1. LICENSE PLATE, VEHICLE AND OWNER/OPERATOR INFORMATION

2. CITY/COUNTY OR OFFICIAL STATE VEHICLE LICENSE PLATE

I affirm under penalty of law this application is true and correct and such disabled decaled plate shall be used by an agency that provides transportation for persons with a disability, as defined in K.S.A. 8-1,124, as a service. I also affirm the agency will only utilize disabled parking privilege when transporting at least one disabled person. I am aware making a false certification that the agency meets the qualifications of K.S.A. 8-1,125 could result in penalty set forth by statute.

3. COMMERCIAL VEHICLE LICENSE PLATE

I affirm under penalty of low this application is true and correct and such disabled decaled plate shall be used by an business/agency that provides transportation for persons with a disability, as defined in K.S.A. 8-1,124, as a service. I also affirm the agency will only utilize disabled parking privilege when transporting at least one disabled person. I am aware making a false certification that the agency meets the qualifications of K.S.A. 8-1,125 could result in penalty set forth by statute.