INFORMATION PACKET # 5 DISABLED PERSON PARKING PERMIT This packet has been designed by the Constitutional Tax Collector’s Office to expedite your application for a permanent or temporary Florida Disabled Person Parking Permit. Permanent disabled person parking permits are issued for four years. Temporary disabled person parking permits may be issued for a period of up to six months. 1. A completed Application for Disabled Person Parking Permit, form HSMV 83039 REV. 06/15/12. Instructions are provided on the back of the application. Faxes or copies of form HSMV 83039 are NOT acceptable. 2. A Florida driver license number or Florida identification card number is required unless the authorized physician certifies the applicant’s disability is too severe to visit or be transported to an office (the special exception section must be completed on the front of the application). 3. Organizations providing regular transportation service to disabled persons must provide either a FEID number or a Florida sales tax registration number. 4. For more information on REAL ID driver license or to make an appointment
or visit www.pbctax.com.
5. A photocopy of your Florida Driver License or Florida Identification Card if applying by mail. There is no fee for a Permanent Disabled Person Parking Permit. The fee for a Temporary Disabled Person Parking Permit is $15.00. An information flyer listing the Tax Collector’s office hours and locations is included for your convenience. ANNE M. GANNON, CONSTITUTIONAL TAX COLLECTOR, SERVING PALM BEACH COUNTY PBCTC FORM 53 (04/13) FLORIDA DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
APPLICATION FOR DISABLED PERSON PARKING PERMIT
*******SUBMIT APPLICATION TO YOUR LOCAL COUNTY TAX COLLECTOR'S OFFICE OR LICENSE PLATE AGENCY*******
www.flhsmv.gov/offices/
This form is not valid for more than 12 months from the date of the certifying authority’s signature.
APPLICATION BY DISABLED PERSON (See Warning Below)
Please Print/Type below
I certify that I am a person with one of the disabilities listed in section 320.0848, Florida Statutes. I further state that my physician or other
certifying practitioner has completed the statement of certification below on my behalf, as required in section 320.0848, Florida Statutes.
Name of Disabled Person as printed on their
Florida Driver License or Florida ID Card
Date of Birth
Sex
Current Disabled Parking Permit Number
(if applicable)
Disabled Person’s E-mail Address
Address
Signature of Disabled Person or Guardian of the Disabled
Person
Disabled Person’s Phone Number Date Signed
City
State
Florida Driver License or Florida ID Number:
(Required for permanent and temporary parking permits
unless exception is noted by physician below)
Zip
If applicable, check one of the following:
I am a frequent traveler.
I am a quadriplegic.
PHYSICIAN/CERTIFYING PRACTITIONER'S STATEMENT OF CERTIFICATION (See Warning Below)
TEMPORARY PERMIT: This is to certify that the applicant named above is a person with a temporary disability (six months or less) that limits or impairs his/her ability to
walk or is temporarily sight impaired. Due to the temporary specific disability(ties) checked below (2-8), the disabled person parking permit should be issued from
__________________________ (date) through ___________________________ (date).
PERMANENT PERMIT: This is to certify that the applicant named above is legally blind or is a disabled person with a permanent disability (ties) that limits or impairs
his/her ability to walk 200 feet without stopping to rest. Specify below (2-8) either legally blind or the specific disability (ties).
DISABILITY TYPE AS DISPLAYED IN FRVIS:
2. Inability to walk without the use of or assistance from a brace, cane, crutch, prosthetic device, or other assistive device, or without assistance of another person. If the
assistive device significantly restores the person's ability to walk to the extent that the person can walk without severe limitation, the person is not eligible for the
exemption parking permit.
3. The need to permanently use a wheelchair.
4. Restriction by lung disease to the extent that the person's forced (respiratory) expiratory volume for 1 second, when measured by spirometry, is less than one liter or
the person's arterial oxygen is less than 60 mm/hg on room air at rest.
5. Use of portable oxygen.
6. Restriction by 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.
7. Severe limitation in a person's ability to walk due to an arthritic, neurological, or orthopedic condition.
8. Legally Blind (This is the only disability an Optometrist can certify.)
WARNING: Any person who knowingly makes a false or misleading statement in an application or certification under section 320.0848, Florida Statutes, commits a
misdemeanor of the first degree, punishable as provided in section 775.082 or 775.083, F.S. The penalty is up to one year in jail or a fine of $1,000 or both.
Certification or License No. (Required) _____________________________ of a Physician, Osteopathic or Podiatric Physician, Chiropractor,
Optometrist, Advanced Registered Nurse Practitioner under the protocol of a licensed physician or a Physician Assistant licensed under
Chapter 458 or 459.
LICENSED IN THE STATE OF
Print/Type Name of Certifying Authority
Business Address
State
Certifying Authority Signature
Date Signed:
City
Zip
(Area Code)Telephone Number
SPECIAL EXCEPTION: The severely disabled applicant named above applying for a permanent placard is unable to obtain a Florida driver license or Identification card.
If the Special Exception box is checked, the certifying physician must provide his/her signature and date signed below.
If the Special Exception box is checked, one of the conditions in boxes 2-8 above must also be checked.
Certifying Authority Signature:
Date Signed:
APPLICATION BY AN ORGANIZATION (See Warning Above)
This is to certify that
their ability to walk or are certified to be legally blind.
Number of Vehicles in fleet for this purpose:
________ provides regular transportation service to disabled persons having disabilities that limit or impair
FEID NUMBER
Organization’s E-mail Address
Signature of Organization’s Authorized Representative
Address:
Date Signed:
City:
State:
Zip:
TAX COLLECTOR USE ONLY
Agency Personnel Processing this Application
HSMV 83039 - REV. 09/07/12
County
www.flhsmv.gov
Agency
Date
PROVISIONS OF LAW: Section 316.1958, Florida Statutes, provides that motor vehicles displaying a license plate or parking permit issued to a disabled person by any other state or district subject to laws of the United States, shall be recognized as a valid plate or permit, allowing such vehicle the special parking privileges in Florida, provided such other state or district grants reciprocal recognition for disabled residents of this state. All of the United States has agreed to reciprocate. Section 320.0848, Florida Statutes, provides for the issuance of the disabled person parking permit. This section was amended to no longer allow the applicant to qualify because they are unable to walk 200 feet. This disability must be due to a condition listed in (b‐g) on the reverse side of this form in the "Physician/Certifying Practitioner's Statement of Certification" section. Section 320.0848(1)(d), Florida Statutes, provides that beginning October 1, 2012, the department shall renew the disabled parking permit of any person certified as permanently disabled on the application if the person provides a certificate of disability issued within the last 12 months pursuant to this subsection. RENEWAL INSTRUCTIONS: Beginning October 1, 2012, submit a copy of the registration for your expiring parking permit and a certificate of disability (form HSMV 83039) completed and signed by the certifying authority within the last 12 months by mail or in person to the tax collector office or license plate agency in the county where you live. For a temporary permit, submit the appropriate fees. Contact your local county tax collector's office or license plate agency for fee information. APPLICATION REQUIREMENTS: 1. The form HSMV 83039 must be accurately completed, including the "Physician/Certifying Practitioner's Statement of Certification" section, verifying the disability. See list below for acceptable "certifying authorities”. 2. A Florida driver license number or Florida identification number is required unless the authorized physician certifies that the applicant’s disability is too severe to visit or be transported to an office to obtain a driver’s license or identification card. 3.
Fees: There is no charge for a Permanent Parking Placard. A Temporary Parking Placard is $15. Note: If a second Temporary Parking Placard is required within one year of the initial Temporary Parking Placard, there will be no charge. If a second Temporary Parking Placard is required outside the one year issuance, a fee of $15 would be required. CERTIFYING AUTHORITIES: The "Physician/Certifying Practitioner's Statement of Certification" section on the reverse side of this form MUST be completed by one of the following and must include the certifying authority's license number and the name of the state where their license was issued: 







Physician licensed to practice under Chapters 458, 459 or 460, Florida Statutes, or similarly licensed by another state. NOTE: Documentation of the physician's licensure in the other state must be submitted. Osteopathic Physician. Podiatric Physician. Chiropractor. Optometrist (for sight only). Physician who practices medicine in a military medical facility, state hospital, or federal prison. Indicate the facility and the address. Advanced registered nurse practitioner licensed under Chapter 464, under the protocol of a licensed physician. Physician assistant licensed to practice under Chapter 458 or Chapter 459. MISCELLANEOUS INFORMATION: 1. 2. 3. 4. 5. 6.
An additional permit may be issued to a disabled person who qualifies as a frequent traveler or as a quadriplegic. An organization may be issued as many disabled person parking permits as it has vehicles (that are used to transport disabled persons). Temporary parking permits are issued for the time period specified by the certifying authority, not to exceed six (6) months. Permits issued to disabled persons will expire in four years on the owner's birthday. Permits issued to an organization will expire in four years on June 30. The permit must be hung on the rear view mirror of any vehicle used to transport the disabled person(s) while parked in a designated disabled person parking space. The permit number must be visible from the front of the vehicle. It is unlawful for any person to obstruct the path of travel to an accessible parking space, curb cut, or access aisle by standing or parking a vehicle within any such designated area. Check your local phone book government pages or visit the following website for current mailing addresses: http://www.flhsmv.gov/offices/ HSMV 83039 - REV. 09/07/12
www.flhsmv.gov
What’s new?
Effective July 1, 2012: Replacements for lost or
stolen (form HSMV 83146 Application for
Replacement License Plate, Validation Decal or
Parking Permit) disabled person parking permits
must have current certification. Replacements
now require a certificate of disability completed
and signed by the certifying authority (a list of
certifying authorities can be found on the second page of form HSMV 83039) within the
last 12 months.
Effective Oct. 1, 2012, any person issued a blue permanent disabled parking permit
must renew the permit every four years and when doing so, provide a certificate of
disability completed and signed by the certifying authority (a list of certifying
authorities can be found on the second page of form HSMV 83039 ) within the last
12 months.
What did they have to do before?
Currently, permanent disabled parking permit holders must renew their parking permit
every four years, but they did not have to submit a certificate of disability when
renewing.
For more information on disabled parking permits the public can go to this page
on the DHSMV Web site: http://www.flhsmv.gov/dmv/disabled_pkg.html .
Dos and Don’ts for Using a Florida Disabled Parking Permit:
http://www.flhsmv.gov/dmv/dosanddonts.html
Who sponsored the legislation?
Sen. Gwen Margolis and Rep. John Julien.
Who advocated for this change?
Several groups supported the bill. Media can contact Jenna Labadie Paladino, National
MS Society, Director of Public Policy at (813) 374-0625 for more information.
Number of permits statewide as of May 1, 2012:
Permanent
Temporary
PERMIT COUNT MAY 2012
1352044
27835
Laws that apply to enforcement of disabled parking permits:
316.1955 Enforcement of parking requirements for persons who have disabilities.
316.1958 Out-of-state vehicles bearing identification of issuance to persons who have
disabilities.—
320.0848 Persons who have disabilities; issuance of disabled parking permits;
temporary permits; permits for certain providers of transportation services to persons
who have disabilities.—
316.1964 Exemption of vehicles transporting certain persons who have disabilities
from payment of parking fees and penalties
Citations:
From 2007 through this point in 2012, 15,272 citations have been issued statewide
for 316.1955 (1) Handicap parking, violation code 397 and (2) Handicap parking obstructing access to parking space, also violation code 397.
Deceased permit holders:
Number of permits turned in to DHSMV where the cancel reason code is deceased.
YTD
2008
2009
2010
2011
2012
1,288 1,596 1,738 1,992
914
Governmental Center • 301 N. Olive Avenue, 3rd Floor • West Palm Beach, FL 33401
Mailing Address • Post Office Box 3715 • West Palm Beach, FL 33402-3715
www.taxcollectorpbc.com • Tel (561) 355-2264 • Fax (561) 355-4123
Serving you.
Belle Glade
Service Center
2976 State Road 15
Belle Glade
Delray Beach/South County
Service Center
PARKING REGULATIONS FOR
DISABLED PERSON PARKING PERMITS
Questions and Answers
1. Will everyone with a disabled parking permit be able to park for
free at meters?
501 South Congress Avenue
Delray Beach
Lake Worth
Service Center
Anyone with a disabled parking permit who parks on the street at a
turnstile meter will continue to park for free. However, there are time
restrictions; 4 hours maximum. The law also allows local municipalities to
exceed the 4 hours maximum by local ordinance.
3551 South Military Trail
Lake Worth
2. What are the guidelines for charging a person to park whose
vehicle displays a disabled parking permit under the law?
Lantana Driver
License Office
1299 West Lantana Road
Lantana
Palm Beach Gardens
Driver License Office
3185 PGA Boulevard
Palm Beach Gardens
Palm Beach Gardens/NE County
The law allows municipalities to remove free parking in the following
settings: government lots that are used for entertainment, such as
convention centers, cruise port terminals, sports stadiums, sports arenas,
coliseums and auditoriums along with airports and city or municipal
garages.
When free parking is removed as described above, the law requires the
free parking be maintained only for those vehicles with ramps, lifts, hand
controls or State of Florida toll exemption permits.
Service Center
3188 PGA Boulevard
Palm Beach Gardens
Royal Palm Beach
Service Center
200 Civic Center Way
3. What is the limit on the number of days I can park using my
disabled parking permit?
The new law allows facilities to restrict the number of days (in a row) a
vehicle may be parked with a permit, if the number of days is being
restricted for the general public.
Royal Palm Beach
West Palm Beach/Downtown
4. What are the requirements for the size of the disabled parking
spaces?
Service Center
301 North Olive Avenue
West Palm Beach
By October 1, 1997, all disabled parking spaces are required to be 12 feet
wide with a 5-foot access aisle. A 5-foot access aisle may be shared by
two accessible spaces. The law also requires the space to have the signs
and painting properly maintained.
5. Who will be enforcing the spaces?
The law allows a law enforcement officer, parking enforcement specialist
and the owner or lessee of the space, who finds a vehicle in violation, to
have the vehicle towed. The officer or enforcement specialist may write a
ticket for the violation. All violations will be recorded by the local clerk and
submitted to the Department of Highway Safety and Motor Vehicles for
input into a statewide computer. This will allow the courts to place stiffer
penalties on those drivers who are repeat offenders. This can include
forty (40) hours of community service with a program that serves people
with disabilities.
6. What new requirements will assist with enforcement?
Access aisles are now a “no parking” zone for all vehicles whether the
vehicle is displaying a disabled person parking permit or not. The fine for
parking in an access aisle is the same for the disabled parking space,
most commonly $250. The placement of the identification number on the
permit will allow the enforcement entity to request the identification card
or driver license. They can then match the number on the ID to the
number on the permit, and match the picture on the ID to the person
using the permit. If anything does not match, a ticket will be written.
7. What new requirements are in place to deter physicians from
signing applications for people who are not eligible?
The application warns all applicants and physicians that permits are only
for those people who are severely mobility impaired. Any physician who
signs an application for someone who is not eligible can be fined $1,000
and/or imprisoned for up to one year. All applications will now be tracked
by computer and the number of applications signed by specific physicians
can be reviewed. Any person who applies and is not eligible can be fined
the same as a physician.
8. What will be done if someone uses a family members’ permit or a
person uses a permit that does not belong to them?
Anyone who obtains or uses a permit that does not belong to them can be
charged with a second degree misdemeanor- fined $1,000 and/or
imprisoned for up to one year. Improper use of the permit is now twice the
fee of a disabled parking violation. This should deter people from loaning
their permits to family members. It does not matter if you are running an
errand for the person with a disability; if the person with a disability is not
present, the fine is $1,000.
Serving you
at Service Centers and Driver License Offices
throughout Palm Beach County.
1
Belle Glade
Service Center
PBC Glades
Office Building
GATOR BLVD
95
PALM BEACH
GARDENS
Palm Beach Gardens
Service Center
NE County Courthouse
BEE
LIN
EH
PGA BLVD.
WY
.
Palm Beach Gardens
RIVIERA
BEACH
Driver License Office
(former DMV Office)
BLUE HERON BLVD.
45TH ST.
Midwestern
Communities
Service Center
West Palm
Beach
PB LAKES BLVD.
Service Center
Governmental
Center
OKEECHOBEE BLVD.
N OLIVE AVE.
Royal Palm
Beach
Service Center
Lantana Driver License Office
1299 W. Lantana Road
Lantana, FL 33462
JUPITER
80
FL TURNPIKE
HOOKER HWY
INDIANTOWN RD.
MILITARY TRAIL
Delray Beach/South County
Service Center
501 South Congress Avenue
Delray Beach, FL 33445
BELLE
GLADE
ROYAL PALM BEACH BLVD.
Belle Glade Service Center
2976 State Road 15
Belle Glade, FL 33430
441
N. MAIN ST.
Note: From time to time, the Tax
Collector’s Office may stop services
when the line for service exceeds
our hours of operation.
NW 16TH ST.
Monday - Friday
8:15 am - 5:00 pm
BACOM POINT RD.
Visit us online at www.taxcollectorpbc.com
for service information, online transactions, service center
wait times and driver license appointments.
WEST PALM
BEACH
SOUTHERN BLVD.
Lake Worth Service Center
3551 South Military Trail
Lake Worth, FL 33463
Royal Palm Beach Service Center
200 Civic Center Way
Royal Palm Beach, FL 33411
West Palm Beach / Downtown
Service Center
301 North Olive Avenue
West Palm Beach, FL 33401
1
10TH AVE. N.
LAKE
WORTH
95
Service Center
ACTAC Building
LANTANA
LANTANA RD.
Lantana
441
Driver License Office
(former DMV Office)
GATEWAY BLVD.
BOYNTON BEACH BLVD.
CONGRESS AVE.
Delray Beach
Service Center
ATLANTIC AVE.
BOYNTON
BEACH
FEDERAL HW
Y.
7
Lake Worth
MILITARY TRAIL
Palm Beach Gardens/NE County
Service Center
3188 PGA Boulevard
Palm Beach Gardens, FL 33410
FOREST HILL BLVD.
JOG RD.
Palm Beach Gardens Driver License Office
3185 PGA Boulevard
Palm Beach Gardens, FL 33410
PALM
BEACH
S. County
Admin. Complex
DELRAY
BEACH
LINTON BVD.
CLINT MOORE RD.
YAMATO RD.
GLADES RD.
PALMETTO PARK RD.
1
BOCA
RATON