ADA Placard

Important Message from Delaware Division of Motor Vehicles

New ADA Placard

This form is for the request of a new ADA placard when age 80 is reached. If you do not already have a placard and need one for a medical condition, you will need to apply in person at your local DMV branch. If you already have an ADA placard and wish to renew, please use this form to apply.

Click here for information on the Accessible Parking Etiquette.

NOTE: Please have your drivers license or ID handy before you begin. Fields denoted by an asterisk (*) are required.

Contact Information

* Last Name:

* First Name:

Middle Initial:

* Address 1:

Address 2:

* City:

* State:

* Zip:

* Email Address

* Primary Phone No.

- -

Identification Information

* Drivers License/Identification Number

* Date of Birth

* Last 4-digits of SSN

Self Certification Information

I certify, under penalty of law, that the above information is true and correct. I also understand that false representation by me can lead to penalties as provided by law as follows: Any person who has not reached the age of 80, and who intentionally and falsely represents that such person has the qualifications to obtain such a parking ID placard in an attempt to obtain such placard shall for the first offense be fined $100. For each subsequent like offense, the person shall be fined $200, or imprisoned not less than 10 nor more than 30 days, or both.

I accept

I Do not accept

Security Code

* denotes required entry

INFORMATION

SERVICES

SERVICE DISCLAIMER: Customers are required to wear shirts and shoes in order to conduct business at DMV. Services will not be rendered if customers are not wearing shirts or shoes. Thank you for your understanding.

REASONABLE MODIFICATIONS: In accordance with the Americans with Disabilities Act (ADA), the Delaware Division of Motor Vehicles (DMV) will make reasonable modifications to policies, practices, and procedures when necessary to provide access to individuals with disabilities. If you need a reasonable modification for your DMV visit, please email DMVCustomerService@delaware.gov or call 302-744-2500 in advance of your visit for assistance and guidance.

CONTACT US

Wilmington: (302) 434 3200
Delaware City: (302) 326 5000
Dover: (302) 744 2500
Georgetown: (302) 853 1000
Email: DMV Customer Svc