HSMV 83039 Application Form – Fillable PDF

The Form HSMV 83039 is the official Florida Department of Highway Safety and Motor Vehicles (FLHSMV) application for a Disabled Person Parking Permit. Whether you need a permanent or temporary permit, this fillable PDF lets you submit accurate information quickly and securely.

What Is Form HSMV 83039?

This form collects personal details, vehicle information, and a medical certification from an approved health professional. It is required for:

• Permanent disabled parking permits (valid up to 4 years)
• Temporary permits for short‑term mobility impairments
• Replacement permits if the original is lost or stolen

How to Complete the Form Online

Instead of downloading, printing, and scanning, simply click the "Fill out this form" button on this page. The Formize PDF Filler app will load, allowing you to type directly into each field, add signatures, and save a completed copy.

1. Click Fill out this form and wait for the filler to load.
2. Enter your personal and vehicle information exactly as it appears on your driver’s license and registration.
3. Upload a scanned signature or use the built‑in drawing tool for the certifying medical authority.
4. Review all entries for accuracy; the filler highlights required fields.
5. Click Download Completed PDF and print or email it to your local tax collector office.

Common Mistakes to Avoid

• Out‑of‑date medical certification: The physician’s signature must be dated within 12 months of submission.
• Missing vehicle VIN: The VIN is required for every permit application.
• Incorrect address: Use the address on your current Florida driver’s license.
• Skipping the "Physician/Certifying Practitioner’s Statement": This section validates the disability and must be fully completed.

Where to Submit Your Application

After completing the form, you have two options:

• In‑person: Bring the printed form to any Florida tax collector office or license plate agency.
• Fax: Certified medical authorities can fax the signed form directly to your local tax collector.

Download the Official PDF

For reference or offline use, you can also download the original PDF from the FLHSMV website.