APPLICATION FOR DISABLED PARKING SIGNS PLEASE READ THE FOLLOWING CAREFULLY BEFORE COMPLETING THE FORM
An application will not be considered complete unless:
? All lines of the application have been completed in full:
? A check or money order for S70.00 made payable to the City of Chicago Is submitted as payment of she appl^a: on fee: Please note: The application fee shall be waived for any person holding a valid, current disabled veterans plate Disability must be permanent as evidenced, by a copy of your valid disabled placard and/or current vehicle registration submitted st Ihe time of application; ¦' .r ¦¦ ' ¦ ¦
? Proof of residency, in the form of a' copy of your drivers license, state identification, or utility bills are submitted ;u the time of application.
Completed application forms may be returned to: the office of your alderman, any City of Chicago Department of Revenue facility, or via mail at P.O. Box 803100, Chicago, IL 60680-3100; ATTN: Disabled Permitting Section: A $25.00.maintenance fee will be b.iled to you annually. Should you have questions or-concerns, please call our permit orocessfng dMsiori at 312-?<14-PARK .-7J75) j'¦ '
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State Identification Numhdr
! 3. Drivors License Number
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Firs; Name
5. Home Address (primary.residence).
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I 6. Address where signs will be postal!
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7. Phone Numbers
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8. Current Pernmr.eni Disabled Placurt! Nurobt
9. Current License Plate Number
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Business
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Relationship to Applicant
!0. Description of Medical Condition arid Disability
Alternatives Parking: Please note your application may be denied it you have alternative accessi...
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