The Texas Vi 4 form is an application for a window tint medical exemption, managed by the Texas Department of Public Safety Regulatory Services Division. It is designed for individuals who require a medical exemption from the state's standard window tinting regulations, allowing them to have darker tints than are normally permitted. If you believe you qualify for this exemption, click the button below to get started on filling out your form.
In Texas, sunlight streaming through a car's windows is a common sight, but for some, this seemingly benign occurrence can present serious health risks. Addressing this issue is the purpose of the Texas Vi 4 form, designed by the Texas Department of Public Safety Regulatory Services Division. Essential for individuals needing an exemption from the state's window tint laws due to medical conditions, this form serves as an application for a Window Tint Medical Exemption. Applicants are required to fill out the form in detail, providing personal information such as their name, driver's license number, and contact details, alongside specific details about their vehicle(s). The form also necessitates a certification from a physician, optometrist, or ophthalmologist, validating the medical necessity for the exemption. This certification can be in the form of a signed letter on the physician's letterhead or an original prescription that outlines the medical reasoning behind the exemption. Once submitted through the designated channels — either online, via fax, or through mail — applicants must allow up to 15 working days for the processing and approval of their exemption. This process underscores the state’s commitment to ensuring the health and safety of its residents, while also maintaining the integrity of its vehicle regulations.
Texas Department of Public Safety Regulatory Services Division www.dps.texas.gov
MUST USE MOST CURRENT FORM
FORM MUST BE TYPED
VEHICLE INSPECTION WINDOW TINT
FOR DPS USE ONLY
APPLICATION FOR WINDOW TINT MEDICAL EXEMPTION
APPLICANT (PLEASE USE NAME AS IT APPEARS ON DRIVER LICENSE)
Name
DL #
State
Expiration
Patient Name
Relationship to Applicant
(IF DIFFERENT FROM APPLICANT)
Residence
City
County
ZIP
Address
Mailing
Date of Birth
Email
Home Phone
Cell Phone
Business Phone
Other Phone
VEHICLE INFORMATION
Vehicle #1
VIN
Year
Make
Model
VEHICLE #2
VEHICLE #3
PHYSICIAN, OPTOMETRIST OR OPHTHALMOLOGIST
License #
Zip
Phone
Fax
Vehicle Owner Certiication
I certify and afirm that all information presented in this form is true and correct, that any documents I have presented to DPS are genuine, and that the information included in all supporting documentation is true and accurate. I make this certiication and afirmation under penalty of perjury and I understand that knowingly making a false statement or representation on this form is a criminal violation.
Applicant / Legal Guardian’s Signature
Date
Completed application must be accompanied by one of the following:
●Letter, on physician letterhead, signed by the physician, indicating the medical reason for the exemption.
●An original prescription including the applicant’s name, physician’s signature and indicating the medical reason for the exemption.
Letters and prescriptions must be dated within one year of exemption request. If the exemption is approved, an exemption letter will be sent to the applicant listed above.
SUBMIT completed form with required documentation:
●Online Secured Email
➢Contact Us, select “Vehicle Inspection” and complete the online form.
➢http://www.txdps.state.tx.us/rsd/contact/default.aspx
●Fax to (512) 424-2774
●Mailing Address: Texas Department of Public Safety
Regulatory Services Division, Compliance & Enforcement Service
Window Tint Medical Exemption
P. O. Box 4087
Austin, Texas 78773-0543
Please allow up to 15 working days for your application to be processed, approved and to receive your exemption certiicate.
VI-4 (Rev. 3/16)
Filling out the Texas Vehicle Inspection Window Tint Medical Exemption Form, commonly known as the Texas VI-4 form, requires careful attention to detail. This process ensures that individuals with a valid medical reason can legally have tinted windows beyond the standard legal limit. After you complete the VI-4 form, you must submit it alongside the required medical documentation. The Department of Public Safety (DPS) will review your submission. If approved, you will receive an exemption certificate. This step is crucial for anyone needing window tinting due to medical conditions, as it aligns with Texas regulations while ensuring the individual's well-being.
After submitting the form and necessary documentation, allow up to 15 working days for processing. The Texas Department of Public Safety will review your application. If everything is in order, you will receive your window tint medical exemption certificate. This certificate is the document that will allow you to legally have your vehicle's windows tinted beyond the state's standard limit, ensuring your medical needs are accommodated while keeping you compliant with Texas law.
The Texas VI-4 Form is an application used by the Texas Department of Public Safety for individuals seeking a medical exemption for window tint regulations. This form allows individuals with certain medical conditions that are exacerbated by sunlight to apply for permission to use darker window tints than the law typically allows.
Any resident of Texas who has a medical condition that requires them to have protection from sunlight beyond the standard window tint limits must fill out this form. The applicant can be the person with the medical condition or a legal guardian acting on their behalf.
The form requires detailed information, including:
The completed application must be submitted along with a letter on physician letterhead or an original prescription that includes the medical reason for the exemption sought. This documentation must be signed by the physician and include the applicant's name.
The form and accompanying documentation can be submitted through:
Applicants should allow up to 15 working days for their application to be processed, approved, and to receive the exemption certificate. This timeline starts from the moment the Texas Department of Public Safety receives the completed form and necessary documentation.
If the exemption is approved, an exemption letter will be sent to the applicant. This letter is the formal documentation of the medical exemption for window tint, indicating that the vehicles specified in the application are legally allowed to have window tints darker than the state standard due to medical necessity.
Yes, the Texas VI-4 Form allows applicants to list up to three vehicles under the same application. Each vehicle's VIN, year, make, and model must be provided.
If your contact information changes after you've submitted your application, it's important to notify the Texas Department of Public Safety as soon as possible. This ensures that any correspondence, including the exemption certificate, reaches you without delay.
When completing the Texas Vi 4 form for a window tint medical exemption, people often make several mistakes that can delay the approval process or result in rejection. Understanding these common errors can help ensure the process is smooth and successful.
Not using the most current form. The Texas Department of Public Safety updates their forms occasionally. Using an outdated form, even if the information provided is correct, can result in an application being rejected.
Failure to type the application. The form explicitly requires that it must be typed. Handwritten forms are not accepted and will lead to an automatic rejection of the application.
Filling out the application with incorrect information as it appears on the driver's license. Every detail, including the name and driver's license number, must match the information on the applicant's driver's license exactly.
Including incorrect vehicle information. The VIN, year, make, and model for each vehicle must be accurately recorded. Mistakes here could lead to issues with the exemption being properly applied to the vehicle.
Omitting contact information or providing outdated contact details. Current contact information, including email and phone numbers, is critical for any follow-up communication.
Failing to submit the required documentation, such as a letter or original prescription from a physician, optometrist, or ophthalmologist. This documentation must clearly state the medical reason for the exemption and be dated within one year of the exemption request.
Here are some additional points to remember:
By avoiding these common mistakes, the process of applying for a window tint medical exemption in Texas can be much smoother, helping applicants receive their exemption certificates more swiftly.
When applying for a window tint medical exemption in Texas, using the Texas VI-4 form, additional documentation is often required to support the exemption request. Apart from this primary document, other forms and documents play a crucial role in ensuring an individual's application is both complete and compliant with Texas regulations. Understanding these supplementary documents can streamline the application process, guaranteeing a smoother interaction with regulatory bodies.
Each document serves its unique purpose, complementing the Texas VI-4 form to paint a complete picture of an applicant's situation. These documents ensure that the application for a window tint medical exemption is grounded in verifiable medical needs and that the vehicle in question is legally eligible for such modifications. This comprehensive approach helps the Texas Department of Public Safety evaluate and process requests more efficiently, maintaining the balance between regulatory standards and individual needs.
The Texas VI-4 form, designed for Window Tint Medical Exemption, closely aligns with the Disability Placard Application used in many states for individuals requiring special parking privileges due to a disability. Both documents necessitate detailed personal information, vehicle identification, and a specifically outlined need for exemption, either for window tinting based on medical reasons or for parking conveniences due to physical limitations. They serve to provide exceptions to general rules for individuals whose medical conditions warrant such needs, ensuring that the accommodations are justified and documented appropriately.
Similarly, the Texas VI-4 form shares common aspects with Handicap License Plate Applications, which are utilized by drivers or vehicle owners seeking to obtain license plates indicating disability status. Like the VI-4 form, applicants must provide personal, vehicle, and medical practitioner information to verify the requirement for special designation. Both applications serve a regulatory exemption purpose based on health conditions, necessitating authoritative verification by a healthcare professional to ensure compliance with specific eligibility criteria.
Another document echoing the VI-4 form is the Application for Disabled Veteran License Plates and Parking Placards. This document, tailored for veterans displaying a service-connected disability, requires comprehensive details reminiscent of those in the VI-4, such as personal identification, vehicle information, and medical verification. The focus is on providing benefits to individuals with specific health-related needs, including exemption privileges and recognition of their unique status through a formal application process.
The Prescription Drug Monitoring Program (PDMP) Request forms, while targeted towards tracking controlled substances, similarly require detailed personal and professional verification. Both the PDMP requests and the VI-4 form necessitate a healthcare provider's input—demonstrating a regulated process that relies on professional expertise to approve a request, be it for medical exemption for window tint or for managing prescription medications.
Custom License Plate Application forms also share a parallel with the VI-4 form in terms of personalizing a vehicle based on user requirements or preferences. Although one focuses on aesthetic or identification changes and the other on medical exemptions, both involve submitting specific vehicle details and justifications for the request, underpinned by official approval processes to meet regulatory standards or personal needs.
Medical Marijuana Card applications, prevalent in states where medicinal cannabis is legalized, resemble the VI-4 form's structure and purpose. Applicants must disclose personal health information, obtain a healthcare provider's endorsement, and demonstrate a qualifying condition—similarly to how the VI-4 mandates documentation of a qualifying medical necessity for window tint exemptions, underscoring the regulated linkage between health conditions and legal exemptions.
Lastly, the International Fuel Tax Agreement (IFTA) License Application, despite its distinct focus on fuel tax licensing for commercial vehicles, requires detailed business and vehicle information, paralleling the VI-4 form's detailed submission criteria. Both involve regulatory compliance, verification procedures, and the need to substantiate the reason for the application—whether for tax purposes or medical exemptions—through a structured, official process.
When filling out the Texas Vehicle Inspection Window Tint Medical Exemption Application (Form VI-4), it is important to adhere to the following do's and don'ts to ensure your application is processed smoothly and efficiently.
Do's:
Don'ts:
Following these guidelines will help ensure your Texas Window Tint Medical Exemption application is processed without unnecessary delay, allowing for a smoother and more efficient exemption request process.
Misunderstandings about forms and regulations, such as the Texas Vi 4 form for window tint medical exemptions, can lead to confusion and incorrect applications. Below are ten misconceptions about the Texas Vi 4 form corrected for clarity.
Correcting these misconceptions optimizes the chances of a successful application by ensuring applicants are well-informed about the requirements and process involved in obtaining a window tint medical exemption in Texas.
Filling out and using the Texas Vehicle Inspection Form VI-4 for a window tint medical exemption requires specific steps and documentation to ensure compliance with the Department of Public Safety. Understanding these requirements can simplify the application process. Here are five key takeables:
Compliance with these guidelines not only facilitates the application process but also ensures that the exemption is legally obtained and recognized by the Texas Department of Public Safety. Prospective applicants should carefully review and adhere to these instructions when seeking a medical exemption for window tinting on their vehicles.
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