Application form for a disabled parking tag and license fee exemption

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date

in case of renewal

Additional vehicle number

car number

The details of the disabled person/restricted mobility

Date of birth

First name

Last Name

Email (E-mail)

phone

Address

settlement

The application must be attached (please mark X for the attached documents)

Photocopy of the certificate (in the case of a digital certificate, the back side of the certificate must also be photographed) and all appendices

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(back side) upload a photograph of the 17th

File in format - jpg or png

17th photo

Upload a 17th photo

File in format - jpg or png

Photocopy of car license

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Photocopy of another car license

File in format - jpg or png

Photocopy of car license

File in format - jpg or png

Current medical documents from professional doctors with reference to the ability to move and leave a photocopy in your hand because there is no return of documents (please do not send CDs and X-rays). A confirmation from the National Insurance on the percentage of disability is not sufficient to determine eligibility for a disabled mobility badge, you must attach medical documents with a doctor&#39;s stamp

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medical documents

File in format - jpg or png

Copy of a check in the name of the disabled person and spouse/parent of a minor/guardian and bank account details to receive a fee refund

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Photocopy of a check

File in format - jpg or png

signature