This is an article about the Georgia Mv 9D form, which is a document that businesses in the state of Georgia use to report various types of taxable transactions. The information on this form can be used by the government to determine how much money it needs to collect in taxes, and businesses in Georgia are required to complete and submit this form every quarter. In addition, there are also specific instructions for completing this form that must be followed closely in order to ensure that the information is accurate and up-to-date.
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Question | Answer |
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Form Name | Georgia Mv 9D Form |
Form Length | 1 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 15 sec |
Other names | how to ga disabled parking, disability dmv form parking, georgia disabled, georgia disabled parking permit |
motor.etax.dor.ga.gov
Disabled Person’s Parking Affidavit
New
Renewal
Section One - Except for signature(s), this form must be typed, electronically completed and printed or legibly hand printed.
Note: The vehicle owner information is only required when applying for a DP license plate. You do not have to own a vehicle to obtain a DP parking permit (placard). Apply at the Tag Office in the county in Georgia where you reside.
* Vehicle Owner’s Full Legal Name
* Driver’s License # & Name of Issuing State (person operating vehicle)
*Vehicle Owner’s Street Address including city, state & zip
Disabled Person’s Full Legal Name
*County of Residence
*Relationship to Vehicle Owner- Check only one box |
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Child |
Self |
Spouse |
Ward |
* Disabled Person's Driver’s License # & Name of Issuing State(if applicable)
Disabled Person’s Street Address including City, State & ZIP
Active Military Duty Retired GA Veteran
Section Two - For Institutions Only: This vehicle is used primarily for the transportation of disabled persons.
Institution’s Full Legal Name (Institution as defined by Georgia Law
Vehicle Year & Make |
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Vehicle Identification # |
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Vehicle Color |
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Institution Authorized Representative’s Signature & Position
Section Three
Vehicle Tag #
Date
Check applicable box(s) below: You may apply for both a Disabled Person’s Parking Permit and Disabled Person’s License Plate with this form.
Temporary Parking Permit (Placard) No
Permanent Parking Permit (Placard) No Fee- Must be replaced every four (4) years from issue date.
Special Permanent Parking Permit (Placard) No
Disabled Person’s License Plate (Fee $20.00 plus any taxes that may be due).
Section Four - To be completed by a licensed doctor of medicine, osteopathic medicine, podiatrist, optometrist or a licensed chiropractor.
Is disability permanent?
Yes
I hereby swear and affirm that the above individual as defined by Georgia Law
Is so ambulatory disabled that he/she cannot walk 200 feet without stopping to rest.
Cannot walk without use of assistance from a brace, a cane, a crutch, another person, a prosthetic device, a wheelchair, or other assistive device.
Is restricted by lung disease to such an extent that his/her forced respiratory volume for one second, when measured by spironmetry is less than one liter, or when at rest his/her arterial oxygen tension is less than 60 millimeters of mercury on room air.
Uses portable oxygen.
Has a cardiac condition to the extent that his/her functional limitations are classified in severity as Class III or Class IV according to standards set by the American Heart Association.
Is severely limited in his/her ability to walk due to an arthritic, neurological, orthopedic condition or complications due to pregnancy.
Is hearing impaired pursuant to Georgia Law
Is blind individual whose central visual acuity does not exceed 20/200 in the better eye with correcting lenses or whose visual acuity. If better than 20/200, is accompanied by a limit to the field or vision in the better eye to such degree that is widest diameter subtends and angle of no greater than
Section Five - Certification
Licensed Doctor’s Printed Name |
Doctor’s License # |
State of Issuance |
Signature |
Office Street Address including City, State & ZIP |
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Telephone # including area code |
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Note: Notarization Required For Licensed Doctor’s Signature |
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Sworn to and subscribed before me
This ________ day of ______________________, ______
(Day) |
(Month) |
(Year) |
Notary Public’s Signature & Notary Seal or Stamp
Date My Notary Commission Expires
County and State Use Only
*Retention Schedule: This form will be retained at the County Tag Office for two (2) years from the date issued. Disabled Person’s Parking Permit # ______________________________________