This version of the form is not currently in use and is provided for reference only. Download this version of Form 96-0104B for the current year.

Form 96-0104B Organization Disability - Plate / Placard Application - Arizona

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What Is Form 96-0104B?

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

FAQ

Q: What is Form 96-0104B?
A: Form 96-0104B is an application for a disability plate or placard in Arizona.

Q: What is the purpose of Form 96-0104B?
A: The purpose of Form 96-0104B is to apply for a disability plate or placard in Arizona.

Q: What information is required on Form 96-0104B?
A: Form 96-0104B requires personal information, medical certification, and vehicle information.

Q: Who is eligible for a disability plate or placard in Arizona?
A: Individuals who have a qualifying disability, as defined by Arizona law, are eligible for a disability plate or placard.

Q: How long is a disability plate or placard valid in Arizona?
A: A disability plate or placard is valid for up to 5 years in Arizona.

Q: Is there a fee for a disability plate or placard in Arizona?
A: Yes, there is a fee for a disability plate or placard in Arizona.

Form Details:

Released on September 1, 2021;
The latest edition provided by the Arizona Department of Transportation;
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 96-0104B by clicking the link below or browse more documents and templates provided by the Arizona Department of Transportation.