Select language

HSMV 83039 Application Form – Fillable PDF

  1. Language English
  2. Country USA
  3. Department Florida Department of Highway Safety and Motor Vehicles
  4. Activity Vehicle Registration
Fill out this form
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.

FAQ
  • Who can sign the HSMV 83039 form?

    A licensed physician, osteopathic doctor, chiropractor, podiatrist, optometrist, advanced practice registered nurse, or physician assistant may sign. Out‑of‑state physicians are allowed if they provide proof of licensure.

  • How recent must the medical certification be?

    The certifying professional’s signature must be dated within the 12 months preceding your submission.

  • Can I submit the form electronically?

    Only the medical authority can fax the signed form. The applicant must still present a printed copy at the tax collector office.

  • What is the fee for a temporary disabled parking permit?

    A temporary permit costs $15. Permanent permits are issued free of charge.

  • Do I need a separate form to replace a lost permit?

    Yes. Use Form HSMV 83146 for replacement permits, along with a completed HSMV 83039.

  • Is the fillable PDF compatible with mobile devices?

    The Formize PDF Filler works on most modern smartphones and tablets. For best results, use a desktop browser.

  • What happens if I make a mistake on the form?

    You can edit any field before downloading the final PDF. Once printed and signed, you must start a new form if errors are discovered.

  • Where can I find the official PDF version of HSMV 83039?

    The official PDF is available from the Florida DHSMV website at the link provided below.

HOW TO

How to fill out HSMV 83039 for free, online in 5 easy steps:

  1. 1
    Open the Fillable Form
    Click the "Fill out this form" button on the page. The Formize PDF Filler app will launch in your browser.
  2. 2
    Enter Your Information
    Type your personal, vehicle, and medical details into the highlighted fields. Use the drop‑down menus where provided.
  3. 3
    Add Signatures
    Upload a scanned signature for yourself and the certifying medical professional, or use the built‑in drawing tool.
  4. 4
    Validate & Download
    Review the completed form, click the validation button, then download the finished PDF to print or email.
  5. 5
    Submit the Application
    Take the printed form to your local tax collector office or have the certifying authority fax it directly.
Formize PDF Filler app
ABOUT

Vehicle Registration Forms

HSMV 83039 is one of Vehicle registration forms that are documents used to register a motor vehicle with the relevant government authority, typically the Department of Motor Vehicles (DMV) or equivalent agency. These forms are required when a person purchases a new or used vehicle, transfers ownership of a vehicle, or moves to a new jurisdiction with a vehicle.

The specific vehicle registration forms can vary by jurisdiction, but they generally require the following information:

Vehicle Information: This includes details about the vehicle, such as the make, model, year, vehicle identification number (VIN), and odometer reading.

Owner Information: The form will require information about the vehicle's owner, including their name, address, contact information, and driver's license number.

Proof of Ownership: Depending on the circumstances, proof of ownership may be required, such as a title certificate, bill of sale, or manufacturer's certificate of origin (for new vehicles).

Insurance Information: Proof of valid vehicle insurance coverage is typically required. This may include providing the insurance policy number, dates of coverage, and insurance company details.

Payment of Fees: Vehicle registration involves payment of various fees, such as registration fees, taxes, and possibly other charges specific to the jurisdiction.

In addition to these basic requirements, some jurisdictions may have additional forms or documentation requirements. For example, emissions test results, safety inspections, or proof of residency might be necessary in certain areas.

Once the vehicle registration forms are completed and submitted, the government authority will issue a registration certificate, license plates, and registration stickers. These documents indicate that the vehicle is legally registered and authorized to be operated on public roads.

It is important to note that vehicle registration requirements can vary significantly by jurisdiction. Therefore, it is recommended to consult the local DMV or equivalent agency for the specific forms and procedures applicable to your location.

FEATURES

PDF Filler

The easiest way to fill HSMV 83039 online

  • Quickly fill out HSMV 83039
    Looking for a way to quickly fill HSMV 83039 online? With our online free PDF form filler, you’ll know how to how to edit and fill this pdf document in less than a minute.
  • Easy to use online PDF editor
    Fed up with printing out PDF files so you can edit them, before rescanning and sending them back? Edit PDF documents for free online. Use our online pdf editor to save time and paper.
  • Great tools, all platforms
    Wondering how to fill in HSMV 83039 on a Mac, or maybe how to use a PDF filler free? Our online PDF tools work on all platforms.
  • Secure file storage
    Completed "HSMV 83039" files are stored in a secured database managed by Amazon Cloud hosting. You can delete your files from our system anytime. In any case, these files are automatically deleted after 24 hours.
  • Chat with HSMV 83039
    Chat with "HSMV 83039" on Chatize that is a free PDF reader assistant. Ask questions and get answers from "HSMV 83039". Just click on Chat With Document button above.

Delete filling session

Delete the selected filling session? In this case, your progress in completing the form will be lost.

Delete editing session

Delete the selected editing session? In this case, your progress in creating and editing the form will be lost.