APPLICATION FOR DISABLED PARKING SIGNS PLEASE READ THE FOLLOWING CAREFULLY BEFORE COMPLETING THE FORM
77751
An application will not be considered complete unless:
• All lines of the application have been completed in full;
• A check or money order for $70.00 made payable to the City of Chicago is submitted as payment of the application 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 al the time of application;
• " Proof of residency, in the form of a copy of your drivers license, state identification, or utility bills are submitted a; ihe
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 billedto you annually.- Should you have questions or concerns; please call our permit processing division at 312-744-PARK (7275).
i. Daie or dirth MO _ DAY _ YEAR nil I \ I r\ I -7 I Q. 2. State Identification Number 5!z|o|oTWe|2-BTo| 11 of <- 3. Dnvers License Number - ! ~t-| T !-T 1 T I T !
4. Applicant Last Name M \k\0 O I I I I I I I I I I I Ml s First Name AlUPl HolMlsl ulSI 1 1
5. Home Address (pr STREET NUMBER mary DIR. w residence) STREET NAME II ZIP CODE MH|Tlhl IS IT |R t'if 1 1 1 1 1 1 1 \(o 10 g $
6. Address where sig STREET NUMBER ns w DIR II be posted STREET NAME |, WARD NUMBER Ml......1 \lfh
7. Phone Numbers Home "7 1"? |3 T^llo D T SIC* M p Business
8. Current Permanent Disabled P...
Click here for full text