Blank Georgia Mv 9D PDF Form

Blank Georgia Mv 9D PDF Form

The Georgia MV-9D form is an application used to request a Person with Disability Parking Placard or a Disabled Person’s License Plate. This form is essential for individuals who need special parking privileges due to a disability. To get started, fill out the form by clicking the button below.

The Georgia MV-9D form is an essential document designed for individuals seeking a Person with Disability Parking Placard or a Disabled Person’s License Plate. This application serves multiple purposes, including new issuances, renewals, and replacements of placards. It is important to note that this form is not intended for recording changes of ownership, addresses, or license plate classifications. To initiate the application process, individuals must complete the form and submit it to their local County tag office, following the instructions provided. The form includes sections for applicant information, guardian details if applicable, and a certification section that must be completed by a licensed health care provider. This certification verifies the applicant's disability status based on specific eligibility requirements outlined in the form. Additionally, the MV-9D includes various request types, such as temporary and permanent placards, as well as a fee structure for disabled person’s license plates. Understanding the components of the MV-9D form is crucial for ensuring a smooth application process and compliance with Georgia state regulations.

Outline

Document Sample

Georgia Department of Revenue - Motor Vehicle Division
Person with Disability Parking Placard/License Plate Application
MV-9D (Revised 05/2025)
Web and MV Manual
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 classication.
How to submit this form:After reviewing the MV-9D form instructions, this fully completed form must be submitted to your local County tag o󰀩ce. Please refer to
our website at https://dor.georgia.gov to locate the address(es) for your specic county.
A REQUEST TYPE
Check applicable box(es) below:
[ ] Disabled Person’s Parking Permit (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.
B APPLICANT INFORMATION
Disabled Person’s
Telephone No.:
Full Legal Name:
Physical Address:
Driver’s License No.: State of Issuance: County:
C 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. Any resident motor vehicle
owner who is the spouse, parent, or legal guardian of a person who is disabled as prescribed in this Code section shall be authorized to obtain
such specialized plates for such vehicle.
Parent/Guardian’s Relationship
Full Legal Name: to Applicant:
Physical Address:
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 BEFORE COMPLETING**
Health Care Provider’s Name:
Medical License No.:
Physical Address:
Telephone No.: Signature:
Sworn to and subscribed before me
this ____ day of _______________, ______
Day Month Year
Notary Seal or Stamp
____________________________________
Notary Signature
____________________________
Commission Expiration Date
E INSTITUTION/BUSINESS INFORMATION (This vehicle is used primarily for transportation of disabled persons.)
Institution/Business FEIN:
Full Legal Name:
Vehicle Identication No. (VIN
Year: Make: Model: Tag No.:
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 a󰀩rm 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:
Placard No.: Record placard number if
renewing or replacing placard.
Have a question? Visit our website at
www.dor.georgia.gov/motor-vehicles
or scan the QR code above for more information.
First Name Middle Initial Last Name Su󰀩x
Street No. Street Name
Apt/Suite No. City
State
Zip Code
First Name Middle Initial Last Name Su󰀩x
Street No. Street Name
Apt/Suite No. City
State
Zip Code
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 certied 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 dened by Georgia Code §31-7-1, must attach a copy of the institutional license. Note: To qualify for a permit, the institution must oper-
ate 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 dis-
played 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
without stopping to rest.
2. Applicant cannot walk without the use of assistance from a brace, a cane,
a crutch, another person, a prosthetic device, a wheelchair, or other
assistive device.
3. Applicant is restricted by lung disease to such an extent that his/her
forced respiratory volume for one second, when measured by spironmetry
is less than one liter, or when at rest his/her arterial oxygen tension is less
than 60 millimeters of mercury on room air.
4. Applicant uses portable oxygen.
5. Applicant has a cardiac condition to the extent that his/her functional
limitations are classied in severity as Class III or Class IV according to
standards set by the American Heart Association.
6. Applicant is severely limited in his/her ability to walk due to an arthritic,
neurological, orthopedic condition or complications due to pregnancy.
7. Applicant is hearing impaired person pursuant to Georgia Code §24-6-
651.
8. Applicant is a blind individual whose central visual acuity does not exceed
20/200 in the better eye with correcting lenses or whose visual acuity, if
better than 20/200, is accompanied by a limit to the eld 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 a󰀩davit, a signed and dated statement from the doctor which
includes the same information as required in an a󰀩davit written upon security
paper as dened in paragraph (38.5) of Code Section 26-4-5.”
Please Note: Certication in lieu of an a󰀩davit (completion and notarization
of Section D) can only be submitted for placards and cannot be provided on
license plate applications.
Who may provide certication: Health care providers that are permitted to
provide a certication are limited to medical practitioners licensed to practice
under Article 2 of Chapter 34 of Title 43 (physicians); Chapter 35 of Title 43
SUBMITTING THIS FORM
After reviewing the MV-9D form instructions, this fully completed form must be submitted to your local County tag o󰀩ce. Please refer to our website at
https://dor.georgia.gov to locate the address(es) for your specic county.
Jane Doe 40
123 Main St.
Secured paper document (as dened by GA Code
26-4-5) from healthcare provider must include:
• Specic disability as indicated on MV-9D
instructions form.
• Indication of permanent or temporary
disability
• Stamp or signature of healthcare provider
• Date
SAMPLE
Have a question? Visit our website at
www.dor.georgia.gov/motor-vehicles
or scan the QR code above for more information.
Get Georgia Mv 9D

File Specifics

Fact Name Description
Purpose The MV-9D form is used to request a Person with Disability Parking Placard or a Disabled Person’s License Plate.
Submission Location Completed forms must be submitted to your local County tag office. Addresses can be found on the Georgia Department of Revenue website.
Fees A fee of $20.00 is required for the Disabled Person’s License Plate, plus any applicable taxes.
Notarization Requirement Section D of the form must be completed and notarized for the application to be valid.
Eligibility Requirements Applicants must meet specific medical conditions to qualify for a placard or license plate, as outlined in the form.
Governing Law The form is governed by Georgia Code §40-2-74 and §31-7-1, which outline the requirements for disability parking permits.

How to Use Georgia Mv 9D

After completing the Georgia MV-9D form, you'll need to submit it to your local County tag office. Make sure all required sections are filled out accurately. Check for any additional documents that may need to accompany your application. Once submitted, you will await approval for your Person with Disability Parking Placard or Disabled Person’s License Plate.

  1. Obtain the MV-9D form from the Georgia Department of Revenue website or your local County tag office.
  2. In Section A, check the appropriate box for your request type: New Issuance, Renewal, Replacement, or Disabled Person’s License Plate.
  3. If renewing or replacing a placard, record the previous placard number where indicated.
  4. Complete Section B with your personal information, including your full name, address, and telephone number.
  5. If applicable, fill out Section C with the parent or guardian's information if you are acting on behalf of a minor.
  6. In Section D, have a licensed health care provider certify your disability. They must fill out their information and sign in the designated area.
  7. Complete Section E if the vehicle is used primarily for transporting disabled persons, providing the necessary details about the institution or business.
  8. Sign and date Section F to affirm that the information provided is true and correct.
  9. Review the completed form for accuracy and completeness.
  10. Submit the completed form to your local County tag office. You can find the address on the Georgia Department of Revenue website.

Your Questions, Answered

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

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

  2. How do I submit the MV-9D form?

    After filling out the MV-9D form, you need to submit it to your local County tag office. You can find the address for your specific county by visiting the Georgia Department of Revenue website at dor.georgia.gov .

  3. What types of placards can I apply for using this form?

    You can apply for several types of placards using the MV-9D form:

    • Temporary Placard
    • Permanent Placard
    • Special Permanent Placard
    • Renewal of a Permanent Placard
    • Replacement of a lost or stolen placard

  4. What information do I need to provide about the applicant?

    You will need to provide the following details about the applicant:

    • First name, middle initial, last name, and suffix
    • Telephone number
    • Full legal name
    • Physical address, including street number, street name, apartment/suite number, city, state, and ZIP code
    • Driver’s license number and state of issuance
    • County of residence

  5. Who can certify the disability for the MV-9D form?

    Only licensed health care providers can certify disabilities for the MV-9D form. This includes physicians, podiatrists, and chiropractors who are authorized under Georgia law.

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

    The fee for a Disabled Person’s License Plate is $20.00, along with any applicable taxes that may be due at the time of application.

  7. What happens if I lose my placard?

    If you lose your placard, you can apply for a replacement using the MV-9D form. Be sure to indicate that you are applying for a replacement due to a lost placard and provide the previous placard number if you have it.

  8. Can I use the placard in any vehicle?

    The placard must be displayed in a vehicle that is used for the transportation of the person with a disability. It is important to remember that the placard should only be used when parked in designated disability parking areas.

  9. What are the eligibility requirements for obtaining a placard?

    Eligibility requirements include having a disability that limits mobility, such as being unable to walk 200 feet without assistance, requiring the use of assistive devices, or having certain medical conditions as specified in the form's instructions.

  10. What should I do if I have more questions about the MV-9D form?

    If you have additional questions, you can visit the Georgia Department of Revenue website at dor.georgia.gov/motor-vehicles for more information or resources.

Common mistakes

  1. Incomplete Sections: Many applicants fail to fill out all required sections of the MV-9D form. Sections A, B, D, and F must be completed for all requests. Missing information can delay the application process.

  2. Incorrect Submission: Submitting the form to the wrong office is a common mistake. Ensure that the completed form is sent to your local County tag office. Use the Georgia Department of Revenue website to find the correct address.

  3. Notarization Issues: Section D must be notarized. Some applicants overlook this requirement, leading to automatic rejection of their application. It is essential to have a licensed notary public complete this section.

  4. Failure to Provide Previous Placard Number: When renewing or replacing a placard, applicants often forget to include their previous placard number. This oversight can complicate the renewal or replacement process.

  5. Improper Certification: Only licensed health care providers can certify disabilities. Applicants sometimes submit certifications from unqualified individuals, which can result in denial of their request. Ensure that the health care provider is authorized to complete this certification.

Documents used along the form

When applying for a Person with Disability Parking Placard or a Disabled Person’s License Plate in Georgia using the MV-9D form, several other documents may also be required. Each of these forms serves a specific purpose in the application process, ensuring that all necessary information is accurately submitted to the local County tag office.

  • MV-1 Form: This is the standard application for a title and registration of a vehicle in Georgia. It is essential for registering any vehicle, including those for which a disability placard or license plate is requested.
  • Form T-22B: This form is used to apply for a Georgia title for a vehicle purchased from a dealer. It provides proof of ownership and is necessary for the registration process.
  • Form MV-18J: This document is for requesting a replacement title. If the original title is lost or damaged, this form must be completed to obtain a new one.
  • Notarized Certification: A signed statement from a licensed health care provider is often required. This document certifies the applicant's disability and must include specific details as outlined in the MV-9D instructions.
  • Proof of Residency: Applicants may need to provide documentation showing their current address, such as a utility bill or lease agreement, to verify residency in Georgia.
  • Identification: A valid Georgia driver’s license or state-issued ID is typically required to confirm the identity of the applicant and ensure the application is properly processed.
  • Institutional License: For businesses or institutions applying for a disabled license plate, a copy of the institutional license is necessary to prove eligibility.

Gathering these documents ahead of time can streamline the application process and help avoid delays. Always refer to the latest guidelines from the Georgia Department of Revenue to ensure compliance with all requirements. If you have questions, resources are available to assist you in navigating this process.

Similar forms

The Georgia MV-9D form is similar to the DMV Form MV-1, which is used for vehicle registration in Georgia. Both forms require personal information from the applicant, such as their full legal name and physical address. The MV-1 form focuses on registering a vehicle, while the MV-9D specifically pertains to requesting disability parking placards or license plates. Each form requires the applicant to provide details about their vehicle, but the MV-9D also necessitates certification from a healthcare provider to confirm the disability, which is not a requirement for the MV-1.

Another related document is the Georgia MV-9 form, which is utilized for renewing or replacing a disability parking placard. Like the MV-9D, the MV-9 requires personal and medical information. However, the MV-9 is specifically designed for individuals who are already in possession of a placard and need to renew or replace it. This form streamlines the process for current placard holders, while the MV-9D serves as an initial application for new applicants or those seeking different types of placards.

The Georgia Form DS-1 is another document that shares similarities with the MV-9D. The DS-1 is a request for a disabled veteran license plate. Both forms require the applicant to provide personal information and details regarding their disability. However, the DS-1 is specifically tailored for veterans, whereas the MV-9D is applicable to any person with a qualifying disability. Both forms also require certification from a healthcare provider, ensuring that the applicant meets the eligibility criteria for their respective requests.

Lastly, the Georgia Form MV-18 is relevant as it pertains to the issuance of a temporary license plate for individuals who may not yet have permanent registration. While the MV-18 focuses on temporary vehicle registration, the MV-9D is centered on disability-related requests. Both forms require personal identification and vehicle information, but the MV-9D includes a section for healthcare certification, emphasizing the applicant’s disability status. This distinction highlights the unique purpose of each form while showcasing their shared elements in collecting essential information.

Dos and Don'ts

When filling out the Georgia MV-9D form, it is essential to follow specific guidelines to ensure a smooth application process. Below is a list of ten things to do and not do when completing the form.

  • Do print clearly in all sections of the form.
  • Do ensure that all required sections are completed, including A, B, C, D, and F.
  • Do provide accurate and current contact information.
  • Do check the applicable box for the type of placard or license plate you are requesting.
  • Do have the certification section completed and notarized by a licensed health care provider.
  • Don't use the MV-9D form for changes of ownership or address.
  • Don't submit the form without reviewing the instructions thoroughly.
  • Don't forget to include your previous placard number if you are applying for a replacement.
  • Don't leave any required fields blank; incomplete forms may be rejected.
  • Don't attempt to submit the form without the necessary signatures and notarization.

Misconceptions

Understanding the Georgia MV-9D form is essential for individuals seeking a disability parking placard or license plate. However, several misconceptions can lead to confusion. Here are eight common misunderstandings:

  • The MV-9D form can be used for any vehicle registration changes. Many believe this form is a catch-all for vehicle-related changes, but it specifically applies only to disability placards and license plates.
  • Anyone can certify the disability. It is a common misconception that any health care provider can certify disabilities for the MV-9D. Only licensed medical practitioners, such as physicians and chiropractors, can provide this certification.
  • Temporary placards can be extended indefinitely. Some individuals think they can keep extending temporary placards. However, these are issued for a maximum of six months and require a new application for renewal.
  • All disabilities qualify for a placard. Not all disabilities meet the eligibility requirements outlined in the MV-9D form. Only specific conditions listed in the form qualify an applicant.
  • Notarization is always required. Many applicants assume that notarization is mandatory for all requests. In fact, notarization is only required for certain applications, such as new or replacement placards.
  • Placards can be used for any vehicle. Some people think they can use a disability placard in any vehicle. In reality, the placard must be displayed only when the vehicle is transporting the person with a disability.
  • Only individuals can apply for a placard. There is a belief that only individuals can apply for disability placards. In fact, institutions and businesses can also apply if they meet specific criteria.
  • Once issued, a placard is permanent. It is a common misunderstanding that once a placard is issued, it lasts forever. However, placards may need to be renewed or replaced based on changes in the individual's condition.

By clarifying these misconceptions, individuals can better navigate the application process and ensure they meet the necessary requirements for obtaining a disability parking placard or license plate in Georgia.

Key takeaways

Here are some important points to keep in mind when filling out and using the Georgia MV-9D form:

  • Purpose: The MV-9D form is specifically for requesting a Person with Disability Parking Placard or a Disabled Person’s License Plate.
  • Submission: After completing the form, submit it to your local County tag office. You can find the address for your county on the Georgia Department of Revenue website.
  • Request Types: You can apply for a new placard, renew an existing one, or request a replacement if it was lost or stolen.
  • Health Care Provider Certification: A licensed health care provider must certify the disability. This is mandatory for temporary placards.
  • Notarization: Section D of the form must be notarized for certain requests, such as new issuances or replacements.
  • Eligibility Requirements: Only specific medical conditions qualify for a disability placard. Review the eligibility criteria carefully.
  • One Placard Rule: Each eligible individual is allowed only one placard at a time.
  • Usage Guidelines: The placard must be displayed only when the vehicle is parked for the transportation of the person with a disability.