The MV-145A form, available through the Pennsylvania Department of Motor Vehicles, serves as an application for individuals seeking a Person with Disability Parking Placard. No fee is required for this application, which encompasses options for original requests, renewals, and replacements, among other changes pertinent to the placard holder's details. For detailed instructions on eligibility and the completion process, applicants are directed to the reverse side of the form. Click the button below to start filling out your MV-145A form and secure your parking placard.
The MV-145A form serves an important role in Pennsylvania for individuals with disabilities by providing a systemized approach to apply for a person with disability parking placard. This no-fee application, accessible through the Pennsylvania Department of Motor Vehicles (DMV), streamlines the process for requesting an original, renewal, or replacement parking placard, as well as ID cards specifically catered to those with disabilities and severely disabled veterans. With clear sections dedicated to personal information, health care provider certification, police officer certification for visual or mobility impairments, and an optional section for veterans verified through the U.S. Department of Veterans Affairs, the form ensures applicants meet all eligibility requirements. Moreover, it accommodates changes in address or name without the need for notarization, simplifying updates to the applicant’s information. This comprehensive approach not only acknowledges various conditions that qualify someone for a disability parking placard but also addresses the needs of organizations transporting people with disabilities, providing an inclusive and accessible solution for eligible residents to maintain their mobility and independence.
MV-145A (7-21)
www.dmv.pa.gov
PERSON WITH DISABILITY PARKING PLACARD APPLICATION NO FEE REQUIRED
SEE REVERSE SIDE FOR INSTRUCTIONS AND ELIGIBILITY REQUIREMENTS
FOR DEPARTMENT USE ONLY
Bureau of Motor Vehicles • P.O. Box 68268 • Harrisburg, PA 17106-8268
q ORIGINAL REQUEST - qPermanent Placard
CHECK ( 4) APPROPRIATE BLOCKS BELOW
qSeverely Disabled Veteran qTemporary Placard
q RENEWAL REQUEST - (For Permanent Placards Only)
q REPLACEMENT REQUEST - qPLACARD
qID CARD qDefaced qLost q Stolen q Never Received PREVIOUS PLACARD # __________________
q CHANGE OF ADDRESS - Complete Sections A and E. NOTE: Notarization is not required.
qCHANGE OF NAME - Complete Sections A and E. Check here to indicate reason for change of name: qMarriage qDivorce qOther: ______________________
APERSON WITH DISABILITY INFORMATION - LIST NAME AND ADDRESS OF PERSON WITH DISABILITY - NOTE: If listing an out-of-state address, you must also complete and attach Form MV-8.
Last Name (or Full Business Name)
First Name
Middle Name
PA DL/Photo ID#
Date of Birth
or Bus. ID#
Street Address
City
State
Zip Code
Email Address
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. In addition, a parent, including an adoptive or foster parent who has custody care or control of the child or adult child or a spouse may sign on
behalf of the child, adult child or spouse (applicant) provided the applicant meets eligibility requirements (1) through (8).
Name of Parent, Person in Loco Parentis or Spouse
Relationship to Applicant
CERTIFICATION FROM A HEALTH CARE PROVIDER LICENSED OR CERTIFIED IN PA OR A CONTIGUOUS STATE (NEW YORK, NEW JERSEY, DELAWARE, MARYLAND, WEST VIRGINIA OR
B
OHIO). THIS SECTION MUST BE COMPLETED IN FULL. HEALTH CARE PROVIDERS MAY ONLY CERTIFY DISABILITIES WITHIN THEIR SCOPE OF PRACTICE. WARNING: Altering or forging a
document issued by the Department, such as a disabled person parking placard, or possessing, using or displaying such a document knowing it to have been altered, forged or counterfeited,
is a misdemeanor of the first degree pursuant to the Vehicle Code, 75 Pa.C.S. Section 7122, punishable by a fine of not more than $10,000 or imprisonment of not more than five years, or both.
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
UNCORRECTED
application under “Eligibility Requirements”: _______________
(NOTE: Only those conditions listed on the reverse side of this application qualify
R
20/
List Reason Code # Here
an applicant for a person with disability placard.)
L
NOTE: If reason code #1 is listed above, please indicate the individual's visual acuity by completing the chart to the right:
If reason code #4 is listed above, please indicate the type of device used: ________________________________________________
CORRECTED
Temporary placards are only issued for a period of time not to exceed six months. If the applicant requires additional time after the expiration of
the placard issued, the applicant must be recertified by a health care provider.
Health Care Provider’s Printed Name
Health Care Provider’s Signature
Medical License No.
Office Street Address
Telephone Number
(
)
C
CERTIFICATION BY POLICE OFFICER - Police officer may only certify that the applicant does not have full use of a leg or both legs, or is blind.
NOTE: If Section B above is completed, please skip this Section and go on to Section E.
This is to certify that the person with disability listed above has the condition listed and is entitled to the use and privileges of the person with disability
parking placard.
qis blind, OR does not have full use of a leg or both legs as evidenced by the use of a: qwheelchair
qwalker
qcrutches
q cane/quad cane
q other prescribed device
Officer’s Printed Name
Officer’s Signature
Badge Number
CERTIFICATION FROM U.S. DEPARTMENT OF VETERANS AFFAIRS REGIONAL OFFICE ADMINISTRATOR (PHILADELPHIA OR PITTSBURGH)
DOR SERVICE UNIT IN WHICH THE VETERAN SERVED OR A LEGIBLE PHOTOCOPY OF THE APPLICANT'S LETTER OF PROMULGATION, AWARDS LETTER, SINGLE NOTIFICATION, OR SUMMARY OF BENEFITS LETTER.
qThis is to certify that the veteran listed above with VA number ___________________________, has a 100% service-connected disability or has the following service connected disability reason code number _______, listed on the reverse side of this application under “Eligibility Requirements.” NOTE: If reason code #4 is listed, please indicate the type of device used: __________________________.
Authorized Printed Name and Title: ____________________________________________ Authorized Signature: ____________________________________________
qIn lieu of the U.S. Department of Veterans Affairs Regional Office Administrator certification, I have attached a legible photocopy of my Letter of Promulgation, Awards Letter, Single Notification Letter, or Summary of Benefits Letter that indicates I have a 100% service-connected disability.
E NOTARIZATION AND APPLICANT SIGNATURE - Person with disability, natural parent or other authorized person listed in Section A must sign below.
SUBSCRIBED AND SWORN
I state that I have read and signed this application after its completion, and I swear or
TO BEFORE ME:
MONTH
DAY
YEAR
affirm that the statements made herein are true and correct, and that any statement
made on or pursuant to this application is subject to the penalties of 18 Pa.C.S.
SIGNATURE OF PERSON ADMINISTERING OATH
Section 4903 (a)(2) (relating to false swearing), which shall include punishment of a
fine not exceeding $5,000, or to a term or imprisonment of not more than two years,
S
or both.
T
SIGN IN PRESENCE OF NOTARY
A
Person with Disability Signature
Date
M
THIS APPLICATION MAY BE DUPLICATED
P
INSTRUCTIONS
1.Permanent Placard - Complete Sections A, B or C (NOT BOTH) and E. NOTE: Individuals should list their PA Driver’s License (PA DL) or Photo ID# in the space provided. Businesses should list their Business ID# (Bus. ID) where indicated (i.e. E.I.N.).
2.Severely Disabled Veteran Placard - Complete Sections A, D and E.
3.Temporary Placard - Complete Sections A, B and E. NOTE: Only licensed health care providers* may certify disabilities for temporary placards. Temporary placards may be issued for a period up to six months and 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.
4.Renewal Request - Complete Sections A and E. NOTE: Notarization is not required.
5.Replacement Request - Indicate if applying for a replacement placard or ID card. Please check reason for replacement; Lost, Stolen, Defaced or Never Received. List your previous placard number and complete Sections A and E. NOTE: If product was not received within 90 days, please check the "Never Received" box or if product was not received for over 90 days please check the "Lost" box.
6.Change of Address - Complete Sections A and E. NOTE: Notarization is not required.
7.Change of Name - Complete Sections A and E. Check the block on the front of this application to indicate reason for change of name. NOTE:
Notarization is not required.
*Health Care Provider is defined as a physician, chiropractor, optometrist, podiatrist, physician assistant, or a certified registered nurse practitioner licensed or certified in Pennsylvania or a contiguous state. Health care providers may only certify disabilities within their scope of practice.
Placard Type
Eligibility Requirements
Qualifying Vehicles
Benefits
Person with Disability Placard
“Reason Codes”
Applicant:
(1)is blind.
(2)does not have full use of an arm or both arms.
(3)cannot walk 200 feet without stopping to rest.
(4)cannot walk without the use of, or assistance from, a brace, cane, crutch, another person, prosthetic device, wheelchair or other assistive device.
(5)is restricted by lung disease to such an extent that the person’s forced (respiratory) expiratory volume for one second, when measured by spirometry, is less than one liter or the arterial oxygen tension is less than 60 MM/HG on room air at rest.
(6)uses portable oxygen.
(7)has a cardiac condition to the extent that the person’s functional limitations are classified in severity as Class III or Class IV according to the standards set by the American Heart Association.
(8)is severely limited in their ability to walk due to an arthritic, neurological or orthopedic condition.
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), complete the appropriate information on the front side of this application.
In addition, a parent, including an adoptive or foster parent who has custody, care, or control of the child or adult child or a spouse, may sign on behalf of the child, adult child, or spouse (applicant) provided the person with disability meets eligibility requirements (1) through (8).
(1)A passenger vehicle or truck with a registered gross weight of not more than 14,000 lbs.
(2)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.
NOTE: Organizations that operate a passenger vehicle to transport persons with disabilities must supply the Department with the following:
a)A notarized statement of how the placard will be used and the type of services that will be provided.
b)The weekly or monthly number of hours that the services are provided.
c)The make of the vehicle(s), including the title number, vehicle identification number and registration plate number. The vehicle(s) must be titled in the name of the organization and must be a passenger vehicle.
d)The number of placards required: (Organizations may not be issued more than eight placards in the organization’s name.)
(1)Parking permitted in spaces designated for disabled persons and for 60 minutes in excess of legal parking period except where local ordinances or police regulations provide for the accommodation
of heavy traffic during morning, afternoon or evening hours.
(2)Upon request of a person with disability, local authorities may erect on the highway as close as possible to the person’s residence a sign(s) indicating that the place is reserved for the person with disability, that no one else may park there unless a person with disability plate or placard is displayed and that any unauthorized person parking there will be subject to a fine.
Severely
Disabled
Veteran
Placard
(1)100% service-connected disability certified by the U.S. Department of Veterans Affairs (Pittsburgh or Philadelphia) or service unit in which the veteran served or as shown on the applicant’s Letter of Promulgation, Awards Letter, Single Notification Letter, or Summary of Benefits Letter.
(2)Same disabilities as listed above for Person with Disability Placard but must be service-
Same as 1 and 2 above for Person with Disability Placard.
Same as above for Person with Disability Placard.
Use of Person with Disability and Severely Disabled Veteran Placards:
. Parking in a designated persons with disability parking space is only permitted with this parking placard when the vehicle is being used for the transportation of the person for which the parking placard was issued.
. Any vehicle lawfully displaying a parking placard will qualify for parking in areas designated only for use by persons with a disability. NOTE: This parking placard can not be used to park where parking is prohibited.
Send completed application to: PennDOT, Bureau of Motor Vehicles, P.O. Box 68268, Harrisburg, PA 17106-8268
Visit us at www.dmv.pa.gov or call us at 717-412-5300. TTY callers — please dial 711 to reach us.
Filling out the MV-145A form is a necessary step for individuals seeking a Person with Disability Parking Placard in Pennsylvania. The process requires careful attention to detail and accurate information regarding the applicant's condition, as certified by a healthcare provider or, in specific cases, a law enforcement officer or the U.S. Department of Veterans Affairs. This placard offers crucial parking privileges to enhance mobility and access for people with disabilities. Here's how to approach filling out the form:
After submitting the form, the Bureau of Motor Vehicles will process the application. Approval will lead to the issuance of the parking placard, granting the applicant the parking privileges they require. It is essential to use the placard correctly, following all guidelines to avoid penalties and ensure the spaces are available to those who genuinely need them.
What is the MV-145A form used for?
The MV-145A form is an application for a parking placard that permits individuals with disabilities and severely disabled veterans to park in designated parking spaces. It is used to apply for a new placard, renew or replace a permanent placard, and update information such as a change of address or name.
Who is eligible to apply for a parking placard using the MV-145A form?
Individuals who have certain disabilities that qualify under the eligibility requirements can apply. These disabilities include visual impairments, inability to walk without assistance, lung disease, use of portable oxygen, severe cardiac conditions, and mobility limitations due to arthritic, neurological, or orthopedic conditions. Severely disabled veterans are also eligible.
Is there a fee associated with the MV-145A form?
No, there is no fee required to submit the MV-145A form for a person with disability parking placard.
Can organizations applying for a placard use the MV-145A form?
Yes, organizations that transport persons with disabilities can use the form to request placards. They must provide additional information about the vehicle(s) used for transportation and the services provided.
How long is a temporary placard valid?
Temporary placards are issued for a period not to exceed six months. If the need for the placard extends beyond this period, a new application must be completed and certified by a health care provider.
What documents are needed to renew or replace a placard?
For a renewal, Sections A and E of the MV-145A form must be completed. For a replacement due to a placard being lost, stolen, defaced, or never received, the appropriate reason must be checked on the form, and Sections A and E completed. If a placard wasn't received within 90 days, the "Never Received" box should be checked.
How can a change of address or name be reported?
To report a change of address or name, complete Sections A and E of the form. For a name change, also indicate the reason for the change (marriage, divorce, or other) on the form.
What signatures are required on the MV-145A form?
The person with a disability, their natural parent, or another authorized individual listed in Section A must sign the form. Notarization is not required for this application.
Where should the completed MV-145A form be sent?
The completed form should be mailed to the PennDOT Bureau of Motor Vehicles at the provided address: P.O. Box 68268, Harrisburg, PA 17106-8268. Additional resources and information can be found by visiting the DMV website or calling their office.
One common mistake when filling out the MV-145A form is not checking the appropriate box to indicate the type of request. This form allows individuals to request an original, renewal, replacement, or change of information for a Person with Disability Parking Placard. Failing to check the correct box can result in delays since the Department of Motor Vehicles (DMV) won't know what action to take without this vital piece of information.
Another frequent error is not completing the certification from a health care provider for temporary placards. The form specifically requires this certification for temporary placard requests, which must include the health care provider's license number, printed name, and signature. Some applicants either leave this section incomplete or do not provide all the needed details, which leads to the rejection of the application.
A third mistake involves not providing the previous placard number when applying for a replacement. Whether the original placard was lost, stolen, defaced, or never received, including the previous placard number is crucial for processing the replacement request efficiently. This number helps the DMV verify your information and previous placard status to issue a replacement promptly.
Incorrectly listing personal information in Section A is also a common issue. This section requires accurate details about the person with the disability, including their name, address, and form of identification (PA DL/Photo ID# or Bus. ID#). Mistakes in this section can cause significant delays in processing the application. Accuracy in providing these personal details is essential for a smooth application process.
Lastly, applicants often forget to sign the form in the presence of a notary for Section E, despite the notarization not being required. This section needs the signature of the person with the disability, their parent, or another authorized person. Overlooking the instruction that notarization is not needed and waiting to sign the form until it can be notarized can delay submission. Therefore, it's important to read the instructions carefully and understand that a notary isn't needed for this form, ensuring that the application is signed correctly and submitted without unnecessary delay.
The MV-145A form serves a critical role in granting mobility and autonomy to individuals with disabilities by providing them access to designated parking spaces. This document itself, while essential, is often part of a suite of forms and documents that applicants might need in conjunction with their application for a Person with Disability Parking Placard. Each document plays a unique role in ensuring that the needs of individuals with disabilities are met comprehensively.
Together, these documents form a network of support for individuals with disabilities, ensuring they have the means and rights to navigate their communities with dignity and ease. Understanding the purpose and requirements of each form ensures that applicants can efficiently manage their needs and maintain their independence.
The MV-145A "Person with Disability Parking Placard Application" is similar to the "Application for Disabled Person License Plate" form found in many states. Both applications serve individuals with disabilities, allowing them to access parking privileges in designated areas. The similarity lies in the requirement for medical certification to validate the applicant’s disability, ensuring that only those with legitimate needs benefit from the parking accommodations provided. However, the license plate application typically requires vehicle registration information, linking the disability benefits directly to a specific vehicle, unlike the more portable nature of the parking placard.
Another related document is the "Temporary Handicap Placard Application," which, like the MV-145A, offers short-term parking privileges for individuals with temporary disabilities. Both forms necessitate certification from a healthcare provider, confirming the nature and expected duration of the disability. The key distinction between them lies in the validity period, with the temporary placard often limited to a timeframe that corresponds with the temporary disability’s expected duration, not exceeding six months as indicated on the MV-145A form.
The "Renewal Application for Disability Placards" shares similarities with the MV-145A form, particularly in the sections regarding renewal requests. Individuals who already possess a disability parking placard use this form to extend their parking privileges, mirroring the renewal process highlighted in the MV-145A. This form maintains a focus on existing placard holders, eliminating the need for repeated medical certification if the disability is permanent and unchanged, streamlining the renewal effort for both the applicants and the issuing authority.
The "Disabled Veteran Parking Placard Application" is akin to the MV-145A form in its service to veterans with disabilities. Both documents require certification of the disability, but the veteran-specific form necessitates proof of the disability’s connection to military service, often requiring validation from the Department of Veterans Affairs. This distinction underscores the acknowledgment of veterans’ sacrifices by providing them with parking benefits tailored to their service-connected disabilities.
Lastly, the "Change of Information for Disability Placard" form parallels the sections in the MV-145A that deal with updating personal details, such as address or name changes. Both forms facilitate the process for individuals to ensure their disability parking placard records remain current, enhancing the usability and regulatory compliance of the issued placards. While focused on updates rather than initial certification, this form underscores the comprehensive approach to managing disability parking privileges, prioritizing convenience and accuracy for the holder’s benefit.
When completing the MV-145A form for a Person with Disability Parking Placard in the state of Pennsylvania, it’s crucial to follow the guidelines carefully to ensure the application process is smooth and successful. The following advice outlines essential dos and don’ts:
Before sending the completed form, it’s wise to make a copy for your records. Prompt and careful attention to the details when completing the MV-145A form greatly assists in the efficient handling of your request for a Person with Disability Parking Placard.
Many people navigating the process of obtaining disability parking privileges may come across the MV-145A form, also known as the "Person with Disability Parking Placard Application" in Pennsylvania. Despite its importance, several misconceptions circulate about the form and its requirements. Here, we aim to clarify some of the most common misunderstandings.
This is incorrect. As indicated directly on the form, no fee is required to submit an application for a Person with Disability Parking Placard. The process has been designed to be accessible and free of charge to ensure that individuals with disabilities can obtain the parking privileges they are entitled to without financial burden.
Contrary to some beliefs, notarization is not a requirement for the MV-145A application. The form specifically notes that notarization is not required, simplifying the process for applicants and ensuring that they can submit their applications more efficiently.
The form clearly outlines that only health care providers licensed or certified in Pennsylvania or a contiguous state (New York, New Jersey, Delaware, Maryland, West Virginia, or Ohio) can certify the disabilities. Moreover, these providers can only certify conditions within their scope of practice, ensuring that the evaluation is conducted by someone with the appropriate expertise.
Temporary placards are issued for a period not to exceed six months and cannot be extended or renewed. If an individual requires the placard beyond the original timeframe, a new application must be completed and certified by a healthcare provider, highlighting the temporary nature of such accommodations.
While the application is intended for Pennsylvania residents, there is provision for those with out-of-state addresses. However, such individuals must also complete and attach Form MV-8, ensuring that all applicants, regardless of their state of residence, are considered for eligibility under specific criteria.
While there are specific blocks to signify that an application is for a Severely Disabled Veteran, the eligibility requirements for the placards remain consistent with those for a Person with Disability Placard. The main difference lies in the certification by the U.S. Department of Veterans Affairs or the presentation of equivalent documentation.
This misunderstanding could lead to misuse of the placard. The regulation is clear that parking in spaces designated for individuals with disabilities is permissible only when the vehicle is being used for the transportation of the person to whom the parking placard was issued. This rule ensures that the benefits are reserved strictly for those who genuinely need them.
Clarifying these misconceptions is crucial for ensuring that all applicants understand the process, requirements, and rules associated with the Person with Disability Parking Placard Application. This knowledge helps streamline the application process and protects the integrity of parking privileges for individuals with disabilities.
Filling out and utilizing the MV-145A form, a Pennsylvania Department of Motor Vehicles (DMV) document, is crucial for individuals seeking a Person with Disability Parking Placard. Below are key takeaways designed to guide applicants through this process:
It's paramount for individuals applying for a Person with Disability Parking Placard to pay close attention to the eligibility requirements and instructions provided on the form to ensure a smooth and successful application process. Remember, these placards are tools designed to improve the quality of life for persons with disabilities, offering them greater independence and accessibility in their daily activities.
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