The Texas Parking VTR 214 form is an application used to request a parking placard and/or license plate for persons with disabilities. This form enables eligible individuals to obtain necessary accommodations, allowing for easier access to public facilities. Applicants must provide proof of eligibility and submit the completed form to their local county tax assessor-collector’s office for processing.
The Texas Parking VTR 214 form serves as a crucial application for individuals seeking a parking placard or license plate designated for persons with disabilities. This form allows eligible individuals to obtain the necessary documentation to access designated parking spaces, which can significantly enhance their mobility and independence. Applicants can request either a parking placard or a specialized license plate, depending on their needs. The application process requires proof of eligibility, which must be verified by a licensed medical professional. Importantly, there are no fees for placards issued to individuals with permanent disabilities, while a nominal fee applies for those with temporary disabilities. The form outlines specific limits on the number of placards and license plates that can be issued, ensuring compliance with state regulations. Additionally, it includes sections for personal identification, vehicle information, and certification of eligibility, all of which must be completed accurately to avoid delays in processing. Individuals applying by mail must include a copy of their photo identification and are advised against sending cash. The VTR 214 form is not just a bureaucratic necessity; it represents a vital resource for enhancing accessibility for individuals with disabilities throughout Texas.
Application for Persons with Disabilities Parking Placard and/or License Plate
County Use Only
License No
Parking Placard 1
Parking Placard
County No
Date Issued
Instructions
Persons with Disabilities Parking Placard: Submit the completed application and payment (if required) in the form of a personal check, money order, or cashier’s check with proof of eligibility to your local county tax assessor-collector’s office or the county tax assessor- collector’s office where you are seeking medical treatment.
Persons with Disabilities License Plate: Submit the completed application and payment (if required) in the form of a personal check, money order, or cashier’s check with proof of eligibility to your local county tax assessor-collector’s office.
Contact the appropriate local county tax assessor-collector’s office for processing application by mail. Do not mail cash. Include a copy of the photo identification (ID) if applying by mail.
IMPORTANT: The signature of a licensed medical professional must be notarized on page 2 if an original prescription is not submitted. Otherwise an original prescription must include the disabled person's name, the signature of the licensed medical professional (as defined on page 2), and a statement if the disability is permanent or temporary.
•A parking placard may be issued to persons with a permanent or temporary disability. There is no fee for a placard issued to a person with a permanent disability, and a $5 fee (per placard) if issued to a person with a temporary disability.
•Disabled Person license plates displaying the International Symbol of Access (ISA) may be issued to persons with a permanent disability (limit one set of plates).
•Limit one (1) placard for persons with Disabled Person license plates. Limit two (2) placards for persons with no Disabled Person license plates.
•Attach a separate application if an additional set of Disabled Person plates is needed for certain specially equipped vehicle(s) with gross weight of 18,000 lbs. or less.
•Active duty U.S. military may list an out of state Driver License (DL) or military ID number.
•Non-Texas residents seeking medical treatment in Texas may provide an out of state or out of country DL or ID number.
Applicant Information
First Name
Middle Name
Last Name
Suffix
Institution Name (if applicable)
Address
City
State
ZIP
Email
Phone Number
Identification Statement – State law makes falsifying information a third degree felony.
Please include your Driver License number (DL #) or Identification Card number (ID #) on this application. The DL or ID # provided on this application will be partially shown on the placard issued. My signature below indicates that I am (check one):
the person with the disability listed above. DL or ID # and state of issuance
making application on behalf of a person with a disability and my vehicle is used to regularly transport the person with the disability. DL or ID # and state of issuance
the administrator or manager of an institution licensed to transport persons with disabilities defined under Transportation Code,
Section 681.0032. DL or ID #. Institutions, facilities, and residential retirement communities licensed under Chapter 242, 246, or 247 of the Health and Safety Code must list a facility ID # issued by the agency:
Application for Parking Placard(s) and/or Disabled Person License Plate(s) – Check one below.
Disabled Person License Plate(s) with no Parking Placard
One (1) Parking Placard with no Disabled Person License Plate(s)
Disabled Person License Plate(s) and one (1) Parking Placard Two (2) Parking Placards with no Disabled Person License Plate(s) Vehicle Information for License Plate(s) – Complete only if you are applying for Disabled Person plate(s).
Vehicle Identification Number
Current TX Plate
Year
Make
Vehicle Type
Passenger Car (up to 18,000 lbs.)
Truck (up to 18,000 lbs.)
Motorcycle/Moped
Certification – State law makes falsifying information a third degree felony.
I meet the eligibility requirements as listed on this application and am providing proof to that effect, or I am making application on behalf of a person with a disability as indicated in the Identification Statement above.
Signature:
Date:
Form VTR-214 Rev. 8/2019
Form available online at www.TxDMV.gov
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Definitions
Transportation Code, Section 681.001(2) defines a disability as a condition in which a person has:
(a)mobility problems that substantially impair the person's ability to ambulate;
(b)visual acuity of 20/200 or less in the better eye with correcting lenses; or
(c)visual acuity of more than 20/200 but with a limited field of vision in which the widest diameter of the visual field subtends an angle of 20 degrees or less.
Transportation Code, Section 681.001(5) defines a mobility problem as one that substantially impairs a person's ability to ambulate, and the person:
(a)cannot walk 200 feet without stopping to rest;
(b)cannot walk without the use of or assistance from an assistance device, including a brace, cane, crutch, another person or a prosthetic device;
(c)cannot ambulate without a wheelchair or similardevice;
(d)is restricted by lung disease to the extent that the person's forced respiratory expiratory volume for one second, measured by spirometry, is less than one liter, or the arterial oxygen tension is less than 60 millimeters of mercury on room air at rest;
(e)uses portable oxygen;
(f)has a cardiac condition to the extent that the person's functional limitations are classified in severity as Class III or Class IV according to standards set by the American Heart Association;
(g)is severely limited in the ability to walk because of an arthritic, neurological, or orthopedic condition;
(h)has a disorder of the foot that, in the opinion of a physician licensed to practice medicine in this state or in a state adjacent to this state, limits or impairs the person's ability to walk; or
(i)has another debilitating condition that, in the opinion of a physician licensed to practice medicine in this state or a state adjacent to this state, or authorized by applicable law to practice medicine in a hospital or other health facility of the Veterans Administration, limits or impairs the person's ability to walk.
Disability Statement – This section to be completed by a Licensed Medical Professional.*
*A Licensed Medical Professional is defined as a physician, podiatrist, optometrist, or qualifying physician's assistant or advanced practice nurse as defined in Chapter 301, Occupations Code. At least one of the following conditions must be met:
•Licensed in Texas, Arkansas, Louisiana, New Mexico, or Oklahoma; or
•Must practice medicine in a U.S. military installation based in Texas;or
•Must practice medicine in a hospital or health facility of the U.S. Department of Veterans Affairs.
I certify that
has a permanent, or temporary disability as defined above.
Printed Name of Person with a Disability or Mobility Problem
Printed Name of Licensed Medical Professional
Professional License Number
Date
Signature of Licensed Medical Professional
Mailing Address
Notary – This section must be completed by a notary if an original prescription is not submitted.
On this date,
the above named licensed medical professional
Name
appeared before me so that I could witness his or her signature.
State of, County of
S T A M P
Notary Public
H E R E
My commission expires
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