Arkansas Handicap Placard Form 10-336: Signatures, Submission, and Renewal

To get an Arkansas disability parking placard, you fill out the top of Arkansas handicap placard Form 10-336 with your personal information, have a licensed medical provider complete and sign the certification section, and submit the form to the Department of Finance and Administration either in person at a Revenue Office or by mail. There is no fee for a permanent or temporary placard.¹

The form’s official title is “Licensed Provider or Organization’s Certification for Issuance of a Special License Plate or Certificate for a Person with a Disability.” You can download it from the DFA’s motor vehicle forms page or pick up a blank copy at any Revenue Office.²

What to Gather Before You Start

Pull these together first so you can finish the form in a single medical visit:

Your Social Security number, driver’s license number, or state-issued ID number. The form asks for one of these.²
A medical appointment with a provider who can certify your condition. Most of Form 10-336 is completed by the provider, not by you, so bring the blank form to the visit.
Your current vehicle registration, if you are applying for a special disability license plate rather than a hanging placard.

Decide before the visit which you want: a permanent placard, a temporary placard, or a special disability license plate. The provider certifies the disability as permanent or temporary, and that choice determines what the DFA issues.

Who Can Sign the Medical Section

The DFA accepts the certification from a licensed physician, a physician’s assistant, a physical therapist, or an advanced practice registered nurse.¹ The provider checks the qualifying condition that applies under Arkansas Code § 27-15-302, marks whether the disability is permanent or temporary, and signs and dates the form with their license number and office contact details. Without a valid provider signature, the application will not be processed.

The qualifying conditions in the statute cover limitations such as inability to walk 100 feet without resting, dependence on an assistive device, specific lung-function thresholds, portable oxygen use, and Class III or Class IV cardiac classifications under American Heart Association standards.³ Your provider will decide which box applies.

Filling Out the Form

Applicant Section

Enter your full legal name, residential address, and the identifying number you brought. Make sure your name is spelled exactly as it appears on your state ID. Mismatches are a common reason applications get kicked back. Mark the box for the type of credential you want: permanent placard, temporary placard, or special disability license plate.

Medical Provider Section

The provider checks the qualifying condition, indicates permanent or temporary status, and signs. Every entry needs to be legible. If staff at the Revenue Office cannot read the handwriting or the signature is missing, the form comes back to you unprocessed. The DFA records the disability type in its permanent file, so this section should be filled in completely, not just signed.²

Where to Submit the Form

You have two options:

In person at any Arkansas Revenue Office, or directly at the Revenue Division Special License Unit in the Ragland Building, 1900 West 7th Street, Little Rock, AR 72201. In-person submissions can result in receiving the placard the same day.
By mail to the Department of Finance and Administration, Special License Unit, P.O. Box 1272, Little Rock, AR 72203.¹

Both permanent and temporary placards are issued at no cost.⁴ A special disability license plate carries no additional plate fee beyond the regular vehicle registration charge.⁵

How Long the Placard Lasts

A permanent placard is valid for four years from the last day of the month it was issued. When it expires, you can renew without a new medical certification.⁵ The DFA sends a reminder as the expiration approaches, and you can renew by mail using that notice, by phone at 1-800-941-2580, or online through the DFA’s STAR system.

A temporary placard expires three months from the last day of the month it was issued.⁴ You may hold up to two temporary placards at once, but they share the same expiration date. Temporary placards cannot be renewed. If you still need one when it expires, you file a new application with a new provider certification.

A special disability license plate follows the regular registration cycle of the vehicle. Owners must submit a physician recertification every four years to keep the plate, unless the disability has been certified as permanent.⁶

Lost, Stolen, or Damaged Placards

Contact the Specialty License Plate Office for a replacement.¹ A replacement for an unexpired temporary placard carries the same expiration date as the original. A temporary placard that has already expired cannot be replaced; you would start a new application instead.

Using the Placard

Hang the placard from the inside rearview mirror when parked in an accessible space, or place it on the dashboard if the vehicle has no rearview mirror. The parking privilege applies only when the vehicle is actually transporting the person the placard was issued for. Lending it to someone else to use without you in the vehicle is illegal and can result in impoundment of the vehicle.²

1
Arkansas Department of Finance and Administration. Persons With Disabilities Placard
2
Arkansas Department of Finance and Administration. Licensed Provider or Organization’s Certification for Issuance of a Special License Plate or Certificate for a Person with a Disability
3
Justia. Arkansas Code 27-15-302 – Definitions
4
Justia. Arkansas Code 27-15-304 – Temporary Special Certificate
5
Arkansas Department of Finance and Administration. Persons With Disabilities License Plate
6
Justia. Arkansas Code 27-15-308 – Special License Plates and Certificates