The MV-145A form serves as an application for a Person with Disability Parking Placard in Pennsylvania. No fee is required to submit this form, which can be used for obtaining an original, renewal, or replacement parking placard as well as for addressing changes in name or address. Highlighted on the form are elements including eligibility requirements, certification from a health care provider or police officer, and special instructions for severely disabled veterans. Click the button below to start the process of filling out your MV-145A form.
The MV-145A form plays a crucial role for individuals with disabilities in Pennsylvania, offering a pathway to apply for a Person with Disability Parking Placard at no cost. This critical document, available through the Pennsylvania Department of Motor Vehicles, facilitates access to designated parking spaces, enhancing mobility and independence. Catering to both temporary and permanent needs, the form outlines eligibility for several groups, including severely disabled veterans, and details the process for obtaining, renewing, or replacing placards. Furthermore, it accommodates changes in address or name, ensuring records are up to date. Not requiring notarization simplifies the application process, while the certification from healthcare providers or authorized entities confirms the applicant's condition. Additionally, the form sets forth the types of vehicles that qualify and enumerates the benefits accorded to placard holders, such as parking privileges. It also specifies the requirements for organizations transporting persons with disabilities. By streamlining access to essential services and benefits, the MV-145A form underscores Pennsylvania's commitment to supporting its residents with disabilities, fostering inclusivity and convenience in their daily lives.
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.
Fulfilling the requirements for the MV-145A form, which is designated for individuals seeking a Person with Disability Parking Placard in Pennsylvania, requires careful attention to ensure accuracy and completeness. This process involves selecting the type of request, filling in personal information, and obtaining the necessary certification to qualify for the placard. Once the form is accurately completed, it is then sent to the designated address for processing. The following steps outline how to fill out the MV-145A form correctly.
After submitting the application, it will be processed by the Bureau of Motor Vehicles. Successful applicants will receive their disability parking placard, allowing them the use of parking spaces designated for persons with disabilities. It’s paramount to remember that the placard must be used in accordance with Pennsylvania’s regulations, ensuring that it benefits those for whom it’s truly intended.
What is the MV-145A form used for?
The MV-145A form is an application for Pennsylvania residents who wish to obtain a Person with Disability Parking Placard. This placard allows individuals with disabilities to park in designated parking spaces, improving accessibility. The form can be used for obtaining an original placard, renewing an existing placard, requesting a replacement, or updating information such as a change in address or name.
Is there a fee required to apply for a Person with Disability Parking Placard?
No. Applicants do not need to pay a fee when applying for a Person with Disability Parking Placard. This applies to both the original issuance of the placard and any subsequent renewals, replacements, or changes in information.
What types of placards are available, and who is eligible?
There are two main types of placards: Temporary and Permanent. A Severely Disabled Veteran Placard is also available. Eligibility for a placard depends on certain conditions including blindness, an inability to walk 200 feet without stopping to rest, the need for assistance from a device or another person when walking, and several other specific health conditions outlined in the form's eligibility requirements.
Can someone else apply on behalf of the person with a disability?
Yes. A parent, guardian, spouse, or an adult charged by law with the person's care can apply on their behalf. This is particularly relevant when assisting minors or adults unable to complete the application themselves. The form includes a section to be filled out by the person applying on behalf of the applicant, identifying their relationship and agreeing to the certification on their behalf.
What documentation is required for certification?
Certification must be provided by a healthcare provider licensed in Pennsylvania or a contiguous state. They must certify the disability and its impact on mobility as described in the eligibility requirements. For veterans, certification of a 100% service-connected disability by the U.S. Department of Veterans Affairs or other official documentation is required. Police officers may certify if the disability involves leg or blindness conditions only.
How long is a temporary placard valid, and can it be renewed?
Temporary placards are issued for a period not to exceed six months. If the applicant requires the placard for additional time past the initial expiration, a new application and certification by a healthcare provider are necessary. It is not a renewal process but rather a new application each time.
What happens if my placard is lost or stolen?
If a placard gets lost, stolen, defaced, or if it was never received, individuals can request a replacement by checking the appropriate box on the MV-145A form and providing their previous placard number. As with the original application, no fee is required for requesting a replacement placard.
Filling out the MV-145A form, also known as the Person with Disability Parking Placard Application in Pennsylvania, is an important step for individuals with disabilities or severe health conditions to gain access to designated parking spaces. However, there are common mistakes that can lead to delays or rejection of the application. It's crucial to pay close attention to detail and thoroughly understand the application process to avoid these pitfalls.
Incorrectly Listing Personal Information: One of the first sections of the application requires personal information, including the applicant's name, address, and identification number (PA DL/Photo ID# or Business ID# for businesses). A frequent error occurs when applicants mistakenly provide outdated or incorrect information, such as a previous address or a misspelled name. This mistake can cause delays in processing, as the information must match the applicant's official identification.
Failing to Complete the Certification Section Properly: The MV-145A form requires certification from a health care provider to verify the disability. Applicants often overlook completing this section in full or neglect to ensure that the health care provider is licensed or certified in Pennsylvania or a contiguous state. Additionally, the health condition listed must be one of the qualifying conditions mentioned on the form. Not filling out this section correctly can result in an incomplete application, delaying the issuance of the parking placard.
Not Indicating the Correct Type of Placard Needed: Applicants must check the appropriate box to indicate whether they are requesting an original, renewal, or replacement placard and if it's for temporary or permanent use. A common error is not clearly marking the intended type, especially distinguishing between temporary and permanent placards. This oversight can lead to receiving the wrong type of placard, which might not suit the applicant's needs.
Omitting the Signature and Date: The final step in completing the MV-145A form is the applicant's signature and the date, confirming that the information provided is accurate. Unfortunately, some applicants forget to sign and date the application, or they might have someone else sign it without proper authorization. This omission can invalidate the entire application, as the signature verifies the truthfulness of the provided information and agrees to the terms.
Understanding and avoiding these common mistakes can help ensure the application process for a Person with Disability Parking Placard in Pennsylvania is smooth and successful. Accurate and complete applications support the efficient processing and issuance of parking placards, helping applicants gain access to convenient parking and fostering greater independence.
When submitting the MV-145A form for a person with disability parking placard in Pennsylvania, various other forms and documents may be needed to support the application or related processes. Understanding these additional documents helps ensure applications are completed accurately and efficiently.
Each document plays a crucial role in the application process for a person with disability parking placard or assisting with the varied operational tasks related to vehicle registration and identification. Accurate completion and submission of these forms and supporting documents streamline the process, helping applicants receive their placards or address changes in a timely manner.
The MV-1 form, "Application for Certificate of Title," is used to apply for a title for a new or used vehicle. Similar to the MV-145A, the MV-1 form is also processed by the Department of Motor Vehicles and requires applicant information and certification for processing. Both forms facilitate vehicle-related requests, though their specific purposes differ.
The DL-180R form, "Renewal Application for a Non-Commercial Driver’s License," is another document processed by the DMV, catering to driver's license renewals. Like the MV-145A form, it serves a specific demographic—drivers needing license renewal versus persons with disability parking needs—and both require personal and certification information.
Form MV-140, "Request for Registration," shares similarities with the MV-145A in that both are utilized for specific vehicular privileges—registration renewal in the case of the MV-140 and disability parking placard application for the MV-145A. Each form requires applicant information and some form of certification or validation.
The J-1 Visa Waiver Recommendation Application form, while from a different domain, necessitates a detailed application process involving personal information and eligibility criteria, akin to the MV-145A form's requirements for disability parking placard eligibility and personal details.
The Voter Registration Application, albeit for a completely different governmental service, requires applicants to provide personal information and, in some instances, proof of eligibility, mirroring the MV-145A form’s requirement for detailed applicant information and eligibility certification for a specific service.
The Social Security Disability Benefits Application also parallels the MV-145A form in that it targets individuals with disabilities, requiring comprehensive personal information and proof of eligibility to access specific benefits or services.
The Passport Application Form (DS-11) requires detailed personal information and various certifications, similar to the MV-145A. Both forms are gateways to acquiring a permit—be it for international travel in the case of the passport, or for disability parking in the case of the MV-145A.
The I-485, Application to Register Permanent Residence or Adjust Status, demands extensive personal data and eligibility proof, reflecting the MV-145A’s necessities for detailed applicant information and condition certification for service access.
Business License Application forms, which vary by municipality, require business details and sometimes proof of eligibility for certain types of businesses, analogous to how the MV-145A needs personal information and eligibility proof for a disability placard.
The Employment Application forms commonly require applicants to provide personal information and, in some cases, eligibility or qualification proof, akin to the MV-145A form's detailed Information section and certification by a healthcare provider or police officer.
Filling out the MV-145A form for a Person with Disability Parking Placard in Pennsylvania is a straightforward process but requires attention to detail. To ensure that your application is processed smoothly, here is a list of dos and don'ts to keep in mind:
Following these guidelines will help ensure that the application process for your Person with Disability Parking Placard or ID card is as smooth and quick as possible. Remember, this placard is a valuable asset for those who genuinely need it, so it's important to use it responsibly and according to the laws and regulations set by the state of Pennsylvania.
Understanding the Person with Disability Parking Placard Application (MV-145A) is crucial for applicants seeking to utilize these placards in Pennsylvania. However, several misconceptions often cloud the process, leading to confusion and errors. Here are eight common misunderstandings and the truths behind them:
The MV-145A form requires a fee: Contrary to some beliefs, there is no fee required to submit the MV-145A form for a Person with Disability Parking Placard in Pennsylvania. The application process is designed to be accessible and free of charge to ensure that individuals who qualify can obtain their placards without financial burden.
Notarization is needed for the application: The application process for both the initial request and subsequent actions such as renewals, replacements, or changes of name or address does not require the form to be notarized. This misinformation can unnecessarily complicate the process for applicants.
Only permanent disabilities qualify for a placard: While there are placards available for permanent disabilities, the state also provides temporary placards for individuals with temporary mobility impairments or health conditions. The eligibility for a placard is not limited to lifelong disabilities but also accommodates those with temporary conditions that impair mobility.
All health care providers can certify for all types of disabilities: The certification for a disability must fall within the scope of practice of the signing health care provider. Only specific types of health care providers, licensed or certified in Pennsylvania or a contiguous state, can certify disabilities, and they can only certify conditions within their area of expertise.
A disability placard allows parking in any location: Personal disability placards provide the privilege to park in spaces designated for persons with disabilities, and under certain conditions, allow for extended parking periods in non-restricted zones. However, they do not permit parking in areas where parking is explicitly prohibited or in spaces not designated for disabled parking.
The placard is transferable among vehicles: The placard is designed to be transferable between vehicles, as long as it is being used for the transportation of the individual to whom it is issued. It is a misconception that the placard is assigned to a specific vehicle. This flexibility allows for the placard to be used in any vehicle transporting the qualified individual.
Organizations cannot apply for disability placards: Organizations that transport individuals with disabilities are eligible to apply for placards. These applications must include detailed information on the use and the services provided, ensuring that the placards are utilized to assist in the transportation of persons with disabilities.
Severely Disabled Veteran Placards require different applications: While veterans with a 100% service-connected disability may apply for a Severely Disabled Veteran Placard using the MV-145A form, the misconception lies in believing a completely separate application process exists. The requirement is for the certification by the U.S. Department of Veterans Affairs or attaching specific VA documentation to the MV-145A application.
Clarification of these misconceptions surrounding the Person with Disability Parking Placard Application ensures that individuals seeking these accommodations are well-informed and equipped to navigate the process smoothly and efficiently.
Filling out and using the MV-145A form, the application for a Person with Disability Parking Placard in Pennsylvania, involves several key points that applicants need to be aware of to ensure the process is completed properly and efficiently. Here are six essential takeaways:
Understanding these key points helps ensure that the application process for a Person with Disability Parking Placard is as smooth as possible, facilitating access to this necessary resource for those who meet the eligibility requirements.
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