your date of birth and driver license number. This information helps to verify your identity.
- If you are applying for a plate, provide vehicle information. This section is applicable only if the vehicle is owned or leased by you or an individual with a disability.
- Complete the medical certification section. This part must be filled out by an authorized health professional who can attest to your condition.
- Sign and date the application, ensuring that the information provided is accurate and completed in full.
- Once you have reviewed all of the information for accuracy, you can save your changes, download the form, or print it for submission.
Complete your application for the Disability Hearing Impaired Plate or Placard online today.
Intake Process: Visit website for application form #96-0104. Must be signed by an Arizona physician, registered nurse, nurse practitioner, audiologist, or hospital administrator. Visit any MVD office or authorized third party office, or write to request disability plates and placards.
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