420-073: Washington Disabled Parking Application for Individuals

Under Applicant, print or type the Name (Last, First, Middle initial) and the Date of birth (mm/dd/yyyy).

Enter the Mailing address (PO Box or street address and apartment number, if applicable), City, State and ZIP code.

Enter the 10-digit daytime phone and the Email address.

Enter the Current license plate, if applicable, and the Registration expiration, if applicable.

When completed, print form and sign here.

Your healthcare provider will determine if you get temporary or permanent disabled parking.

Temporary placard: valid for 1 year or less. Only one placard will be issued (no fee required). A new application is required to renew.

Permanent disabled parking: valid for 5 years. You must be the registered owner of the vehicle that has permanent plates or tabs.

Permanent disabled parking choices (choose only one).

Placard only: no fee required. Number of placards: 1 or 2.

Permanent plates: fee required (see dol.wa.gov for current fees). Select one: 1 placard and 1 set of license plates, or 1 set of license plates.

Disabled parking tab for specialty or personalized plates, or Disabled parking tab for WATV: fee required (see dol.wa.gov for current fees). Select one: 1 disabled parking tab, or 1 placard and 1 disabled parking tab.

Healthcare provider: Doctor, physician, or licensed registered nurse practitioner fills out this section.

Print or type the Name, Professional classification and Professional license number.

Enter the Office address (Street address, City, State, ZIP code) and the 10-digit phone number.

You must provide a separate signed authorization stating: (1) the applicant's name and (2) they have a condition which qualifies them for disabled parking privileges.

This authorization must be on prescription paper or your office letterhead.

If this application is printed on prescription paper, it meets both the application and authorization requirements.

Return this form and your signed authorization to the applicant.

Privilege duration: Permanent, or Temporary for: months (up to 12 months).

My patient meets one of the qualifying conditions: Cannot walk 200 feet without stopping to rest or must use assistive device; Walking severely limited due to arthritic, neurological, or orthopedic condition; Uses portable oxygen or walking restricted by lung disease; Class III or IV impairment by cardiovascular disease; Acute sensitivity to auto emissions that limits ability to walk; Legally blind with limited mobility; Restricted by porphyria (applicant benefits from a decrease in exposure to light).

"I declare under penalty of perjury under the law of Washington that the applicant named above has a medical necessity that severely affects mobility or involves acute sensitivity to light."

Once you and your healthcare provider have completed each section, take this application and a separate signed authorization from your healthcare provider to any vehicle licensing office or mail to any location from the attached page. Mail your completed Disabled Parking Application to one of the locations listed on page 3 of the form, for example the Department of Licensing Applications & Issuance PO Box 9043 Olympia, WA 98507.

An applicant or healthcare practitioner who knowingly provides false information on this application is guilty of a gross misdemeanor. The penalty is up to 364 days in jail and a fine of up to $5,000 or both (checked November 8, 2026).

A parking permit for a person with disabilities may be issued only for a medical necessity that severely affects mobility or involves acute sensitivity to light (RCW 46.19.010).