Application for Disabled Placard - Form 2769
This file contains the Application for Disabled Person Placard (Form 2769) provided by the Missouri Department of Revenue. It provides instructions for obtaining a disabled person placard, including application requirements and associated fees. Users can learn how to fill out the form and understand eligibility criteria through this document.
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How do I fill this out?
To fill out the Application for Disabled Person Placard, begin by gathering necessary personal information including your name, address, and driver's license number. Ensure you have medical certification confirming the disability, which is needed for your application. Follow the instructions carefully to complete the form and avoid errors.

How to fill out the Application for Disabled Placard - Form 2769?
1
Gather required personal and medical information.
2
Complete the Application for Disabled Person Placard (Form 2769).
3
Ensure physician certifies the disability by completing Form 1776.
4
Submit the completed application along with the appropriate fee.
5
Retain the validated receipt once your application is approved.
Who needs the Application for Disabled Placard - Form 2769?
1
Physically disabled individuals who require special parking.
2
Parents or guardians of disabled persons needing accessibility.
3
Representatives from transport agencies serving disabled individuals.
4
Organizations that transport multiple physically disabled persons.
5
Any individual acting on behalf of a disabled person needing assistance.
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What are the instructions for submitting this form?
To submit your Application for Disabled Person Placard, visit your local license office. You can also send your completed application by mail to the Missouri Department of Revenue, Motor Vehicle Bureau, P.O. Box 598, Jefferson City, MO 65105-0598. Make sure to include all required documents and fees as specified on the form to ensure a smooth processing experience.
What are the important dates for this form in 2024 and 2025?
For the year 2024, ensure your application is submitted by the designated deadlines as noted in the form. In 2025, keep an eye out for renewal dates to remain compliant. It is advisable to submit your applications early to avoid any delays.

What is the purpose of this form?
The purpose of this form is to facilitate the process for individuals with disabilities seeking special parking accommodations. By completing the Application for Disabled Person Placard, users can apply for a temporary or permanent placard, which allows them to access designated disabled parking spaces. This form is essential for ensuring that individuals with mobility challenges receive the proper support and accessibility options they need.

Tell me about this form and its components and fields line-by-line.

- 1. Name: Full legal name of the disabled person or applicant.
- 2. Address: Current residential address of the applicant.
- 3. Driver License Number: Numbers associated with the applicant’s driver's license.
- 4. Social Security Number: Social security details to verify identity and eligibility.
- 5. Medical Certification: Certification from a licensed medical professional stating the nature of the disability.
What happens if I fail to submit this form?
Failure to submit this form may lead to the inability to obtain a disabled person placard, limiting access to necessary parking accommodations. It is crucial for applicants to complete and submit the form accurately to avoid delays in processing.
- Access Restrictions: Applicants may find it difficult to access designated disabled parking spaces.
- Legal Consequences: Parking without the appropriate placard can lead to fines and legal penalties.
- Increased Challenges: Individuals may face increased difficulties in community mobility without appropriate documentation.
How do I know when to use this form?

- 1. New Placard Application: Use this form to apply for a new disabled person placard.
- 2. Renewal Application: Submit this form to renew an existing placard nearing expiration.
- 3. Replacement Request: Utilize this form if the placard has been lost, stolen, or damaged.
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