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Request for Replacement Placard Medical Affairs Branch Phone: 8573688020 Print Name: License or Social Security Number: Date: AFFIDAVIT FOR REPLACEMENT PLACARD: I, Last First Middle Address City/Town

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What is request for replacement placard?

Request for replacement placard is a formal application to receive a new placard to replace a lost, stolen, or damaged one.

Who is required to file request for replacement placard?

Any individual or entity who has lost, stolen, or damaged their placard is required to file a request for replacement placard.

How to fill out request for replacement placard?

To fill out a request for replacement placard, one must provide their personal information, details of the lost/stolen/damaged placard, and a reason for the replacement.

What is the purpose of request for replacement placard?

The purpose of request for replacement placard is to ensure that individuals or entities have a valid placard for parking purposes.

What information must be reported on request for replacement placard?

Information such as personal details, placard details, and reason for replacement must be reported on the request for replacement placard.

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