Instructions and Application for Disabled Placard or Plate
The Application For Disabled Person Placard or Plates (REG 195) form (REV 2/2004) has been revised. The new REG 195 is linked below or can be found on the Internet at www.dmv.ca.gov. Only this revision dated 2/2004 will be accepted after September 1, 2004. Please destroy all obsolete forms.
The Doctor's Certification of Disability is on the back of the two-sided form and must be signed by a licensed physician, surgeon, chiropractor or optometrist. It is important that the Doctor's Certification of Disability, sections F and G, be complete and legible. The DMV cannot issue a disabled person placard or plate unless the applicant has specific disabilities that are in California Vehicle Code sections 5007(c) (1), 22511.55 (b)(1) and 22511.59. Those disability reasons are listed on the REG 195 form. Individuals with disabilities that are not listed on the REG 195 are not eligible for a disabled person placard or plates.
If printing or photocopying the REG 195, please make sure both sides of the form are given to the applicant.