Application for Disable Person License Plate, Placard, or Decal

(1) A disabled person is:

• one who is disabled by paraplegia, amputation of leg, foot or both hands, or other condition, certified by a physician duly
  licensed to practice medicine, APRN,PT,DC,or PA resulting in an equal degree of disability (specifying the particular
  condition) so as not to be able to get about without great difficulty, including impairments that, regardless of cause or
  manifestation, require the person to use a wheelchair or cause such person to be so ambulatory disabled that he or she
  cannot walk two hundred feet (200’) without stopping to rest and includes, but is not limited to, those persons using
  braces or crutches, arthritics, spastics and those with pulmonary or cardiac ills who may be semi-ambulatory;”
• the owner of a motor vehicle with vision of not more than 20/200 with correcting glasses.
• the owner of a motor vehicle who is so ambulatory disabled that he or she cannot walk two hundred feet (200’) without
  stopping to rest and who is seeking treatment and/or healing solely by prayer through spiritual means in the practice of
  religion in accordance with the creeds or tenets of the First Church of Christ, Scientist in Boston, Massachusetts. Such
  condition shall be certified by a Christian Science practitioner listed in The Christian Science Journal as resulting in a
  degree of disability so that such person is not able to get about without great difficulty;”

(2) One (1) registration and license plate shall be provided free to those disabled persons who use a wheelchair because of a
permanent incapacity for ambulation, when so certified by a physician’s statement. One (1) registration and license plate shall
also be provided free to the parent or legal guardian of a disabled individual who uses a wheelchair because of a permanent
incapacity for ambulation, when so certified by a physician’s statement.

(3)Any owner or lessee of a motor vehicle who is permanently disabled as certified by a physician licensed to practice medicine, a
physician’s assistant, nurse practitioner, licensed chiropractic physician, or physical therapist acting in conjunction with a written
protocol developed jointly by a physician, or a Christian Science practitioner OR any owner or lessee of a motor vehicle who is the
parent or legal guardian of a person who is permanently disabled and who is incapable of operating a motor vehicle, qualifies for a
disabled person license plate.

(4)Permanent and temporary placards shall be issued by the local county clerks.

(5) Permanent placards:

• may be issued to persons who are permanently disabled as noted on the physician’s statement;
• may be issued to the parent or legal guardian of a permanently disabled individual;
• shall cost the same as the regular fee for passenger motor vehicles;
• shall expire two (2) years from the date issued.

(6) Temporary placards:

• may be issued to persons who are temporarily disabled by a non-ambulatory or semi-ambulatory condition due to
  surgery, bone fracture or breakage, or similar condition, and whose temporary disabling condition and the estimated
  duration of such condition is noted on the physician’s statement;
• shall cost $10.00 for the initial placard issuance and subsequent renewals;
• shall be issued for the estimated duration of the condition, but not in excess of six (6) months;
• the use of a “prescription pad” statement can also be used as evidence to determine eligibility for a temporary placard if it
  is attached to form RV-F1310301 and describes the mobility disabilities as “non-ambulatory” or “semi-ambulatory”.

(7) Disabled Driver Decals:

• may be issued to allow holders of new specialty earmarked license plates to keep their specialty plate but take advantage
  of the disabled parking privileges.

(8) Disabled Veteran Placard:

In accordance with Tenn. Code Ann. § 55-21-106 any veteran who has been honorably discharged from any of the Armed
Services of the United States and who has a service connected disability shall be entitled to receive and the department is
authorized to issue a serially numbered certificate of identification for the personal use of the veteran with a physical disability.
Proof of eligibility outlined in Tenn. Code Ann. § 55-4-252 must be produced at the time of issuance.

NOTE: An affidavit must accompany this application when replacing a lost or stolen placard. If the placard is mutilated, the
remaining portion of the placard must also accompany the application.