SP-27: Nevada 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.

You must have a permanent disability to qualify for disabled persons license plates.

You may select two (2) placards, or license plates and one (1) placard.

Check Disabled License Plates (permanent disability only), Disabled Motorcycle Plate (permanent disability only) or Disabled Moped Plate (permanent disability only).

Check Disabled Motorcycle Sticker (permanent or moderate) or Disabled Moped Sticker (permanent or moderate).

Check Disabled Placards(s) (no fee for placards) and One or Two.

If applying for license plates you must go to your local DMV and provide your current Nevada evidence of insurance.

Please Print or Type the Full Legal Name (Disabled Person): First, Middle and Last.

Enter the Nevada Driver's License or Identification Card Number and the Date of Birth.

Under Physical Address and under Mailing Address, enter the Address, City, State and Zip Code.

Enter the County of Residence, Telephone No. and E-Mail Address.

A LICENSED PHYSICIAN, PHYSICIAN'S ASSISTANT (PA), ADVANCED PRACTICE REGISTERED NURSE (APRN), OCCUPATIONAL THERAPIST (OT) OR PHYSICAL THERAPIST (PT) MUST COMPLETE THIS PORTION.

If the Physician's, APRN's, or Physician's Assistant portion is not completed in full, this application cannot be processed.

Please check one: Licensed Physician, Advanced Practice Registered Nurse (APRN), Physician's Assistant, Occupational Therapist or Physical Therapist.

Enter the Printed Name: First, Middle and Last.

Enter the License No. and the State.

Enter the Mailing Address: Address, City, State, Zip Code and Telephone No.

Cannot walk two hundred feet without stopping to rest.

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 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 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.

Is severely limited in his/her ability to walk because of an arthritic, neurological, or orthopedic condition.

Has a visual disability.

Uses portable oxygen.

I further certify that my patient's condition is a: Temporary Disability (6 months or less) must indicate length of time not to exceed 6 months beginning and ending; Moderate Disability (reversible but disabled longer than 6 months) Must indicate length of time not to exceed 2 years beginning and ending; Permanent Disability (irreversible, permanently disabled in his/her ability to walk, certification is valid indefinitely.

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.

I declare under penalty of perjury that the information on this application is true and correct.