Form BMV4531 "Application for Removable Windshield Placard for Active Duty Military/Veterans With Disabilities" - Ohio

What Is Form BMV4531?

This is a legal form that was released by the Ohio Department of Public Safety - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2020;
  • The latest edition provided by the Ohio Department of Public Safety;
  • 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 printable version of Form BMV4531 by clicking the link below or browse more documents and templates provided by the Ohio Department of Public Safety.

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Download Form BMV4531 "Application for Removable Windshield Placard for Active Duty Military/Veterans With Disabilities" - Ohio

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OHIO DEPARTMENT OF PUBLIC SAFETY
BUREAU OF MOTOR VEHICLES
APPLICATION FOR REMOVABLE WINDSHIELD PLACARD FOR
ACTIVE DUTY MILITARY / VETERANS WITH DISABILITIES
INSTRUCTIONS:
Note: Placard must be hung on the rear view mirror when the vehicle is parked. Remove placard when driving.
A veteran must submit the following items to qualify for gratis veteran disability placard:
1. A letter, dated within one (1) year, from the Department of Veteran’s Affairs indicating that the applicant’s
disability is service-related, as defined in Ohio Revised Code (R.C.) 4503.44.
2. Sections A and B of this form completed (page 2)
3. Either a prescription written by the applicant’s health care provider or section C of the form completed by
health care provider.
If you need to contact the Department of Veteran’s Affairs, the toll free number is (800) 827-1000.
An active duty military member must submit the following to qualify for a gratis disability placard:
1. Sections A and B of this form completed (page 2)
2. Either a prescription written by the applicant’s health care provider or section C of the form completed by
health care provider.
3. Current Department of Defense convalescent leave statement or other documentary evidence supporting
that the person currently has an ill or injured casualty status or has limited duties.
PAYMENT: NO FEE FOR VETERANS OR ACTIVE DUTY MILITARY MEMBERS.
RETURN PROMPLTY: Applicants may take completed application to any local Deputy Registrar Agency or mail to the Ohio
Bureau of Motor Vehicles/Registration Support Services, P.O. Box 16521, Columbus, Ohio 43216-6521. For additional
information, call: Registration Support Services (614) 752-7518 or go to www.bmv.ohio.gov.
Note: Please allow 10-15 business days for processing if mailed.
FINES AND PENALTIES
In accordance with R.C. 4511.69, no person shall stop, stand, or park a motor vehicle at special clearly marked parking locations
provided in or on privately owned parking lots, parking garages, or parking areas designated for persons with disabilities without the
vehicle being operated by or transporting such person and displaying a disability placard or special license plates. Whoever violates this
section is guilty of a misdemeanor. The fine is at least $250.00, but not more than $500.00, is not punishable with imprisonment, and is
not a criminal offense.
In accordance with R.C. 4731.481 and R.C. 4734.161, no health care provider shall furnish a prescription to a person to enable the
person to obtain a disability placard or special license plates if they do not meet the criteria in R.C. 4503.44. Nor shall any health care
provider provide the person with a prescription misrepresenting the expected length of disability. These offenses are misdemeanors of
the first degree and are punishable by imprisonment of not more than six (6) months, a fine of not more than $1,000, or both, and
sanctions by the State Medical Board, the Chiropractic Examining Board or the Board of Nursing respectively.
In accordance with R.C. 4503.44, no person or organization shall misrepresent themselves as eligible for a disability placard or special
license plates if they are not eligible according to the guidelines of this section. The penalty for this offense is confiscation of the placard
or license plates and the revocation of privileges to obtain a disability placard or special license plates.
BMV 4531 3/20 [760-0616] Page 1 of 2
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OHIO DEPARTMENT OF PUBLIC SAFETY
BUREAU OF MOTOR VEHICLES
APPLICATION FOR REMOVABLE WINDSHIELD PLACARD FOR
ACTIVE DUTY MILITARY / VETERANS WITH DISABILITIES
INSTRUCTIONS:
Note: Placard must be hung on the rear view mirror when the vehicle is parked. Remove placard when driving.
A veteran must submit the following items to qualify for gratis veteran disability placard:
1. A letter, dated within one (1) year, from the Department of Veteran’s Affairs indicating that the applicant’s
disability is service-related, as defined in Ohio Revised Code (R.C.) 4503.44.
2. Sections A and B of this form completed (page 2)
3. Either a prescription written by the applicant’s health care provider or section C of the form completed by
health care provider.
If you need to contact the Department of Veteran’s Affairs, the toll free number is (800) 827-1000.
An active duty military member must submit the following to qualify for a gratis disability placard:
1. Sections A and B of this form completed (page 2)
2. Either a prescription written by the applicant’s health care provider or section C of the form completed by
health care provider.
3. Current Department of Defense convalescent leave statement or other documentary evidence supporting
that the person currently has an ill or injured casualty status or has limited duties.
PAYMENT: NO FEE FOR VETERANS OR ACTIVE DUTY MILITARY MEMBERS.
RETURN PROMPLTY: Applicants may take completed application to any local Deputy Registrar Agency or mail to the Ohio
Bureau of Motor Vehicles/Registration Support Services, P.O. Box 16521, Columbus, Ohio 43216-6521. For additional
information, call: Registration Support Services (614) 752-7518 or go to www.bmv.ohio.gov.
Note: Please allow 10-15 business days for processing if mailed.
FINES AND PENALTIES
In accordance with R.C. 4511.69, no person shall stop, stand, or park a motor vehicle at special clearly marked parking locations
provided in or on privately owned parking lots, parking garages, or parking areas designated for persons with disabilities without the
vehicle being operated by or transporting such person and displaying a disability placard or special license plates. Whoever violates this
section is guilty of a misdemeanor. The fine is at least $250.00, but not more than $500.00, is not punishable with imprisonment, and is
not a criminal offense.
In accordance with R.C. 4731.481 and R.C. 4734.161, no health care provider shall furnish a prescription to a person to enable the
person to obtain a disability placard or special license plates if they do not meet the criteria in R.C. 4503.44. Nor shall any health care
provider provide the person with a prescription misrepresenting the expected length of disability. These offenses are misdemeanors of
the first degree and are punishable by imprisonment of not more than six (6) months, a fine of not more than $1,000, or both, and
sanctions by the State Medical Board, the Chiropractic Examining Board or the Board of Nursing respectively.
In accordance with R.C. 4503.44, no person or organization shall misrepresent themselves as eligible for a disability placard or special
license plates if they are not eligible according to the guidelines of this section. The penalty for this offense is confiscation of the placard
or license plates and the revocation of privileges to obtain a disability placard or special license plates.
BMV 4531 3/20 [760-0616] Page 1 of 2
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SECTION A
PLEASE PRINT OR TYPE
TO BE COMPLETED BY APPLICANT
NAME OF PERSON WITH A DISABILITY
DL / ID / SSN OF PERSON WITH A DISABILITY
STREET ADDRESS
CITY
STATE
ZIP CODE
COUNTY
TELEPHONE NUMBER
DATE SIGNED
SIGNATURE OF PERSON WITH A DISABILITY, NEXT OF KIN OR CARE PROVIDER
X
SECTION B
INDICATE TYPE OF PLACARD REQUESTED.
New Placard
Replacement
Replacement reason
Damaged
Lost
Stolen
Additional Placard, Please list the reason
Renewal (Do not apply more than 90 days prior to expiration date.)
Previous Placard Number
(Applies only to renewal or replacement.)
R.C. 4503.44 allows an applicant to obtain one (1) disability placard. One (1) additional placard may be issued at the discretion
of the Registrar. Therefore the applicant must state separately the reason why the additional placard is necessary.
You may make a non-refundable donation to Opportunities for Ohioans with Disabilities (OOD) by checking the box below
and entering the amount you wish to donate. Add this to your total fees due. For more information, please visit
https://ood.ohio.gov/wps/portal/gov/ood/about-us/resources/donations-to-ood.
I would like to donate $
to the Opportunities for Ohioans with Disabilities Agency.
CERTIFICATION FOR PRESCRIPTION (R.C. 4503.44)
1.
Cannot walk two hundred feet without stopping to rest.
4.
Uses portable oxygen.
Has a cardiac condition to the extent that the person’s
2.
Cannot walk without the use of or assistance from a brace,
5.
cane, crutch, another person, prosthetic device, wheelchair or
functional limitations are classified in severity as Class III or
other assistive device.
Class IV according to standards set by the American Heart
Association.
3.
Is restricted by lung disease to such an extent that the
person’s forced (respiratory) expiratory volume for one (1)
6.
Is severely limited in the ability to walk due to an arthritic,
second, when measured by spirometry, is less than one (1)
neurological, or orthopedic condition.
liter, or the arterial oxygen tension is less than sixty
7.
Is blind, legally blind, or severely visually impaired.
millimeters of mercury on room air at rest.
THE PRESCRIPTION MUST STATE THE FOLLOWING INFORMATION
Original prescriptions required (copies are not accepted)
1.
Name of the person with the disability.
4.
How long the disability is expected to last. The health care
provider must specify an ending date, not to exceed five
2.
Indicate you are applying for a disability placard or
years, or the prescription will be rejected. Placards expire on
similar wording.
the date specified by the health care provider.
3.
The health care provider must sign and date the
prescription. Pursuant to R.C. 4503.44(A)(3), health
care provider means “a physician, physician
assistant, advanced practice nurse, optometrist, or
chiropractor as defined in this section.”
SECTION C
NAME OF HEALTH CARE PROVIDER
LICENSE NUMBER
ADDRESS
CITY
STATE
ZIP CODE
OH
EXPECTED DURATION OF DISABILITY OR PLACARD END DATE
DAYTIME PHONE NUMBER
I certify that the named applicant has a disability that limits or impairs the ability to walk as defined above by R.C. section 4503.44.
SIGNATURE OF HEALTH CARE PROVIDER
DATE SIGNED
X
Warning: Knowingly making a false statement on this form constitutes falsification, a first degree misdemeanor punishable by
criminal fines and imprisonment, and also may result in civil liability (R.C. 2921.13).
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