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555 Wright Way
Carson City, NV 89711
Reno/Carson City (775) 684-4DMV (4368)
Las Vegas (702) 486-4DMV (4368)
Fax (775) 684-4797
dmv.nv.gov
DISABLED PERSONS LICENSE PLATES AND/OR PLACARDS APPLICATION
NRS 482.384 & 484B.467
First time applications for Disabled Persons license plates, motorcycle or moped license plates must be made in
person. In order to apply for disabled persons license plates or disabled motorcycle stickers your name must appear on the
vehicle certificate of registration and provide your current Nevada evidence of insurance. If your vehicle is currently registered,
you have the option of maintaining your current vehicle registration expiration date or renewing for a full twelve (12) month
period. Credit for any unused portion of your current registration is transferable to your disabled license plate registration. In
applicable counties, if you are renewing for a full 12-month period, and your previous emissions test was obtained more than
90 days ago, the vehicle must be re-tested prior to registration. You must have a permanent disability to qualify for
disabled persons license plates (see description below). If the Physician’s, APRN’s, or Physician’s Assistant portion is
not completed in full, this application cannot be processed.
Erasures or whiteout will void this form.
Applicant Must Complete this Portion
You may select two (2) placards, or license plates and one (1) placard. If applying for license plates you must go to your
local DMV and provide your current Nevada evidence of insurance.
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Disabled License Plates (permanent disability only)
Disabled Placards(s) (no fee for placards)
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One
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Two
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Disabled Motorcycle Plate (permanent disability only)
Disabled Motorcycle Sticker (permanent or moderate)
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Disabled Moped
Plate (permanent disability only) Disabled Moped Sticker (permanent or moderate)
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Please Print or Type
Full Legal Name (Disabled Person)
First
Middle
Last
Nevada Driver’s License or Identification Card Number
Date of Birth
Physical Address
Address
City
State
Zip Code
Mailing Address
Address
City
State
Zip Code
County of Residence
Telephone No.
E-Mail Address
I declare under penalty of perjury that the information on this application is true and correct.
I understand that a violation of the use of disabled person license and placards is a misdemeanor
violation of NRS 484B.467 and punishable by fines.
Signature of Applicant
Date
SP-27 (2/2023) Page 1 of 2
Please Print or Type Full Legal Name
First
Middle
Last
(Disabled Applicant)
A LICENSED PHYSICIAN, ADVANCED PRACTICE REGISTERED NURSE (APRN), OR PHYSICIAN’S ASSISTANT MUST
COMPLETE THIS PORTION
Please print or type and complete in full:
Please check one:
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Licensed Physician
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Advanced
Practice Registered Nurse (APRN)
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Physician’s Assistant
Physicians, APRN’s, or Physician’s Assistant: Printed Name:
First
Middle
Last
Physicians, APRN’s or Physician’s Assistant:
License No.
State
Mailing Address
Address
City
State
Zip Code
Telephone No.
As a Physician, APRN, Physician’s Assistant for the above-named patient, I hereby certify that the applicant:
1.
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Cannot walk two hundred feet without stopping to rest.
2.
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Cannot walk without the use of a brace, cane, crutch, wheelchair, or prosthetic, or other assistive device, or another person.
Has a cardiac condition to the extent that functional limitations are classified as Class III or Class IV according to
3.
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standards adopted by the American Heart Association.
Is restricted by a lung disease to such an extent that the person’s forced expiratory volume for 1 second, when measured
4
.
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by a spirometer, is less than 1 liter, or the arterial oxygen tension is less than 60 millimeters of mercury on room air while
the person is at rest.
5.
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Is severely limited in his/her ability to walk because of an arthritic, neurological, or orthopedic condition.
6.
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Has a visual disability.
7.
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Uses portable oxygen.
I further certify that my patient’s condition is a:
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Temporary Disability
(6 months or less) must indicate length of
time not to exceed 6 months beginning
and ending
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Moderate Disability (reversible but disabled longer than 6 months)
Must indicate length of time not to exceed 2 years beginning
and ending
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Permanent Disability (irreversible, permanently disabled in his/her ability to walk, certification is valid indefinitely.
Physician’s, APRN’s, or Physician’s Assistant Signature
Date
FOR OFFICE USE ONLY
Plate/Placard Number (s)
DMV Tech Initials
Date Issued
SP-27 (2/2023) Page 2 of 2
