Permanent: expected to last the duration of the applicant's life. Temporary: of limited duration and expected to improve during the applicant's life.
Licensed physician: includes MD., DO., Chiropractor, Advanced Nurse Practitioner, and Physician's Assistant.
Part II: complete all of Part II; failure to do so will result in this form being returned to the sender for completion.
License plates: can only be issued to an applicant whose name appears on the WV vehicle registration.
Vehicle and Insurance Information: this section is only required to be completed if this request is for a license plate.
Social Security Number: the mobility impaired person must enter their Social Security Number in the light gray box on the upper right corner of the page.
| Question | Answer |
|---|---|
| Form Name | DMV-41-TR |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 31 |
| Avg. time to fill out | 6 min |
| Edition | Rev. 06/2023 |
| Issuing agency | West Virginia Department of Transportation Division of Motor Vehicles |
| Mail to | Mobility Impaired Placards & Plates, PO Box 17030, Charleston, WV 25317 |
| Other names | DMV-41-TR, DMV 41 TR, Parking Application for a Mobility Impaired Person |
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