MV-145A: Person with Disability Parking Placard Application

Check the appropriate blocks. For an Original Request, check Permanent Placard, Severely Disabled Veteran or Temporary Placard. For a Permanent Placard, complete Sections A, B or C (NOT BOTH) and E.

For a Severely Disabled Veteran Placard, complete Sections A, D and E.

For a Temporary Placard, complete Sections A, B and E. 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.

Renewal Request is for Permanent Placards only. Complete Sections A and E.

For a Replacement Request, indicate if applying for a replacement PLACARD or ID CARD. Please check reason for replacement; Defaced, Lost, Stolen or Never Received. List your previous placard number and complete Sections A and E.

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.

For a Change of Address, complete Sections A and E.

For a Change of Name, complete Sections A and E. Check the block on the front of this application to indicate reason for change of name: Marriage, Divorce or Other.

Customers with a permanent placard have the option to renew their placard, request a replacement placard or change the address online, or scan the QR code on the front of this application.

Enter the Last Name (or Full Business Name), First Name, Middle Name, PA DL/Photo ID# or Bus. ID#, Date of Birth, Street Address, City, State, Zip Code and Email Address.

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.).

If listing an out-of-state address, you must also complete and attach Form MV-8.

A health care provider licensed or certified in PA or a contiguous state (New York, New Jersey, Delaware, Maryland, West Virginia or Ohio) completes this section. This section must be completed in full. Health care providers may only certify disabilities within their scope of practice.

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.

Certify that the person with the disability is under your care and has the following condition listed in the reverse side of this application under "Eligibility Requirements", and list the Reason Code # here. Only those conditions listed in the reverse side of this application qualify an applicant for a person with disability placard.

If reason code #1 is listed, indicate the individual's visual acuity by completing the chart (UNCORRECTED and CORRECTED, R 20/, L 20/ and B 20/). If reason code #4 is listed, indicate the type of device used.

The health care provider enters the Printed Name, Signature and Medical License No., then the Office Street Address, City, State, Zip Code and Telephone Number.

Police officer may only certify that the applicant does not have full use of a leg or both legs, or is blind. If Section B is completed, please skip this Section and go on to Section E.

Certify that the person with disability is blind, OR does not have full use of a leg or both legs as evidenced by the use of a: wheelchair, walker, crutches, cane/quad cane or other prescribed device.

The officer enters the Printed Name, Signature and Badge Number, then the Office Street Address, City, State, Zip Code and Telephone Number.

Section D is the certification from the U.S. Department of Veterans Affairs Regional Office Administrator (PHILADELPHIA OR PITTSBURGH) or 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.

This is to certify that the veteran with VA number has a 100% service-connected disability or has a service connected disability reason code number from the Eligibility Requirements in the reverse side of this application.

Enter the day on the "Signed on the" line, then "day of" and "at" with the county or other location, and state, and the country.

Enter the Printed Name of Person with Disability, the Person with Disability/Loco Parentis Signature and the Telephone Number.

For a Person with Disability Placard, the Eligibility Requirements "Reason Codes" say the 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.

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.)

Send completed application to: PennDOT, Bureau of Motor Vehicles, P.O. Box 68268, Harrisburg, PA 17106-8268.

No fee is required.

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. (checked October 21, 2026) Any statement made on or pursuant to this application is subject to the penalties of 18 Pa.C.S. Section 4904 (relating to unsworn falsification), which include criminal prosecution and a term of imprisonment, the maximum of which may be one year [18 Pa.C.S. 4904(b)]. (checked October 21, 2026) The term of imprisonment may be up to two years [18 Pa.C.S. 4904(a)]. In addition to any other penalty, a person convicted under this section shall be sentenced to pay a fine of at least $1,000 [18 Pa.C.S. 4904(d)]. (checked October 21, 2026)