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Disabled Parking Replacement
of ID Card, Placard, Plate or Tab
Use this form to replace your disabled parking license plate, license plate with tab, ID card, or placard.
If your disabled parking privilege has expired, a new application and authorization from your healthcare provider is
required (see form TD-420-073, Disabled Parking Application for Individuals).
Take this completed form and applicable fees, in a check or money order payable to Department of Licensing, to
any vehicle licensing oce or mail to:
Application and Issuance
Department of Licensing
PO Box 9043
Olympia, WA 98507-9043
Questions: Contact our Customer Care center at 360.902.3770 or [email protected].
Replace the following disabled parking item because it was lost, stolen, destroyed, or mutilated (check all that apply):
ID card
Placard number (list all placard numbers):
Disabled license plate number (call or visit any vehicle licensing oce for applicable fees):
License plate with disabled parking tab (call or visit any vehicle licensing oce for applicable fees):
Applicant (individual with disability)
PRINT or TYPE Name Date of birth (mm/dd/yyyy)
Address
City State ZIP code
10-digit phone number Email
NOTE: The address you provide is used to update your Disabled Parking record only.
To update your vehicle or driver license address:
• Vehicle address – go to dol.wa.gov/vehicleregistration/changeaddress.html or visit any vehicle licensing oce.
• Driver license address – go to dol.wa.gov/driverslicense/addresschange.html or visit any driver licensing oce.
Complete this section if signing for the applicant
Name Relationship
Address
City State ZIP code
I declare under penalty of perjury under the law of Washington that the foregoing is true and correct.
Date and place (city or county) signed
Signature of applicant or individual signing for the applicant
AI-420-076 (R/12/21)WA
Print completed form and sign here.
