Arizona · Help

Already have a signed form? Here is where it goes

ADOT MVD Special Plates Unit, for a placard: by mail, by fax to 602-239-6077, or by email to specialplates2@azdot.gov. Plates are handled at an MVD office. The placard is free.

What to bring

1. The signed MVD 96-0104, with the certifier’s license number. Arizona does not accept stamped signatures.
2. Your Arizona driver license or ID card, and a street address (not a PO Box).
3. If you are doing this for someone else, ask ADOT MVD what they need from you.

Without a visit

A placard application can be faxed or emailed to ADOT.

Do not have the form yet?

It is free from Arizona Department of Transportation, Motor Vehicle Division. Your own doctor can complete the medical part.

Mistakes that cause a second trip

• A stamped rather than signed certification.
• A PO Box instead of a street address.
• The wrong application: a disabled-veteran plate uses VA paperwork instead.

No doctor who will complete it? An Arizona-licensed doctor can evaluate you online. Start a free check ›