Complete this form legibly in ink. Illegible, incomplete, and/or unsigned forms will be returned.
Proof: applicants must provide a copy of acceptable proof of their legal name and date of birth with this application, or the application will be rejected.
Signatures: only original signatures will be accepted, no photocopies or faxes.
Pages 2 and 3: both pages 2 and 3 are required in order to process the application.
Temporary placard: valid for up to 180 days or the date noted by your qualifying licensed medical professional, whichever timeframe is less.
Permanent placard: valid for two years and expires on June 30 of every odd-numbered year.
Where to submit: completed applications can be submitted in person or by mail.
| Question | Answer |
|---|---|
| Form Name | REG 195 |
| Form Length | 3 pages |
| Fillable? | Yes |
| Fillable fields | 63 |
| Avg. time to fill out | 11 min |
| Edition | 11/2023 |
| Where to submit | In person or by mail |
| Who signs | The applicant or organization authorized representative, and the medical provider |
| Matches the agency's file | Yes, checked October 2, 2026 |
| Other names | REG 195, REG195, REG-195, DMV REG 195, California REG 195, Application for Disabled Person Placard or Plates |
| Official source | REG 195 (Rev 11/2023), DMV |
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