Learning all the ins and outs of the various government forms can be a daunting process. But it doesn't have to be! Understanding what Ps 15 from Maine is, who needs to complete it, why it matters, and how you can use it are all essential parts of developing effective strategies for filing taxes and other documents in Maine. In this blog post, we will unpack everything you need to know about Ps 15 Form so that you never find yourself overwhelmed by paperwork again! So if you're ready to learn more about this important document, keep reading as we navigate through its purpose and functions.
| Question | Answer |
|---|---|
| Form Name | Ps 15 Form Maine |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | removable, Exp, Placard, rearview |
MAINE BUREAU OF MOTOR VEHICLES
APPLICATION FOR SEAT BELT EXEMPTION
___ New Application ___
Applicant’s Name:________________________________________
Address: _______________________________________________
_______________________________________________
BMV Use Only
Placard #: ________________
Issue Date: _______________
Exp Date: ________________
Returned #: _______________
Replaced #: _______________
Issued By: ________________
Entered: __________________
Daytime Phone #: ______________________________ DOB: _____________
Applicant’s Statement of Understanding:
This removable windshield placard is designed to hang from the rearview mirror when the vehicle is in motion without obstructing the view of the operator. If the vehicle is not equipped with a rearview mirror, the placard must be displayed on the dashboard. A placard issued to a person expires when the physician's certificate expires which may not exceed one year.
Applicant’s Signature:_____________________________________________ Date: _________________
/////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////////
Physician’s Statement:
This seatbelt exemption should expire on ___________________ (may not exceed one year).
This patient has a medical condition that warrants an exemption from the requirements of having to wear a seatbelt while riding in or operating a motor vehicle.
The patient’s specific condition is:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Wearing a seatbelt is a risk for this patient because:
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Physician’s Printed Name: ____________________________________________________________________
Signature: ________________________________________________________________Date _____________
Physician’s Address: ________________________________________ License #: ______________________
__________________________________________________________ Phone #: ______________________________
Phone: |
Fax: |
Mail to: Bureau of Motor Vehicles |
Attn: Disability Section |
29 SHS Augusta ME