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State of Illinois Handicap Form 2015-2023
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Part 3.
PART 1: Applicant Information
I hereby certify that I meet the definition of a person with a disability as provided in 625 ILCS 5/1-159.1, and I certify that my physical
condition entitles me to the issuance of a Persons with Disabilities Parking Placard/License Plates. By affixing my signature below, I
understand that the parking placard/license plates may not be used unless I am the driver or passenger of the vehicle.
WARNING: Misuse of a parking placard/plates or...
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