Form 10-337 template
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Van Accessible Decal Application Form
This form is an application for a special decal to be issued by the State of Arkansas for vehicles used to transport persons with limited or no use of their legs and certain mobility devices. The application requires the physician or advanced practice registered nurse to certify the applicant's disability and vehicle description. Eligible vehicles include passenger vehicles, 1 ton trucks, vans, and light trucks up to ¾ ton as rated by the manufacturer. The decal can be affixed as a placard only, plate only, or both. The form also includes fields for the applicant's information, signature, and guardian (if applicable), and revenue office use.
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