Form MV-663 "Certification for an Additional Set of License Plates for Persons With Disabilities" - New York

What Is Form MV-663?

This is a legal form that was released by the New York State Department of Motor Vehicles - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 1, 2015;
  • The latest edition provided by the New York State Department of Motor Vehicles;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form MV-663 by clicking the link below or browse more documents and templates provided by the New York State Department of Motor Vehicles.

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Download Form MV-663 "Certification for an Additional Set of License Plates for Persons With Disabilities" - New York

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CERTIFICATION FOR AN ADDITIONAL SET OF
LICENSE PLATES FOR PERSONS WITH DISABILITIES
A registrant is entitled to an additional set of license plates for persons with disabilities (that is, plates
with the International Symbol of Access logo on them) if ALL of the following conditions are met:
1. the disabled REGISTRANT must:
a. already have license plates for persons with disabilities on his/her vehicle.
b. have another vehicle registered in his/her name.
c. have another family member who is disabled.
2. the disabled FAMILY MEMBER must:
a. live with the registrant.
b. be the usual licensed driver of the vehicle for which the additional set of license plates
for persons with disabilities is being requested.
c. qualify as severely disabled, and provide a physician’s statement to that effect (to be
attached to the registrant’s application).
Disabled registrant requesting an additional set of license plates:
Last Name
First
M.I.
Driver License ID Number
Plate Number for First Set of License Plates
Disabled family member for whom license plates are requested:
Last Name
First
M.I.
Driver License ID Number
Relationship to Disabled Registrant
CERTIFICATION
I certify that these plates will be used according to the conditions specified in 1 and 2 above.
X
Date:
Signature of Disabled Registrant (Sign Name in Full)
www.dmv.ny.gov
MV-663 (9/15)
CERTIFICATION FOR AN ADDITIONAL SET OF
LICENSE PLATES FOR PERSONS WITH DISABILITIES
A registrant is entitled to an additional set of license plates for persons with disabilities (that is, plates
with the International Symbol of Access logo on them) if ALL of the following conditions are met:
1. the disabled REGISTRANT must:
a. already have license plates for persons with disabilities on his/her vehicle.
b. have another vehicle registered in his/her name.
c. have another family member who is disabled.
2. the disabled FAMILY MEMBER must:
a. live with the registrant.
b. be the usual licensed driver of the vehicle for which the additional set of license plates
for persons with disabilities is being requested.
c. qualify as severely disabled, and provide a physician’s statement to that effect (to be
attached to the registrant’s application).
Disabled registrant requesting an additional set of license plates:
Last Name
First
M.I.
Driver License ID Number
Plate Number for First Set of License Plates
Disabled family member for whom license plates are requested:
Last Name
First
M.I.
Driver License ID Number
Relationship to Disabled Registrant
CERTIFICATION
I certify that these plates will be used according to the conditions specified in 1 and 2 above.
X
Date:
Signature of Disabled Registrant (Sign Name in Full)
www.dmv.ny.gov
MV-663 (9/15)