VTR-615: Texas Application for Disabled Veteran License Plates and/or Parking Placards

Fill in First Name, Middle Name, Last Name and Suffix (if any), then Address, City, State and ZIP, then Email, Phone Number and Driver License State and No.

State law makes falsifying information a third-degree felony.

Please include your Driver License number (DL #) or Identification Card number (ID #) on this application.

Your signature below indicates that you are (check one): the person with the disability listed above (enter your DL or ID #), or the administrator or manager of an institution licensed to transport persons with disabilities defined under Transportation Code, Section 681.0032 (enter the DL or ID #).

Institutions, facilities, and residential retirement communities licensed under Chapter 242, 246, or 247 of the Health and Safety Code must list a facility ID # issued by the agency.

Annual specialty license plate fee applies for the first set of plates only. Otherwise, registration and local fees apply.

One vehicle is eligible for a Disabled Veteran (DV) license plate. Additional vehicles may display a DV license plate; however, registration and local fees will apply.

Fill in Vehicle Identification Number, Current TX Plate (if any), Year, Make and Body Style.

Under Vehicle Type, check Passenger Car (up to 18,000 lbs.), Truck (up to 18,000 lbs.), Motor home or Motorcycle/Moped.

Common mistake: Check ONE Plate Design: DV license plate (standard design), DV license plate with Emblem (select design choice on page 4), DV ISA license plate, or DV ISA license plate with Emblem (select design choice on page 4).

DV license plates displaying the ISA may be issued to persons with a permanent disability who meet the eligibility requirements (limit two sets of plates).

Common mistake: State law does not allow the ISA on a vehicle weighing more than 18,000 lbs.

The appropriate Vehicle Type must be indicated on page 1.

Check for two disabled parking placards to be issued without a set of DV ISA license plates. Check for one disabled parking placard to be issued with one set of DV ISA license plates. Check for two disabled parking placards to be issued with two sets of DV ISA license plates.

Persons with Disabilities Parking Placard: Submit the completed application with proof of eligibility to your local county tax assessor-collector's office or the county tax assessor-collector's office where you are seeking medical treatment.

A parking placard may be issued to Disabled Veterans with a permanent disability who meet the eligibility requirements and who are issued DV ISA license plates. There is no fee for a placard issued to a person with a permanent disability.

Common mistake: To obtain Disabled parking placards, the signature of a licensed medical professional must be notarized on page 3 if an original prescription is not submitted.

Proof of Eligibility is to be completed by a U.S. Department of Veterans Affairs Regional Office or appropriate service branch. The Texas Department of Motor Vehicles will accept either a letter from the U.S. Department of Veterans Affairs certifying the applicant's disability percentage, or this section must be completed.

The lines for the certifying officer are Agency, Address, Name and Title of Certifying Officer, Certifying Officer Signature and Date.

I, the applicant listed on page 1, meet the eligibility requirements as listed above and am providing proof to that effect, or I am making application on behalf of a person with a disability as indicated in the Identification Statement.

Sign on the Signature line and fill in the Date.

Disability Statement: To be completed by a Licensed Medical Professional. An original prescription is acceptable proof if not providing a written statement or completing the Disability Statement.

A Licensed Medical Professional is defined as a physician, podiatrist, optometrist, or qualifying physician's assistant or advanced practice nurse as defined in Chapter 301, Occupations Code.

At least one of the following conditions must be met: licensed in Texas, Arkansas, Louisiana, New Mexico, or Oklahoma; or must practice medicine in a U.S. military installation based in Texas; or must practice medicine in a hospital or health facility of the U.S. Department of Veterans Affairs.

Licensed Medical Professional: On the line after I certify that, write the Printed Name of Person with a Disability or Mobility, and check the box before permanent disability.

The lines for the Licensed Medical Professional are Printed Name of Licensed Medical Professional, Professional License Number, Date, Signature of Licensed Medical Professional, Mailing Address, City, State and ZIP.

Notary: On this date, the above named licensed medical professional (page 3) appeared before me so that I could witness his or her signature.

The notary's lines are State of, County of, Notary Public and My commission expires, next to the STAMP HERE box.

DV License Plate with Emblem: Options in lieu of the standard Disabled Veteran plate. See Additional Requirements for these plates on page 5 and select a design choice on page 4 only if you checked the box on page 2 for DV license plate with Emblem.

Circle your specialty plate choice on page 4 or enter your choice here.

Personalize Your Plate: If you would like to personalize your specialty plate, there will be a fee per year in addition to the specialty plate fee or annual registration fee.

Show personalization(s) exactly as you want them to appear on your license plate(s).

You may list more than one option in the event the personalization you have chosen has been issued.

Common mistake: A personalization that has been issued, is deemed offensive, or conflicts with the regular license plate numbering system cannot be approved.

Enter your desired personalized letters, numbers, and/or symbols in the blocks under 1st Choice, 2nd Choice and 3rd Choice.

The available symbols include: a period, a dash, a blank space, a Texas silhouette (use an asterisk “*” to indicate), a heart (use an at “@” to indicate), and a star (use an ampersand “&” to indicate).

Personalized plates must include “DV” as a prefix or suffix, which counts as two (2) characters.

Passenger car and truck plates are limited to six (6) characters total, including punctuation characters.

Motorcycle/moped plates are limited to six (6) characters total without an emblem and four (4) characters total with an emblem, including punctuation characters.

The International Symbol of Access (ISA) counts as two (2) characters and will be located at the beginning of the plate number.

If you are disabled and applying for personalized specialty plates, use a percent “%” to indicate the ISA.

Common mistake: The DV ISA and DV ISA plate with military Emblem are not eligible for personalization.

Common mistake: The personalization fee will not be refunded once the application is submitted.

This form is the Application for Disabled Veteran License Plates and/or Parking Placards. Parking Placard: Owners of passenger cars, trucks, and motor homes who meet the eligibility requirements for a DV ISA license plate may be issued a disabled parking placard with approval of this application.

The applicant listed on page 1 signs the Certification. A Licensed Medical Professional signs the Disability Statement. A U.S. Department of Veterans Affairs Regional Office or appropriate service branch completes Proof of Eligibility, unless the applicant has a Veterans Affairs letter. The Notary section is only for placards; a Notary Public completes it if an original prescription is not submitted.

Submit the completed application and payment in the form of a personal check, money order, or cashier's check with proof of eligibility to your local county tax assessor-collector's office.