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Get Form To Renew Handicap Placard

RED P.O. Box 68268 Harrisburg, PA 17106-8268 FOR DEPARTMENT USE ONLY CHECK ( ) APPROPRIATE BLOCKS BELOW - See reverse side for instructions and eligibility requirements A ORIGINAL REQUEST - Person with Disability Severely Disabled Veteran Temporary Placard PLACARD # (if applicable) REPLACEMENT/RENEWAL REQUEST (NOTE: Temporary Placards may not be extended for an additional period of time.) CHANGE OF ADDRESS/NAME APPLICANT INFORMATION - LIST NAME AND ADDRESS.

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