rking permit describedThis permit is issued for travel purposes only a - PDF document

1 rking permit describedThis permit is iss
rking permit describedThis permit is issued for travel purposes only and is valid forOnce you receive a replacement disabdestroyed, or stolen, then all prior permits are invalid. parking permit that has been replaced by another permit, you could be subject to citation PAR.IN* PERMITS ID Card and Permit: If you qualify for a parking permit but do not have a valid driving privilege or ID card, you may be eligible for a parking ID card. This parking ID card is issued to individuals who need a parking permit, but are unable to go to a DMV field office because it would be impractical or harmful to the individual.write DMV Driver Transactions Unit - Permits Clerk at 1905 Lana Ave NE, Salem, OR 97314 or FAXDisability parking permits are qualifying conditions are not being mirror, place the permit on the dashboard. Remove permit from rearview mirror before driving your vehicle. If you have a golf cart or motorcycle and have applied for a parking decal, affix the decal to the back of the left rearview mirror. If such a display is not possible, the decal is to be affixed to the front fender of the vehicle so that the permit number and DMV receives notice that the permit holder (excluding Family or Program permits) is deceased.ir Oregon driver license, This form is for use by individualsfee for the permit. Once you and your physician have completed the appropriate sections, take this application to any DMV office or mail to: Driver Transactions Unit, Oregon DMV, 1905 Lana Ave NE, Salem Oregon 97314.DATE OF BIRTH (MMDDYYYY)DRIVER LICENSEHAIR COLOREYE COLORSTATE=IP CODESTATE=IP CODEYour physician will determine if you qualify for temporary or p– valid for up to 6 months as authorized under ORS 811.606. Onlred to renew. CHEC. TO INDICATE THE PAR.IN* PERMIT TRANSACTION YOU ARE APPLYIN* FOR: (Original) application for a parking permit Expiration date i Expiration date is 8 years Lost Stolen DestroyedYou must have a current valid parking permit. Travel permits are valid for up to 120 days from the date of issuance. Physician certification is not required. Must submit letter from U.S. Veterans Administration of having at least 50 service arrior Sticker connected disabi

2 lity and dischargerelease under
lity and dischargerelease under other than dishonorable conditions *olf Cart or Other: By signing below, I certify that I am eligible for a disability parking permit as defined in ORS 801.387 Person with a Disability (see below) and have submitted a medical certification to DMV as proof and that the information on this application is true and correct. I understand that it is a crime to by jail time, a fine, or bothCERTIFICATE OF DISABILITY-I certify under penalty of perjury under the laws of the state of Oregon that the applicant named above has a medical condition meeting the definition of a person with a disability as defined in ORS 801.387 (see below). I understand that it is a crime to certify the truth of a statement when I know the statement s legs or arms; (2) A person who is affected by loss of vision or substantial loss of visual acuity or visual field beyond correction; or (3) A person who has any the person from walking without the use of an assistive device ormphysema; Arthritis; Rheumatism; or Ulcerative colitis or related chronic bowel disorder.(a)Submits written proof to the Department of Department of Veterans Affairs total disability rating of at leaspercent as a result of an injury or illness that the veteran incurred, or that was aggravated, during active military service; and(b)Received a discharge orrelease under other than dishonorable conditions. DISABILITY SIGNS AND PERMITS 735-6500 151617 JANMARMAYAUGSEOCTNOVPARKING USE ONLY WHEN PERMIT HOLDER IS AN OCCUPANT OF VEHICLE.PQ 000000 735-6500 151617 JANMARMAYAUGSEOCTNOVPARKING USE ONLY WHEN PERMIT HOLDER IS AN OCCUPANT OF VEHICLE.PQ 000000 735-6500WP 151617 JANMARMAYAUGSEOCTNOVPARKING USE ONLY WHEN PERMIT HOLDER IS AN OCCUPANT OF VEHICLE.WPUSERW FAMILYPROGRAM 000000 735-6500WP 151617 JANMARMAYAUGSEOCTNOVPARKING USE ONLY WHEN PERMIT HOLDER IS AN OCCUPANT OF VEHICLE.WPUSERW FAMILYPROGRAM 000000 735-6500WP 151617 JANMARMAYAUGSEOCTNOVPARKING USE ONLY WHEN PERMIT HOLDER IS AN OCCUPANT OF VEHICLE.WPUSERW FAMILYPROGRAM 000000 EXPIRESON: TEMPORARY735-6500TP (5-14) STK # 305328OREGON 141516 JANFEBMARAPRMAYJUNJULAUGSEOCTPARKING USE ONLY WHEN PERMIT HOLDER Important: Remove from mirror bef

3 ore driving vehicleDECNOV 000000 ILYmirr
ore driving vehicleDECNOV 000000 ILYmirror before driving vehicle735-6500 (1-18) 18 19 2 0 2 1 2 2 2 3 2 4 2 5 2 6 2 7 2 8 2 9 JANFEBMARAPRMAYJUNJULAUGSEOCTNOVDECPARKING USE ONLY WHEN PERMIT HOLDER • OREGONWOUNDED WARRIOR EXPIRESON: TEMPORARY735-6500TP (5-14) STK # 305328OREGON JANFEBMARAPRMAYJUNJULAUGSEOCTPARKING USE ONLY WHEN PERMIT HOLDER 000000 EXPIRESON: TEMPORARY735-6500TP (5-14) STK # 305328OREGON JANFEBMARAPRMAYJUNJULAUGSEOCTPARKING USE ONLY WHEN PERMIT HOLDER EXPIRESON: TEMPORARY735-6500TP (5-14) STK # 305328OREGON 141516 JANFEBMARAPRMAYJUNJULAUGSEOCTPARKING USE ONLY WHEN PERMIT HOLDER Important: Remove from mirror before driving vehicleDECNOV 000000 OREGON DEPARTMENT OF TRANSPORTATION 735-6500M (1-08) PARKING PERMIT PDEXPIRES: OREGON DEPARTMENT OF TRANSPORTATION 735-6500M (1-08) PARKING PERMIT PDEXPIRES: • OREGON WOUNDED WARRIOR International Symbol & tandard Text: These spaces are designated for all persons with disabilities. All persons that have a valid disability parking permit may park in these spaces.Van Accessible: These spaces are designed with a wider access aisle for special transport vehicles equipped with a lift. Although all persons holding a valid disability parking permit may park in van accessible spaces, permit holders are asked to use a regular disability parking space if they do not require the additional room. Wheelchair User & Program Placards: These spaces are designated for persons with disabilities who use wheelchairs or similar low-powered devices. Only persons that have a valid wheelchair user permit (placard includes “Wheelchair User” and a large white “W”) can park in these spaces. Golf Cart/Motorcycle Decal: Decals are a�xed to golf carts, motorcycles, or other similar vehicles. Form# 735-265P (7-20) ILYmirror before driving vehicle735-6500 (1-18) 18 19 2 0 2 1 2 2 2 3 2 4 2 5 2 6 2 7 2 8 2 9 JANFEBMARAPRMAYJUNJULAUGSEOCTNOVDECPARKING USE ONLY WHEN PERMIT HOLDER • OREGONWOUNDED WARRIOR EXPIRESON: TEMPORARY735-6500TP (5-14) STK # 305328OREGON JANFEBMARAPRMAYJUNJULAUGSEOCTPARKING USE ONLY WHEN PERMIT HOLDER 000000 EXPIRESON: TEMPORARY735-6500

4 TP (5-14) STK # 305328OREGON
TP (5-14) STK # 305328OREGON JANFEBMARAPRMAYJUNJULAUGSEOCTPARKING USE ONLY WHEN PERMIT HOLDER EXPIRESON: TEMPORARY735-6500TP (5-14) STK # 305328OREGON JANFEBMARAPRMAYJUNJULAUGSEOCTPARKING USE ONLY WHEN PERMIT HOLDER 000000 EXPIRESON: TEMPORARY735-6500TP (5-14) STK # 305328OREGON JANFEBMARAPRMAYJUNJULAUGSEOCTPARKING USE ONLY WHEN PERMIT HOLDER 000000 EXPIRESON: TEMPORARY735-6500TP (5-14) STK # 305328OREGON JANFEBMARAPRMAYJUNJULAUGSEOCTPARKING USE ONLY WHEN PERMIT HOLDER EXPIRESON: TEMPORARY735-6500TP (5-14) STK # 305328OREGON JANFEBMARAPRMAYJUNJULAUGSEOCTPARKING USE ONLY WHEN PERMIT HOLDER 4 4 4 4 4 4 4 4 4 4 4 4 This packet contains information on requirements to obtain an individual, wheelchair user, Oregon Wounded Warrior, or temporary disability parking permit or parking decal. Please complete all sections that apply and have your licensed physician complete the Certificate of Disability. There is no fee for the Parking Permit. After you have With the exception of the temporary permits, applicants must have an Oregon driver license, identification card, golf cart permit, or parking identification card to be issued an individual parking permit. If you do not have a driver license, card, golf cart driver permit, or parking identification card, you must apply for one. For information on these Parking in a public parking zone that has a limit of more than 30 minutes without being charged overtime Parking in a metered public parking zone that hasa limit of more than 30 minutes without paying the parking ary disability for the purpose of parking in chair or similar low-powered newed by submitting a new Individual Disabilityertificate of Oregon Wounded Warrior: Oregon Wounded Warrior permits are for individuals who qualify as an “Oregon Wounded Warrior.”To qualify as an Oregon Wounded Warrior, in addition to the completed Disability Parking Permit Application, Park in spaces that are marked or signed to provide parking for people with disabilities.ark in publicly designated p ay be renewed by submitting a new Individualas well as the documentation from the United States Veterans Affairs and (Continued on next page...