The Louisiana Window Tint Exemption Sticker form allows individuals with specific medical conditions to obtain an exemption from the state's standard window tint regulations. This form is essential for those who require additional sun protection due to health issues, enabling them to legally tint their vehicle windows beyond the usual limits. If you qualify, take the next step by filling out the form; click the button below to get started.
In Louisiana, individuals with specific medical conditions can seek relief from standard window tint regulations through the Window Tint Medical Exemption Sticker form. This form serves as an essential document for those who require sun-screening materials on their vehicles due to valid medical reasons. It allows for tinting beyond the typical light transmission limits, which are generally set at 40% for front side windows, 25% for rear side windows, and 12% for the rear windshield. The form requires the affiant—typically the vehicle owner or an immediate family member—to declare their relationship to the vehicle and the necessity of the exemption based on their medical condition. Additionally, it mandates that the applicant has not been convicted of any drug offenses or violent crimes, ensuring that the exemption is granted to responsible individuals. A physician's endorsement is crucial, as they must detail the medical condition and explain why conventional sunglasses would not suffice for protection. Importantly, the exemption is non-transferable and valid for a limited duration, typically three years, unless the owner is over 60 years old, in which case it remains valid for as long as they own the vehicle. This process not only highlights the intersection of public safety and individual health needs but also underscores the importance of proper documentation and compliance with state regulations.
State of Louisiana
Parish of ___________________________
WINDOW TINT MEDICAL EXEMPTION AFFIDAVIT
Tint may be placed on the windshield being affixed to the topmost portion of the
windshield not to extend more than six inches down from the top.
FULL NAMEDRIVER’S LICENSE NUMBERDATE OF BIRTH
_____________________________________________________________
ADDRESS
CITY
STATE
ZIP
(AREACODE) PHONE NUMBER
YEAR
MAKE
MODEL
VEHICLE IDENTIFICATON NO.
LICENSE PLATE
___________________________________________________________________________
Vehicle Information
Affiant declares that he/she is the registered owner or the spouse or immediate family member having significant use of the above- described Louisiana registered vehicle. Affiant states that, pursuant to L.R.S. 32:361.2, valid medical reasons (indicated below) exist which makes it necessary to equip the above described vehicle with sun-screening material which would be of a light transmission or luminous reflectance in violation of L.R.S. 32:361.1.
Affiant further declares that he/she has not been convicted of any drug offense or any violent crime and authorizes the Department to perform a criminal history inquiry.
Further, Affiant authorizes the Louisiana State Police access to all medical records related to the medical condition which may qualify as an exemption under L.R.S. 32:361.1 as defined L.R.S. 361.2.
Exemption will be valid for the duration of ownership of a vehicle whose owner is age 60 years or older.
I certify and attest under penalty of law, the information provided herein is true and accurate.
__________________________________
_________________
SIGNATURE OF AFFIANT
DATE
___________________________________
NOTARY PUBLIC
________________
SEAL / NOTARY NUMBER
LSP Certificate Number
NOT VALID UNLESS AUTHORIZED BY LOUISIANA STATE POLICE
Approved & Authorized
Disapproved
________________________________
_________
________
TESS-MVI
For the Deputy Secretary, Public Safety Services
Data Number
Date
Section
DPSSP 1060 (REV 8/09)
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(Legal window tint is 40% light transmission.)
NOTE: L.R.S. 32:361.1 provides that the legal limits to the sun screening device (window tint) on a passenger car are light transmissions of 40% for the front side windows, 25% for the rear side windows and 12% for the rear windshield.
WINDOW TINT MEDICAL EXEMPTION
THIS MEDICAL EXEMPTION IS NON-TRANSFERABLE AND EXPIRES THREE (3) YEARS FROM DATE OF ISSUANCE. THE ORIGINAL CERTIFICATE MUST BE CARRIED IN THE VEHICLE AT ALL TIMES AND SHALL BE VOID IF ALTERED OR FALSIFIED.
BELOW THIS LINE FOR OPTOMETRIST OR PHYSICIAN’S USE ONLY
Patient’s Full Name ___________________________
Patient’s DOB ____________________
Indicate the below listed World Health Organization International Classification of Disease ICD- 9-CM recognized condition which would require a medical exemption under L.R.S. 32:361.2. Provide a complete and detailed description under the section indicated as “DESCRIBE”. Louisiana State Police may seek the Medical Advisory Board’s opinion whether to grant the medical exemption.
Albinoism Lupus (Lupus Family) Porphyria
Describe (All other)________________________________________________________________
________________________________________________________________________________
Photophobia as a medical condition requires an explanation as to the exemption under L.R.S. 32:361.2. Indicate in detail why a correct pair of sunglasses would not be adequate protection thus requiring the exemption under L.R.S. 32:361.2, and why this exemption under L.R.S.361.2 will not affect the individual’s ability to drive at night.
_________________________________________________________________________________
Print Physician Name
Physician Signature
(Area Code) Phone Number
PAGE 2 of 3
Official Use Only of the Medical Advisory Board
Date_____________________ Approved ____________________ Denied___________________
Reason for Approval or Denial
__________________________________________________________________________________
_________________________________
Advisory Board Physicians Signature
LAC 55:813(T) The Medical Exemption Affidavit shall:
i. be valid for a period of not more than 3 years, except for the following provisions;
(a). The registered owner of the vehicle is 60 years and older at the time of application for a Medical Exemption Affidavit, or the individual becomes 60 years old while in possession of a valid Medical Exemption Affidavit, then the affidavit will be valid for the duration of that individual’s ownership of the vehicle as provided in LRS 32:361.2(A)(3)(c) unless deemed otherwise by the Department.
(b). The applicant for the Medical Exemption Affidavit is 60 years and older at the time of application for a Medical Exemption Affidavit, or the individual becomes 60 years old while in possession of a valid Medical Exemption Affidavit, but is not the registered owner of the vehicle, in which case the Department shall review the case as provided in LRS 32:361.2(A)(3)(b) and LRS 32:361.2(A)(3)(c).
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Filling out the Louisiana Window Tint Exemption Sticker form requires careful attention to detail. This process involves providing personal information, vehicle details, and medical justification for the exemption. Follow the steps outlined below to complete the form accurately.
After submitting the form, it will be reviewed by the Louisiana State Police. If approved, you will receive an exemption certificate, which must be kept in the vehicle at all times. Remember, the exemption is non-transferable and expires three years from the date of issuance.
The Louisiana Window Tint Exemption Sticker form is a document that allows individuals with specific medical conditions to apply for an exemption from the state’s standard window tinting regulations. This form is intended for those who require darker window tinting for health-related reasons, such as sensitivity to light. It must be completed and submitted to the Louisiana State Police for approval.
Eligibility for the window tint exemption is primarily based on medical conditions that necessitate the use of sun-screening materials on a vehicle. Individuals who have conditions such as albinism, lupus, porphyria, or severe photophobia may qualify. The applicant must be the registered owner of the vehicle or a family member who uses the vehicle significantly. Additionally, applicants must not have any drug offenses or violent crime convictions.
The medical exemption is valid for three years from the date of issuance. However, if the registered owner of the vehicle is 60 years or older at the time of application, the exemption remains valid for the duration of ownership of that vehicle, unless otherwise specified by the Department.
The application requires several key pieces of information, including:
Additionally, a physician or optometrist must provide their name, signature, and contact information, confirming the medical condition.
If your application for the window tint exemption is denied, you will receive a notice explaining the reason for the denial. It is advisable to review the feedback provided and consider addressing any concerns. You may also consult with your physician to ensure that the medical justification is adequately documented. If appropriate, you can reapply or appeal the decision based on the guidance received.
No, the medical exemption is non-transferable. It applies only to the specific vehicle for which it was issued. If you change vehicles, you will need to submit a new application for the exemption for the new vehicle.
Incorrect Personal Information: Failing to provide the full name, driver's license number, or date of birth can lead to delays or rejections.
Missing Vehicle Details: Not including the year, make, model, and vehicle identification number (VIN) can cause complications in the approval process.
Improper Medical Justification: Providing vague or insufficient explanations for the medical condition can result in denial of the exemption.
Neglecting Signature Requirements: Forgetting to sign the affidavit or have it notarized can render the application invalid.
Ignoring Exemption Duration: Not understanding that the exemption is valid for only three years, unless specific conditions are met, can lead to expired permits.
Failing to Carry the Certificate: Not keeping the original certificate in the vehicle at all times can result in penalties if stopped by law enforcement.
Overlooking Criminal History Check: Not disclosing any drug offenses or violent crimes can lead to automatic disqualification.
Inadequate Physician's Information: Missing the physician's name, signature, or contact details can delay processing and approval.
When applying for the Louisiana Window Tint Exemption Sticker, several other forms and documents may be necessary to ensure compliance with state regulations. Each document serves a specific purpose in the application process and helps to establish eligibility for the exemption.
Each of these documents plays a vital role in the application process for the Louisiana Window Tint Exemption Sticker. Ensuring that all required forms are completed and submitted can help facilitate a smoother approval process. It is important to carefully review each document to avoid delays or complications.
The Louisiana Window Tint Exemption Sticker form shares similarities with the Medical Marijuana Patient Registry Card. Both documents require individuals to provide personal information, including their name, address, and date of birth. They also necessitate a medical justification for the exemption. In the case of the Medical Marijuana Patient Registry Card, applicants must present a qualifying medical condition that justifies their need for medical marijuana, much like how the window tint exemption requires a medical condition that necessitates darker window tinting for health reasons.
Another similar document is the Americans with Disabilities Act (ADA) Service Animal Registration. This registration requires individuals to provide proof of a disability and the necessity of a service animal. Similarly, the Louisiana Window Tint Exemption form requires medical documentation to validate the need for an exemption. Both documents serve to protect individuals with specific health-related needs, allowing them to navigate public spaces and transportation with necessary accommodations.
The Vehicle Registration form also bears resemblance to the Louisiana Window Tint Exemption Sticker form. Both documents require detailed information about the vehicle, including the make, model, and identification number. Just as the Vehicle Registration form is essential for legal ownership and operation of a vehicle, the Window Tint Exemption form is crucial for legally modifying the vehicle's tint based on medical necessity.
The Louisiana Driver’s License application is another comparable document. It requires personal identification information, including name, date of birth, and address. Both forms also necessitate a signature to affirm the truthfulness of the information provided. While the Driver’s License application is focused on granting driving privileges, the Window Tint Exemption form is aimed at accommodating specific medical needs while driving.
Similar to the Louisiana Window Tint Exemption form is the Health Insurance Portability and Accountability Act (HIPAA) Authorization form. This document allows individuals to authorize the release of their medical records for specific purposes. Both forms require individuals to disclose sensitive health information and often necessitate a physician's signature. They ensure that personal health information is shared appropriately to support the individual's needs.
The Special Needs Trust form also aligns with the Louisiana Window Tint Exemption Sticker form. This legal document is designed to protect the assets of individuals with disabilities while allowing them to receive government benefits. Both documents aim to provide necessary support for individuals with specific health-related challenges, ensuring their rights and needs are recognized and accommodated.
Another document that shares similarities is the Disability Parking Permit application. This application requires proof of a qualifying disability and allows individuals to park in designated spaces. Like the Window Tint Exemption form, it aims to ease mobility challenges faced by individuals with medical conditions, providing them with necessary accommodations to enhance their quality of life.
Lastly, the Prescription Medication form is akin to the Louisiana Window Tint Exemption Sticker form. Both require detailed information about the individual, including medical conditions and the necessity of specific treatments. The Prescription Medication form must be completed by a licensed healthcare provider, similar to the requirement for medical documentation in the Window Tint Exemption form. Both documents ensure that individuals receive appropriate care and accommodations based on their health needs.
When filling out the Louisiana Window Tint Exemption Sticker form, it’s essential to follow certain guidelines. Here are seven things to keep in mind:
Misconceptions about the Louisiana Window Tint Exemption Sticker form can lead to confusion. Here are ten common misunderstandings: