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Get Az Dot 96-0104 2014
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How to fill out the AZ DoT 96-0104 online
This guide provides comprehensive instructions to help users complete the AZ DoT 96-0104 form online with confidence. Follow the step-by-step process to ensure all necessary information is accurately submitted.
Follow the steps to fill out the AZ DoT 96-0104 form online
- Press the ‘Get Form’ button to access the form and open it in your preferred document editor.
- Fill in the applicant's name, mailing address, and phone number in the designated fields. Ensure all information is accurate.
- Select the application type by choosing either ‘New Plate’ or ‘New Placard’. If this is a renewal, note that form # 40-0112 should be used instead.
- Provide the date of birth and driver license number of the applicant.
- If applying for a plate, enter the vehicle information below, including the Vehicle Identification Number, year, make, and current plate number.
- Indicate if the applicant qualifies under one of the listed disabilities by selecting the appropriate checkbox and providing necessary medical certification details.
- Complete the medical certification by entering the name and contact information of the health professional, ensuring this is signed by an authorized individual.
- Confirm the status of the applicant by selecting either ‘Permanent Physical Disability’, ‘Temporary Physical Disability’, or ‘Hearing Impaired’.
- Sign the application ensuring the signature is from the person with a disability or their authorized representative, and indicate the date.
- Review all entered information for accuracy. Once confirmed, you can save your changes, print the form, or share it as needed.
Complete your AZ DoT 96-0104 form online today for a smoother application process.
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Yes, a 100% disabled veteran is eligible for a handicap placard in Arizona. To obtain this placard, veterans must provide proper documentation confirming their disability status. By following the AZ DoT 96-0104 guidelines, veterans can gain access to accessible parking options that support their mobility.
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