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  • Az Dot 96-0104 2017

Get Az Dot 96-0104 2017

Azdot.gov 960104 R01/17 Mail Drop 801Z Special Plates Unit Motor Vehicle Division PO Box 2100 Phoenix AZ 850012100 INDIVIDUAL DISABILITY HEARING IMPAIRED PLATE/PLACARD APPLICATION Clear Application.

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How to fill out the AZ DoT 96-0104 online

The AZ DoT 96-0104 form is essential for individuals with disabilities seeking to obtain special plates or placards. This guide provides clear, step-by-step instructions on how to complete the application process online, ensuring a smooth and efficient experience.

Follow the steps to complete the application for disability plates or placards.

  1. Click ‘Get Form’ button to access the application form in your preferred online format.
  2. Select the type of application you are submitting by marking the appropriate box — either ‘New Plate’ or ‘New Placard’. For renewals, be sure to obtain form # 40-0112.
  3. Provide the applicant's name, which should include a person with a disability or hearing impaired, and fill in your phone number and date of birth.
  4. Enter your driver license number and physical address, including city, state, and zip code.
  5. If your application is not being submitted in person, include your mailing address. This is mandatory for applications sent via mail.
  6. For plate applicants only: Fill in vehicle information, including Vehicle Identification Number, year, make, and current plate number. This information must pertain to a vehicle owned or leased by the applicant.
  7. Complete the medical certification section by providing details from the authorized health professional. This section must include their name, medical license or certification number, phone number, and mailing address.
  8. Ensure the health professional provides their signature and the date the certification was completed. Note that a signature stamp is not accepted.
  9. If applicable, fill out the information stating why the medical certification was not completed by the authorized professional from another state, including the plate or placard number.
  10. Sign the application form, certifying that the information provided is accurate and that you understand the responsibility associated with the Disability Placard(s) or Plates.
  11. Review all entered information for accuracy before final submission. Upon completion, you can save your changes, download, print, or share the form as needed.

Complete your AZ DoT 96-0104 application online today for efficient processing and to obtain your disability plates or placards.

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To apply for a disability placard in Arizona, start by gathering the required documentation, including proof of your disability. You can complete the application form available through the AZ DoT 96-0104 webpage. After filling out the form, submit it along with any necessary medical certifications to your local motor vehicle division for processing.

In Arizona, qualifying for a handicap placard involves having a medical condition that limits your mobility. This includes disabilities from birth, diseases, or injuries that significantly impede your ability to walk. The AZ DoT 96-0104 guidelines provide detailed criteria for determining eligibility, making it crucial to review them carefully when applying.

In Arizona, a 100% VA disability rating provides veterans with significant benefits, including access to specialized health care, increased monthly compensation, and potential tax exemptions. Additionally, these veterans may qualify for various state programs aimed at assisting those with disabilities. Understanding these benefits is key to maximizing your entitlements, especially regarding the AZ DoT 96-0104 program, which can further aid your mobility.

Yes, you can use your AZ handicap placard in many other states, as most states recognize valid handicap placards issued by your home state. However, it's a good idea to verify local regulations, as rules may vary. Keep your AZ DoT 96-0104 placard displayed properly in your vehicle to avoid any issues while traveling.

To obtain a handicap placard in Arizona, start by completing the AZ DoT 96-0104 application form. You can find this form online or at your local Motor Vehicle Division. After you complete the application and gather necessary documents confirming your disability, submit your application in person or by mail. The placard will be mailed to you once your application is approved.

To apply for a handicap placard in Arizona, you need to complete the application form, known as the AZ DoT 96-0104. You can download this form from the Arizona Department of Transportation's website. After filling it out, visit your local Motor Vehicle Division office or submit it by mail. Ensure you have the necessary documentation, such as proof of disability.

Yes, a 100% disabled veteran can obtain a handicap placard in Arizona. Veterans with such a designation qualify for benefits that include accessible parking privileges. By submitting the appropriate paperwork, including the AZ DoT 96-0104 form, veterans can enjoy the advantages of a handicap placard.

To obtain a temporary handicap placard in Arizona, you must complete the AZ DoT 96-0104 form. Ensure your healthcare provider verifies your temporary disability and signs the form. Once you submit the completed form to the AZ DoT, you will receive your placard, helping you access accessible parking spaces during your recovery.

A temporary disability placard in Arizona allows individuals with temporary disabilities to park in designated accessible spaces. This placard, issued by the AZ DoT, provides convenience and ensures that those with temporary conditions have access to necessary locations. The AZ DoT 96-0104 is the specific form used to apply for this placard, making it a straightforward process for those in need.

To get an AZ handicap placard, contact your doctor to discuss your eligibility. Your doctor will need to complete the AZ DoT 96-0104 form to document your disability. Submit this form along with your application to the Arizona Department of Transportation to acquire your placard.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Your Privacy Choices
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
altaFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
AZ DoT 96-0104
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