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Outline

The Kentucky TC 96 204 form is an essential document for individuals seeking a special parking permit designated for disabled persons. This application is crucial for those who face mobility challenges, allowing them to access designated parking spaces more easily. Applicants must provide their personal information, including name, phone number, and address, along with the Vehicle Identification Number (VIN) of the vehicle they own or lease. The form consists of three main sections: the first section is completed by the applicant, while the second section requires the County Clerk to attest to the applicant's disability status. In cases where additional verification is needed, the third section must be filled out by a licensed physician or an advanced practice registered nurse (APRN). This section outlines the specific disabilities that limit the applicant's ability to walk. It’s important to note that the application can be submitted for either a permanent or temporary disability. Completing this form accurately and promptly is vital for those in need, as it directly impacts their ability to secure the necessary parking accommodations.

Sample - Kentucky Tc 96 204 Form

Kentucky Transportation Cabinet

TC 96-204

Division of Motor Vehicle Licensing

July 2011

 

APPLICATION FOR DISABLED PERSON’S SPECIAL

 

PARKING PERMIT

 

(Complete and forward to your County Clerk.)

 

SECTION 1 – TO BE COMPLETED BY APPLICANT

Name: _____________________________________________________________________________ Phone: ________________________

Address: _______________________________________________________________________________________________________________

(Street or Post Office)(City)(State)(Zip Code)

VIN of the vehicle owned or leased by a person with a disability __________________________________________

CHECK ONE:

￿ License Plate or ￿ Placard

 

￿ Applicant now holds disabled parking license/placard No. HP _______________________________

 

￿ Applicant now holds disabled veteran license/placard No. HV _______________________________

 

￿ County Clerk attests that applicant is obviously disabled in Section 2 below.

 

￿ A licensed physician signs statement that applicant is disabled in Section 3 below.

__________________________________________________________

__________________________________________________________

(Signature of Applicant)

(Social Security)

Subscribed and sworn to before me this __________ day of _________________________________ 20 __________

My commission expires _________________________, 20 _________

________________________________________________

 

(Signature of Person Attesting Oath)

SECTION 2 – TO BE COMPLETED BY COUNTY CLERK

I hereby attest that the applicant is obviously disabled in compliance with KRS 186.042, and should be issued a special parking permit.

Signature of Clerk __________________________________________________________

County ________________________________

Section 3 need not be completed when Section 2 is completed.

SECTION 3 – TO BE COMPLETED BY A LICENSED PHYSICIAN OR ADVANCED PRACTICE

REGISTERED NURSE

I certify that the applicant is a person with disabilities which limit or impair the ability to walk 200 feet without stopping; without the use of assistant device; without portable oxygen; due to arthritic, neurological, or orthopedic condition; restricted by lung disease; or has a cardiac condition in compliance with KRS 186.042.

CHECK ONE: This is a

￿

￿

Permanent Disability

Temporary Disability

Signature of Licensed Physician/APRN _________________________________________________________________________________

Printed Name of Physician/APRN ______________________________________________ License # ______________________________

COUNTY CLERK’S USE ONLY

Previous Placard # __________________________________________________

Expires _____________________________________

New Placard # ______________________________________________________

Expires _____________________________________

Replacement Reason: __________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

County Clerk File Copy

Form Information

Fact Name Details
Form Title Kentucky Transportation Cabinet TC 96-204
Purpose This form is used to apply for a disabled person’s special parking permit.
Governing Law The application is governed by KRS 186.042.
Sections The form consists of three sections: Applicant Information, County Clerk Attestation, and Physician Certification.
Submission The completed form must be forwarded to the County Clerk.
Signature Requirement The applicant must sign the form, and a licensed physician or advanced practice registered nurse must also provide a signature in Section 3.
Expiration The form includes a section for the County Clerk to note the expiration date of the parking permit.
Additional Information The form allows for the indication of whether the disability is permanent or temporary.

Detailed Guide for Filling Out Kentucky Tc 96 204

Filling out the Kentucky TC 96-204 form is an essential step for obtaining a special parking permit for individuals with disabilities. After completing the form, it must be submitted to the County Clerk for processing. Here are the steps to fill out the form accurately:

  1. Begin with Section 1, which is for the applicant. Write your full name in the designated space.
  2. Provide your phone number to ensure the County Clerk can contact you if necessary.
  3. Fill in your complete address, including street or post office, city, state, and zip code.
  4. Enter the Vehicle Identification Number (VIN) of the vehicle owned or leased by the person with a disability.
  5. Check the appropriate box to indicate whether you are applying for a license plate or a placard.
  6. If applicable, fill in the number of any existing disabled parking license or placard you hold.
  7. Sign your name in the space provided to certify the information is accurate.
  8. Include your Social Security number as requested.
  9. Have a person authorized to attest the oath sign and date the form, noting their commission expiration date.
  10. Move to Section 2, which must be completed by the County Clerk. The Clerk will attest to your disability status by signing the form and noting the county.
  11. If Section 2 is completed, Section 3 does not need to be filled out. However, if required, it should be completed by a licensed physician or advanced practice registered nurse (APRN).
  12. The physician or APRN will certify the disability and check whether it is permanent or temporary.
  13. The physician or APRN must sign and print their name, along with their license number.
  14. Finally, ensure that the County Clerk's use section is completed with any previous placard number and expiration dates if applicable.

Obtain Answers on Kentucky Tc 96 204

  1. What is the Kentucky TC 96-204 form?

    The Kentucky TC 96-204 form is an application for a disabled person’s special parking permit. It is used to request either a disabled parking license plate or a placard that allows individuals with disabilities to park in designated spaces. This form must be completed and submitted to the county clerk.

  2. Who can apply for a disabled parking permit using this form?

    Individuals with disabilities that limit their ability to walk may apply for this permit. The application requires verification from either a county clerk or a licensed physician. The disabilities must meet specific criteria outlined in Kentucky law.

  3. What information is required to complete the form?

    The applicant must provide personal information, including their name, phone number, and address. Additionally, the vehicle identification number (VIN) of the vehicle owned or leased by the person with a disability is necessary. The applicant must also indicate whether they are applying for a license plate or a placard.

  4. How does the verification process work?

    The verification process involves two steps:

    • The county clerk must attest that the applicant is obviously disabled.
    • A licensed physician or advanced practice registered nurse (APRN) must certify that the applicant has a qualifying disability.

    Section 2 of the form is completed by the county clerk, while Section 3 is for the physician or APRN.

  5. Is there a difference between a permanent and temporary disability on the form?

    Yes, the form allows applicants to indicate whether their disability is permanent or temporary. This distinction is important as it affects the duration of the parking permit issued.

  6. What happens after the application is submitted?

    Once the completed form is submitted to the county clerk, it will be reviewed. If approved, the applicant will receive a special parking permit, either as a placard or a license plate, which will be valid for a specified period.

  7. Can the permit be replaced if lost?

    Yes, if a disabled parking permit is lost, the applicant can request a replacement through their county clerk. The reason for the replacement must be provided on the application form.

Common mistakes

Filling out the Kentucky TC 96-204 form can be straightforward, but many people make common mistakes that can delay the process. One frequent error is not providing complete contact information. Applicants often forget to fill in their phone number or address fully. Missing details can lead to confusion and delays in processing.

Another mistake involves the Vehicle Identification Number (VIN). Some applicants may write down the wrong VIN or leave it blank. The VIN is crucial for identifying the vehicle associated with the disabled parking permit. Double-checking this number is essential to avoid complications.

People sometimes check the wrong box when indicating whether they want a license plate or a placard. This choice is important, and making an incorrect selection can result in receiving the wrong type of permit. It's best to review this section carefully before submitting the form.

In Section 2, the County Clerk must attest to the applicant's disability. Some applicants mistakenly believe they can skip this section if they have a physician's statement. However, if the County Clerk does not complete their part, the application may be rejected.

Another common error is related to signatures. Applicants often forget to sign the form or neglect to have the person attesting the oath sign it as well. Both signatures are necessary to validate the application. Missing signatures can lead to delays or denials.

Section 3 requires a licensed physician or advanced practice registered nurse to certify the applicant's disability. Some applicants do not include this section when the County Clerk has attested to their disability. However, it is still important for the physician to complete their part if the applicant is seeking a permanent or temporary disability designation.

People sometimes overlook the expiration dates on previous placards. When applying for a new placard, it is essential to provide accurate information about any prior permits. Failing to do so can complicate the issuance of a new permit.

Another mistake is not specifying whether the disability is permanent or temporary. This distinction is important for the type of permit issued. Applicants should ensure they check the correct box to avoid confusion.

Finally, some applicants fail to provide a reason for a replacement if they are requesting one. The form has a section for this, and not filling it out can lead to questions from the County Clerk. Providing a clear reason helps streamline the process.

Documents used along the form

The Kentucky TC 96-204 form is essential for applying for a disabled person’s special parking permit. However, several other documents may be required or helpful in conjunction with this form. Below is a list of related documents that are often used alongside the TC 96-204.

  • Physician's Statement: This document is completed by a licensed physician or advanced practice registered nurse. It certifies the applicant's disability and is crucial for validating the need for a special parking permit.
  • Proof of Residency: Applicants may need to provide documentation that verifies their current address. This could include utility bills, lease agreements, or bank statements.
  • Identification Documents: A government-issued ID, such as a driver’s license or state ID, is often required to confirm the identity of the applicant.
  • Previous Parking Permit Documentation: If the applicant has previously held a disabled parking permit, they may need to provide details or copies of the old permit for reference.
  • Application for Renewal: For those renewing an existing permit, a specific renewal application may be necessary. This ensures that the permit remains valid and up-to-date.
  • County Clerk's Attestation Form: In some cases, a separate form may be required for the county clerk to officially attest to the applicant's disability status.

Having these documents ready can streamline the application process and help ensure that the request for a special parking permit is processed without delays. Be sure to check with your local county clerk for any additional requirements.

Similar forms

The Kentucky TC 96-204 form is used to apply for a special parking permit for individuals with disabilities. Several other documents serve similar purposes or are related in function. Here are nine documents that are comparable to the TC 96-204 form:

  • Application for Disabled Veteran License Plate: This form allows veterans with disabilities to apply for special license plates, similar to how the TC 96-204 permits access to disabled parking.
  • Application for Handicap Parking Placard: This document is specifically for individuals seeking a placard for parking, akin to the TC 96-204 but may vary in its requirements and processing.
  • Physician’s Certification for Disability: Often required for various disability-related applications, this form confirms an individual’s disability status, much like the physician's section in the TC 96-204.
  • State Vehicle Registration Application: This document registers a vehicle with the state. While not specifically for disabilities, it is essential for obtaining any type of license plate, including those for disabled individuals.
  • Temporary Disability Parking Permit Application: Similar to the TC 96-204, this application is for individuals who need a temporary parking solution due to a disability.
  • Application for Senior Citizen Discount License Plate: This form allows seniors to apply for discounted license plates, paralleling the TC 96-204 in its focus on special circumstances.
  • Application for Accessible Parking Space: This document requests the installation of accessible parking spaces in public areas, similar in intent to the TC 96-204’s goal of facilitating parking for individuals with disabilities.
  • Certification of Disability for Public Transportation: This form certifies an individual’s disability status for public transportation benefits, reflecting the same need for verification found in the TC 96-204.
  • Application for Special Needs Identification Card: This card identifies individuals with special needs, similar to how the TC 96-204 identifies those eligible for disabled parking permits.

Dos and Don'ts

When filling out the Kentucky TC 96-204 form, keep the following tips in mind:

  • Do ensure all information is accurate and complete.
  • Do include your full name, phone number, and address.
  • Do check the appropriate box for license plate or placard.
  • Do have a licensed physician or advanced practice registered nurse sign Section 3 if needed.
  • Do provide the VIN of the vehicle owned or leased by the person with a disability.
  • Don't leave any sections blank unless instructed.
  • Don't forget to sign and date the application.
  • Don't submit the form without confirming that the county clerk has completed Section 2.
  • Don't use white-out or correction fluid on the form.

Following these guidelines will help ensure your application is processed smoothly.

Misconceptions

Understanding the Kentucky TC 96-204 form is essential for individuals seeking a disabled person’s special parking permit. However, there are several misconceptions that can lead to confusion. Below is a list of common misunderstandings about this form, along with clarifications to help you navigate the process.

  • The TC 96-204 form is only for permanent disabilities. Many believe this form is exclusively for individuals with permanent disabilities. In fact, it accommodates both permanent and temporary disabilities.
  • A physician's signature is always required. While a physician's signature is necessary for certain cases, if the county clerk attests to the applicant's obvious disability, Section 3 does not need to be completed.
  • Only certain medical conditions qualify. There is a misconception that only specific medical conditions are recognized. The form actually covers a broad range of disabilities that impair walking ability.
  • The application can be submitted without any supporting documents. Applicants must provide necessary documentation, including a physician's statement or the county clerk's attestation, to support their claim.
  • Anyone can fill out the form. The form must be completed by the individual applying for the permit, not by someone else on their behalf, unless legally authorized.
  • There is no expiration for the permit. Some individuals think that once issued, the permit lasts indefinitely. However, permits do have expiration dates and must be renewed.
  • There is a fee for the application. Many assume there is a cost associated with submitting the TC 96-204 form. In most cases, there is no fee for the application itself.
  • Permits are transferable between vehicles. It is a common belief that disabled parking permits can be used in any vehicle. However, they are typically issued for specific vehicles and should not be shared.
  • All counties process the application the same way. Some applicants think the process is uniform across the state. In reality, each county may have different procedures or requirements.
  • Once approved, the permit is automatically mailed. Many expect that approval means the permit will be sent automatically. However, applicants may need to pick up their permit from the county clerk's office.

By addressing these misconceptions, individuals can better understand the requirements and processes associated with the Kentucky TC 96-204 form. This knowledge can facilitate a smoother application experience and ensure that individuals receive the necessary accommodations they deserve.

Key takeaways

When filling out the Kentucky TC 96-204 form, keep these key points in mind:

  • Complete all sections: Make sure to fill out all required sections accurately to avoid delays.
  • Provide personal information: Include your name, address, and phone number clearly.
  • Vehicle Information: Don’t forget to enter the VIN of the vehicle owned or leased by the person with a disability.
  • Signature Requirements: Ensure that the form is signed by both the applicant and the county clerk or a licensed physician.
  • Temporary vs. Permanent: Indicate whether the disability is temporary or permanent, as this affects the type of permit issued.
  • Submission: Submit the completed form to your County Clerk’s office to obtain your special parking permit.

Following these steps will help ensure a smooth application process for your disabled person’s special parking permit in Kentucky.