Section Trans 130.03 - Application form(1) APPLICATION BY A PERSON FOR AN INDIVIDUAL CARD AND APPLICATION FOR SPECIAL REGISTRATION PLATES. Each application by a person for a permanent individual or temporary individual card and each application for special registration plates shall be on a form provided by the department or in a letter, except as allowed in s. Trans 130.10, and shall contain the following information: (a) The date of the application.(b) The name and address of the person.(c) The age, gender and date of birth of the person.(d) Whether or not the person holds a valid Wisconsin operator's license issued under ch. 343, Stats.(e) The person's Wisconsin operator's license number, if applicable.(f) A notification that the person, if he or she holds an operator's license, may be required to demonstrate to the department that the disability does not impair the person's ability to operate a motor vehicle safely.(g) The signature of the person or, if applicable, the signature of anyone authorized to sign for the applicant.(h) The relationship of the signer to the person with the disability, if signed by someone other than the person.(i) A statement from a health care specialist including: 1. The date of the health care specialist's statement.2. A certification that the individual has a disability within the meaning of s. 340.01(43g), Stats.3. Whether the disability is permanent or temporary.4. The duration of the disability, not to exceed 6 months, if temporary.5. In an application for a permanent individual card, whether or not the health care specialist believes that the person's disability impairs the person's ability to drive safely.6. The health care specialist's signature, name and address.7. The health care specialist's medical license number, if applicable, and telephone number.(j) Any other information necessary to assist the person, the person signing the application, and the health care specialist to understand the requirements and privileges of ss. 340.01(43g), 341.14(1), (1a), (1e), (1m), or (1q), 343.51, 343.52 and 346.50(1m), (2a) (h), (j), and (k), and (3), Stats., and this chapter.(k) As required by s. 343.51(1m) (b), Stats., the person making application to the department shall make and retain a copy of the statement from the health care specialist, for the period of time during which the special identification card is valid. The person shall carry the copy of the statement on the person or in the vehicle and shall, upon request by any traffic officer, produce the statement for inspection.(2) APPLICATION BY AN ORGANIZATION FOR A PERMANENT ORGANIZATION CARD. Each application for a permanent organization card by an organization shall be on a form provided by the department or in a letter, and shall contain the following information:(a) The date of application.(b) The name and address of the organization.(bm) The Federal Employer Identification Number, or FEIN, of the organization.(c) A certification by the organization that it regularly transports persons as defined in s. Trans 130.02 (6).(d) The total number of motor vehicles operated by or on behalf of the organization to transport persons as defined in s. Trans 130.02 (6).(e) The number of organization cards being requested.(f) The printed name, signature and official capacity of the person authorized to sign for the organization.(g) Any other information necessary to assist the organization to understand the requirements and privileges of ss. 343.51, 343.52 and 346.50(1m), (2a) (h), (j) and (k), and (3), Stats., and this chapter.(h) The organization making application shall make and retain at its regular place of business for the period of time in which the organization card is valid, a copy of the certification by the organization that it regularly transports persons, and shall make the certification available for inspection to a traffic officer upon request.(i) The organization shall maintain a record of the name of any person to whom the organization has issued one of its organization cards, and the date of issue. Whenever any person no longer operates a vehicle on behalf of the organization, the organization shall make a good faith effort to retrieve the organization card from that person.Wis. Admin. Code Department of Transportation Trans 130.03
Cr. Register, July, 1994, No. 463, eff. 8-1-94; corrections in (1) (j) and (2) (g) made under s. 13.93(2m) (b) 7, Stats., Register November 2002 No. 563; CR 07-072: am. (1) (intro.) and (i) 5., (2) (intro.) and (e), cr. (1) (k), (2) (bm), (h) and (i), Register November 2007 No. 623, eff. 12-1-07; correction in (1) (j) made under s. 13.92(4) (b) 7, Stats., Register January 2011 No. 661.Amended by, CR 22-048: am. (1) (h), (i) 2. Register July 2023 No. 811, eff. 8/1/2023