➨

Fill a Valid Georgia Mv 9D Template

The Georgia MV-9D form serves as an application for a Person with Disability Parking Placard or a Disabled Person’s License Plate. This essential document ensures that individuals with disabilities can access designated parking spaces, enhancing their mobility and independence. Proper completion and submission of the form to your local County tag office is crucial for obtaining these important resources.

Access Editor Now

Article Structure

Common mistakes

Not Checking the Request Type: One common mistake is failing to check the appropriate box for the type of placard or license plate being requested. Ensure you indicate whether you are applying for a new issuance, renewal, or replacement.
Incomplete Applicant Information: Many applicants forget to fill out all required fields in the applicant information section. Missing details like the full legal name, address, or telephone number can delay processing.
Neglecting Notarization: For certain requests, Section D must be completed and notarized. Skipping this step can result in the application being rejected.
Incorrect Health Care Provider Certification: Some applicants do not ensure that their health care provider is qualified to certify disabilities. Only licensed medical practitioners can complete this section.
Failing to Submit the Form Properly: Lastly, applicants sometimes overlook the requirement to submit the fully completed form to their local County tag office. Ensure you know the correct address for your county to avoid delays.

Essential Points on This Form

What is the purpose of the Georgia MV-9D form?

The Georgia MV-9D form is designed to request a Person with Disability Parking Placard or a Disabled Person’s License Plate. It is important to note that this form should not be used for recording changes of ownership, address, or license plate classification.

How do I submit the MV-9D form?

After completing the MV-9D form according to the provided instructions, you must submit it to your local County tag office. You can find the address for your specific county by visiting the Georgia Department of Revenue's website at dor.georgia.gov.

What types of requests can I make using the MV-9D form?

The form allows for several types of requests, including new issuances for temporary or permanent placards, renewals of existing permanent placards, and replacements for lost or stolen placards. Each request type requires specific sections of the form to be completed.

What information do I need to provide as an applicant?

As an applicant, you need to provide your full legal name, physical address, telephone number, and driver's license number. If you are applying on behalf of a minor, additional information about the parent or guardian must also be included.

What is required for the health care provider's certification?

A licensed or certified health care provider must complete Section D of the form. This includes certifying that the individual with a disability is under their care and specifying the condition that qualifies for a parking placard. The certification must be notarized and include the provider's signature, license number, and physical address.

Are there specific eligibility requirements for obtaining a disability placard?

Yes, eligibility is determined based on specific medical conditions. For instance, applicants may qualify if they are unable to walk without assistance, have severe lung disease, or are classified as blind. The form includes a list of qualifying conditions that must be met.

What is the fee for a Disabled Person’s License Plate?

The fee for a Disabled Person’s License Plate is $20.00, in addition to any applicable taxes. This fee is separate from any costs associated with the placard itself.

Can a temporary placard be extended?

No, temporary placards cannot be extended. If additional time is needed, a new application must be completed and certified by a health care provider. Temporary placards are valid for a maximum of six months.

What should I do if my placard is lost or stolen?

If your placard is lost or stolen, you must indicate this on the form when applying for a replacement. You will need to provide your previous placard number and complete the necessary sections of the form to request a replacement.

Check out Common Templates

Live Plant License Georgia - Submission of the application signifies agreement to state regulations.

How Old Do You Have to Be to Have a Permit - Original permits must be carried during travel with the load.

In addition to its importance in standard transactions, obtaining a Georgia Bill of Sale form from trusted sources, such as OnlineLawDocs.com, ensures that all legal requirements are met and protects both parties involved in the transfer of ownership.

Mv-6 - Clear communication is essential when submitting your application to avoid delays.

Georgia Mv 9D Sample

CLEAR

MV-9D (Revised 1-2019)

Web and MV Manual

Georgia Department of Revenue - Motor Vehicle Division

Person with Disability Parking Placard/License Plate Application

Purpose of this form: This form is to be used to request a Person with Disability Parking Placard or a Disabled Person’s License Plate. This form should not be used to record a change of ownership, change of address, or change of license plate classification.

How to submit this form: After reviewing the MV-9D form instructions, this fully completed form must be submitted to your local County tag office. Please refer to our website at https://dor.georgia.gov to locate the address(es) for your specific county.

REQUEST TYPE

Check applicable box(es) below:

Placard No.: Record placard number if

[

]

Disabled Person’s Parking Permit (Placard):

renewing or replacing placard.

[

] New Issuance: [

] Temporary Placard [ ] Permanent Placard [ ]

Special Permanent Placard

[

] Renewal (Permanent Placards Only) Record placard number 

[

] Replacement: [ ]

Lost [ ] Stolen Record previous placard number 

[

]

Disabled Person’s License Plate Fee: $20.00 Plate Fee plus any taxes that maybe due. Please Note: Section D must be completed and notarized.

APPLICANT INFORMATION

Disabled Person’s

First Name

Middle Initial

Last Name

Suffix

Telephone No.:

Full Legal Name:

Physical Address:

Street No.

Street Name

Apt./Suite No.

City

State

ZIP Code

Driver’s License No.:

State of Issuance:

County:

PARENT/GUARDIAN INFORMATION

Note: If you are the parent or adult charged by law with the natural parent’s rights, duties and responsibilities acting on behalf of a minor child (under 18) in place of the child’s natural parents (person in loco-parentis), you must complete the information below.

Parent/Guardian’s

First Name

Middle Initial Last Name

Suffix

Relationship

Full Legal Name:

to Applicant:

Physical Address:

Street No.

Street Name

Apt./Suite No.

City

State

ZIP Code

Driver’s License No.:

State of Issuance:

County:

D CERTIFICATION FROM A LICENSED OR CERTIFIED HEALTH CARE PROVIDER

I hereby certify that the person with the disability listed above is under my care and has the following condition listed on the reverse side of this application under

“Eligibility Requirements.” Enter Reason Code No.:

(Note: Only those conditions listed on the reverse side of this application qualify

an applicant for a Person with Disability Parking

Placard.) **PLEASE SEE INSTRUCTIONS BEFORECOMPLETING**

Health Care Provider’s Name:

Sworn to and subscribed before me

Medical License No.:

this ____ day of _______________, ______

Day

Month

Year

Notary Seal or Stamp

Physical Address:

Street No., Street Name, Suite No.

City, State, ZIP Code

____________________________________

Notary Signature

Signature:

____________________________

Telephone No.:

Commission Expiration Date

INSTITUTION/BUSINESS INFORMATION (This vehicle is used primarily for transportation of disabled persons.)

Institution/Business

FEIN:

Full Legal Name:

Vehicle Identification No.:

Make:

Model:

Tag No.:

Year:

Authorized Representative’s

Position/ Job Title:

Printed Name:

Authorized Representative’s

Date:

Signature:

F APPLICANT SIGNATURE

I state that I have read and signed this application after its completion, and I swear or affirm that the statements made herein are true and correct, and I acknowledge that any person knowingly or willfully making a false statement on or pursuant to this application is guilty of a misdemeanor under Georgia Code §40-2-74(a.1).


Signature:	Date:	/	/

Have a question? Visit our website at https://dor.georgia.gov/motor-vehicles or scan the QR code above for more information.

INSTRUCTIONS

How to complete the MV-9D Form

COMPLETING THIS FORM

Temporary Placard: Complete Sections A, B, C, D and F. Note: Only licensed health care providers may certify disabilities for temporary placards. Temporary placards may not be extended for an additional period of time. When additional time is needed, a new application must be completed and certified by a health care provider. In addition, please list your previous placard number. Temporary placards are only issued for a period of time not to exceed six months.

Permanent Placard: Complete Sections A, B, C, D and F. Note: Individuals should list their Georgia Driver’s License number or Photo ID number in the space provided. Businesses should list their Business ID number (Bus. ID) where indicated (i.e., E.I.N.) and provide a copy of business license.

Special Permanent Placard: Follow the instructions for a Permanent Placard. A Special Permanent Placard (gold placard) is issued only to an individual with a disability who (1) drives a motor vehicle equipped with hand controls for the operation of brakes and accelerator or (2) is disabled due to loss, or loss of use, of both upper extremities.

Renewal Request: Complete Sections A, B and F. Note: Notarization is not required.

Replacement Request: Indicate if applying for a replacement placard. Please check reason for replacement (Lost or Stolen). List your previous placard number and complete Sections A, B and F.

Institution/Business Information: Complete Sections A, B, E and F. Follow these additional special instructions:

•Institutions, as defined by Georgia Code §31-7-1, must attach a copy of the institutional license. Note: To qualify for a permit, the institution must operate the vehicle primarily to transport individuals with disabilities.

•Businesses, to qualify for a special plate, must meet the requirements of Georgia Code §40-2-74, including limits on the type of business organization. Note: The business vehicle must be used only or primarily by the disabled employee for whom the plate was issued.

Please Note:

•A placard is to be used only when the vehicle in which it is displayed is parked and is being used for the transportation of the person with disability or the severely disabled veteran.

•Any vehicle lawfully displaying a placard will qualify for parking in areas designated for use by persons with disability only.

•The placard will not allow vehicles to park where parking is prohibited.

•The placard is required to be displayed when the vehicle is parked in areas designated for use by persons with disability only and must not be displayed when the vehicle is being operated on the highway.

•Each eligible individual will be issued only one placard.

ELIGIBILITY REQUIREMENTS – REASON CODES

1.	Applicant is so ambulatory disabled that he/she cannot walk 200 feet	5.	Applicant has a cardiac condition to the extent that his/her functional
	without stopping to rest.		limitations are classified in severity as Class III or Class IV according to
2.	Applicant cannot walk without the use of assistance from a brace, a cane, a		standards set by the American Heart Association.
	crutch, another person, a prosthetic device, a wheelchair, or other assistive	6.	Applicant is severely limited in his/her ability to walk due to an arthritic,
	device.	6.
	device.		neurological, orthopedic condition or complications due to pregnancy.
3.	Applicant is restricted by lung disease to such an extent that his/her forced
3.		7.	Applicant is hearing impaired person pursuant to Georgia Code §24-6-651.
	respiratory volume for one second, when measured by spironmetry is less	7.
	than one liter, or when at rest his/her arterial oxygen tension is less than 60	8.	Applicant is a blind individual whose central visual acuity does not exceed
	millimeters of mercury on room air.		20/200 in the better eye with correcting lenses or whose visual acuity, if
4.	Applicant uses portable oxygen.		better than 20/200, is accompanied by a limit to the field of vision in the
			better eye to such a degree that its widest diameter subtends an angle of

no greater than 20 degrees.

QUALIFYING VEHICLES

A passenger vehicle or truck with a registered gross weight of not more than 10,000 lbs. This restriction does not apply to institution or business applications.

CERTIFICATION FROM A LICENSED OR CERTIFIED HEALTH CARE PROVIDER

“For purposes of this Code section (40-2-74.1) the department shall accept, in lieu of an affidavit, a signed and dated statement from the doctor which includes the same information as required in an affidavit written upon security paper as defined in paragraph (38.5) of Code Section 26-4-5."

Please Note: Certification in lieu of an affidavit (completion and notarization of Section D) can only be submitted for placards and cannot be provided on license plate applications.

Who may provide certification: Health care providers that are permitted to provide a certification are limited to medical practitioners licensed to practice under Article 2 of Chapter 34 of Title 43 (physicians); Chapter 35 of Title 43 (podiatrists); and Chapter 9 of Title 43 (chiropractors) of the Georgia Code.

Jane Doe	40
123 Main St.

Secured paper document (as defined by GA Code 26-4-5) from healthcare provider must include:

• Specific disability as indicated on MV-9D instructions form.

• Indication of permanent or temporary disability

• Stamp or signature of healthcare provider

• Date

SAMPLE

SUBMITTING THIS FORM

After reviewing the MV-9D form instructions, this fully completed form must be submitted to your local County tag office. Please refer to our website at https://dor.georgia.gov to locate the address(es) for your specific county.

Have a question? Visit our website at https://dor.georgia.gov/motor-vehicles or scan the QR code above for more information.

Key takeaways

Filling out the Georgia MV-9D form correctly is essential for obtaining a Person with Disability Parking Placard or Disabled Person’s License Plate. Here are some key takeaways to keep in mind:

Understand the Purpose: This form is specifically for requesting parking placards or license plates for individuals with disabilities. It should not be used for ownership changes or address updates.
Submission Process: After completing the form, submit it to your local County tag office. You can find the correct address on the Georgia Department of Revenue website.
Certification Requirement: A licensed health care provider must certify the disability by completing Section D. This is mandatory for both temporary and permanent placards.
Eligibility Criteria: Ensure that the disability meets the specific criteria listed on the form. Only certain conditions qualify for a placard or license plate.

Document Characteristics

Fact Name	Details
Purpose	The MV-9D form is used to request a Person with Disability Parking Placard or a Disabled Person’s License Plate.
Submission Location	This form must be submitted to your local County tag office after completion.
Fees	A fee of $20.00 is required for a Disabled Person’s License Plate, in addition to any applicable taxes.
Notarization Requirement	Section D must be completed and notarized for certain requests, such as new issuances or replacements.
Eligibility Criteria	Only individuals with specific disabilities, as defined by the form, qualify for the placard or license plate.
Temporary Placard Duration	Temporary placards are issued for a maximum period of six months and cannot be extended.
Health Care Provider Certification	Only licensed health care providers can certify disabilities for the application.
Governing Laws	The application process is governed by Georgia Code §40-2-74 and §31-7-1.