The handicap parking permit application is the paper form the Nebraska Department of Motor Vehicles (DMV) uses to issue a handicapped parking permit. It covers a new permit, a renewal, a second permit and a replacement, and it includes a medical certificate that a licensed physician, physician assistant or nurse practitioner completes. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the DMV publishes the original at dmv.nebraska.gov and mails the permit once the application is processed.
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What is Handicap Parking Permit Application – Nebraska?
The Application for Handicapped Parking Permit is the Nebraska Department of Motor Vehicles (DMV) form, issued through its Driver and Vehicle Records Division, used to request a handicapped parking permit. The DMV lists it among its Handicap Plates and Handicap Permits forms.
At the top you mark the request type: New, Renewal (with the previous permit number), Second Permit (with the current permit number) or Replacement for a lost or damaged permit (with the permit number). You also mark Permanent or Temporary, and you may enter a vehicle license plate number. Below that are your name, date of birth, address, sex and phone number, plus your signed statement that you know your rights, duties and responsibilities and the penalties for handicapped parking infractions.
The middle of the form is a Medical Certificate. A licensed physician, physician assistant or nurse practitioner marks the qualifying condition (visual, physical or neurological impairment limiting mobility, respiratory problems, a Class III or IV cardiac condition, or permanent loss of use of one or more limbs) and certifies it. A box for issuing-site use only closes the form.
The reverse side explains proper use: the permit is not transferable, cannot be altered or reproduced, and is used only when a disabled person enters or exits the vehicle in a designated space. No more than two permits are issued to one handicapped individual.
Who needs to file Handicap Parking Permit Application – Nebraska?
A person with a handicap or disability that limits mobility, as certified by a licensed physician, physician assistant or nurse practitioner, uses this application to get a handicapped parking permit in Nebraska. The form separates two kinds of permit:
- Permanent: for a handicap or disability the medical professional determines to be a permanent medical condition.
- Temporary: for a handicap or disability the medical professional expects to limit mobility no longer than one year.
Existing permit holders also use the form: to renew, to request a second permit, or to replace a permit that was lost, stolen or damaged. No more than two permits are issued to a handicapped individual, and individuals are limited to two replacements.
Your medical professional completes the Medical Certificate, not you. If that professional is licensed in Nebraska, the DMV instructions say they may submit a new or renewal request through the Online Handicap Parking Permit service. If they are not licensed to provide medical services in Nebraska, a paper application is necessary.
When to file Handicap Parking Permit Application – Nebraska
File the application when you need a new permit, or when an existing permit is nearing expiration, needs a second copy or has been lost or damaged.
- Permanent permit renewal: you may submit the application 180 days before expiration. Renewal permits are not mailed until 10 days before the previous permit expires. A permanent permit expires on the last day of the month of the holder's birthday in the sixth year after issuance.
- Temporary permit renewal: you may submit it any time within the month of expiration; the renewal is mailed 10 days before the previous permit expires. A temporary permit can be renewed one time only. It is issued for three or six months, based on the recovery date the medical professional gives.
- Replacement: request it when a valid permit has been lost or stolen. A new application with medical certification is required if the second permit is lost or stolen.
The form prints no processing time. Once processed, the DMV mails the permit to the applicant.
Documents you need
- A photocopy of acceptable proof of identification, mailed with a paper application and with a second-permit or replacement request submitted by paper.
- Valid driver's license, as proof of ID.
- Valid state identification card, as proof of ID.
- Valid certified birth certificate, as proof of ID.
- Valid passport, as proof of ID.
- Another valid, reliable form of identification containing date of birth, or a combination of valid, reliable forms containing date of birth.
- Completed Medical Certificate on the form, signed by a licensed physician, physician assistant or nurse practitioner, for a new or renewal application and when a second replacement permit is lost or stolen.
How to fill out Handicap Parking Permit Application – Nebraska
Mark the type of request
At the top, mark one: New, Renewal with the previous permit number, Second Permit with the current permit number, or Replacement (lost/damaged) with the permit number.
Mark permanent or temporary
In the second column, mark Permanent or Temporary (limited mobility expected to be temporary). You may also enter the vehicle license plate number.
Print your name and birth date
Print your last, first and middle initial, and your date of birth as Month/Day/Year.
Enter address, sex and phone
Print your street, route or PO Box, city, state and ZIP; mark Male or Female; and add your phone number with area code.
Sign and date the statement
Sign and date the applicant statement that you are aware of your rights, duties and responsibilities and the penalties for handicapped parking infractions.
Have the medical professional certify
Take the form to a licensed physician, physician assistant or nurse practitioner, who marks the qualifying condition. For a temporary permit, they mark 3 Months or 6 Months.
Complete the certifier's details
The certifier prints their name, phone, medical practice name and address, then signs with title and date. This section must be complete before the application can be processed.
Leave the issuing site box blank
Do not fill in the For Issuing Site Use Only section (issuing site, phone, proof of identity submitted, verifier's signature).
Review and download the completed PDF
Check each entry and signature, then download or print the completed PDF from FillingPDF. Add a photocopy of your proof of ID and submit as described under How to submit.
How to submit Handicap Parking Permit Application – Nebraska
You can submit through your medical professional online, or by mailing the paper application to the DMV.
- Online (medical professional): a Nebraska-licensed physician, physician assistant or nurse practitioner may submit your new or renewal request through the Online Handicap Parking Permit service at https://dmv.nebraska.gov/services.
- Online (second or replacement permit): a permit holder can request these at the same address using the Personal Identification Number (PIN) on the Permit ID Card.
- By mail: have your medical professional complete the Medical Certificate, then mail the application with a photocopy of acceptable proof of identification to: Nebraska Department of Motor Vehicles, Driver and Vehicle Records Division, Attn: Handicapped Parking Permits, PO Box 94789, Lincoln, NE 68509-4789. A paper application is necessary if your medical professional is not licensed in Nebraska.
- Second permit or replacement by paper: complete the top portion, check Second Permit or Replacement, and send it to the DMV with acceptable proof of identification.
Leave the "For Issuing Site Use Only" box blank. FillingPDF lets you fill out and download the PDF; submission follows the DMV channels above.
Common mistakes to avoid
- Mailing the application without the Medical Certificate completed by a licensed physician, physician assistant or nurse practitioner.
- Leaving out the photocopy of acceptable proof of identification when mailing the paper application.
- Marking Temporary without marking 3 Months or 6 Months in the certifier's section; that section must be complete before the application can be processed.
- Applying for a third permit; no more than two permits are issued to a handicapped individual.
- Requesting a third replacement; individuals are limited to two replacements, and a new application with medical certification is required after the second permit is lost or stolen.
- Submitting a permanent renewal earlier than 180 days before expiration, or expecting the renewal permit to be mailed sooner than 10 days before expiration.
- Trying to renew a temporary permit a second time; temporary permits may be renewed one time only.
- Writing in the For Issuing Site Use Only box, which is reserved for the issuing site.
- Mailing the form to a street address instead of PO Box 94789, Lincoln, NE 68509-4789.
Frequently asked questions
What is the handicap parking permit application in Nebraska?
It is the Nebraska DMV's Application for Handicapped Parking Permit. It is used to request a new, renewal, second or replacement permit and includes a Medical Certificate that a licensed physician, physician assistant or nurse practitioner completes.
Who can complete the medical certificate?
A licensed physician, physician assistant or nurse practitioner. If that professional is licensed in Nebraska, they may submit a new or renewal request through the DMV's online service; otherwise a paper application is necessary.
Where do I mail the handicap parking permit application?
Mail it, with a photocopy of acceptable proof of ID, to Nebraska Department of Motor Vehicles, Driver and Vehicle Records Division, Attn: Handicapped Parking Permits, PO Box 94789, Lincoln, NE 68509-4789.
What ID do I need to send with the application?
A photocopy of a valid driver's license, state ID card, certified birth certificate or passport. Another valid, reliable ID containing your date of birth, or a combination of such IDs, is also acceptable.
How long is a Nebraska handicap parking permit valid?
A permanent permit expires on the last day of the month of your birthday in the sixth year after issuance. A temporary permit is issued for three or six months, based on the recovery date your medical professional gives.
How do I replace a lost handicap parking permit?
Request a replacement online at https://dmv.nebraska.gov/services with the PIN on your Permit ID Card, or check Replacement on the application and send it with proof of ID. You are limited to two replacements.
Can I fill out the handicap parking permit application online?
You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is independent of the Nebraska DMV and does not submit the application; you mail it or use the DMV's channels described on this page.
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