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The New Jersey MR-15 form serves as an application for individuals seeking a medical exemption to apply sun-screening material to their vehicles, as designated by the New Jersey Motor Vehicle Commission. This exemption is aimed at persons with specific medical conditions that necessitate protection from the sun's rays, including conditions like poly morphous eruption and lupus erythematosus, among others. Applicants are required to submit the form, duly filled out by themselves and their physician, to the MVC for approval, without which unauthorized sun-screening materials could lead to penalties.

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Content Overview

In New Jersey, the MR-15 form plays a crucial role for individuals requiring medical exemptions for sun-screening materials on their vehicles. This necessity arises from specific medical conditions that necessitate protection against sunlight, such as poly morphous light eruption, persistent light reactivity, actinic reticuloid, porphyrins, solar urticaria, and lupus erythematosus. The New Jersey Motor Vehicle Commission outlines the process, requiring applicants to complete and submit the form, detailing their condition, as corroborated by a physician. It's important to note that merely submitting this form does not immediately authorize the application of sun-screening materials; it undergoes a review process. If approved, a "Medical Exemption for Vehicle Sun-Screening Certificate" is issued, specifying the permitted sun-screening materials and their applicable windows. This certificate strictly adheres to New Jersey's tint regulations to ensure safety and compliance. Additionally, it's the applicant's responsibility to remove the sun-screening material if the vehicle is sold or if the license plates are transferred, emphasizing the importance of compliance with state requirements and the careful consideration given to health-related exemptions concerning vehicle window tinting.

Document Sample

New Jersey

Motor Vehicle Commission

STATE OF NEW JERSEY

Dear Applicant:

West Deptford Service Center

215 Crown Point Road

Suite100

West Deptford, New Jersey 08086

Information enclosed references legislation that allows sun-screening material for explicit medical reasons such as poly morphous eruption, persistent light reactivity, actinic reticuloid, porphyrins, solar urticaria, and lupus erythematosus.

To apply for sun-screening material, please complete the enclosed application and return to the Motor Vehicle Commission (MVC). The application is to be fully completed by you and your physician. Incomplete or missing information will be cause for rejection. This application does not grant you permission to have sun- screening material applied to your vehicle. All unauthorized sun-screening materials installed are subject to removal, fines and failure to pass New Jersey inspection. Upon sale of vehicle or transfer of license plates, you must return your Medical Exemption for Sun-Screening Certificate to the MVC.

Upon review and approval by MVC you will be issued a “Medical Exemption for Vehicle Sun-Screening Certificate”. This certificate will reflect the type of sun- screening material to be applied to a specific vehicle and windows. Applicants approved for sun-screening materials are responsible for removal of this material prior to the sale or transfer of the exempted vehicle.

You must adhere to the New Jersey tint regulation (N.J.A.C. 13:20-1.1-1.8) requirements listed below:

All medical sun-screening materials must be applied to the portion of the windshield above the AS-1 line. To reduce the transmittance of normally incident light reflection below 70%.

The sun-screening materials could be applied to the upper most portion of the front side window. To reduce visible light below 35%.

The sun-screening materials applied to the windshield or front side windows shall not exceed 8%.

All sun-screening materials applied must be of clear film.

Please visit the MVC Website www.state.nj.us/mvc/Licenses/sunscreening.htm for a list of licensed tinting facilities.

On the Road to Excellence

Visit us at www.njmvc.gov

New Jersey is an Equal Opportunity Employer

NEW JERSEY

MOTOR VEHICLE COMMISSION

West Deptford Regional Service Center

215 Crown Point Road, Suite 100

West Deptford, NJ 08086

REQUEST FOR MEDICAL EXEMPTION TO APPLY VEHICLE SUN-SCREENING

The following information is to be completed by the applicant. (Please print or type.)

Name:

 

 

 

 

Phone number: ________________________

Driver License No.:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address:

 

 

 

 

 

 

 

 

 

 

Street

City

 

 

State

Zip Code

Vehicle

 

 

 

 

 

 

 

 

Make

Model

Year

Plate No.

Vehicle Identification No.

The following information is to be completed by your physician. (Please print or type.)

Check the medical condition that may require the application of sun-screening material:

poly morphous light eruption

persistent light reactivity

actinic rectuloid

porphyrins

solar urticaria

lupus erythematosus

Description of Patient's condition requiring sun-screening:

Recommended treatment:

If the condition is dermatological, has photo testing been done to identify the action spectra or wavelength eliciting a

photo-sensitive medical condition?

Yes

No

If "Yes," what is the wavelength eliciting photosensitivity:__________ nm or;

If "No," what is the action spectra (UVA, UVB, near UV, visible):_________________________________

Physician Information

Name:

Business Address:

 

Street or P.O Box

 

City

State

Zip Code

Medical License No.:

 

State

 

Date of Licensure

 

I certify, under penalty of law, that the above facts are true and correct to the best of my knowledge.

Physician's Signature:

 

Date:

 

(When complete, return to the address above.)

MR-15 (R 6/09)

Form Attributes

Fact Name Description
Purpose of the Form The New Jersey MR-15 form is designed for individuals seeking medical exemption to apply sun-screening materials to their vehicle windows for specific medical conditions.
Medical Conditions Covered Qualifying medical conditions include poly morphous light eruption, persistent light reactivity, actinic rectuloid, porphyrins, solar urticaria, and lupus erythematosus.
Approval Requirement Both the applicant and a licensed physician must fully complete the form. Incomplete applications will be rejected.
Regulation Compliance Approved applications must adhere to New Jersey tint regulation (N.J.A.C. 13:20-1.1-1.8), which sets specific limits on the type and placement of sun-screening material.
Governing Law The MR-15 form and the associated medical exemption process are governed by New Jersey state law, specifically N.J.A.C. 13:20-1.1-1.8, which outlines the regulations for sun-screening materials on vehicles.

New Jersey Mr 15: Usage Guide

Filling out a New Jersey MR-15 form is essential for applicants needing medical exemption for vehicle sun-screening. The form requires careful completion by both the applicant and their physician. For those qualifying due to medical conditions such as lupus erythematosus or solar urticaria, this form is the first step toward obtaining permission for tinted vehicle windows beyond the standard legal limits. It is crucial to fill out the form accurately and provide all required information to avoid delays or rejections. Follow the steps below to complete your application correctly.

  1. Start with writing your full name as it appears on your driver's license.
  2. Provide your phone number next to your name.
  3. Enter your driver license number in the designated space.
  4. Fill out your complete address, including street, city, state, and zip code.
  5. Proceed to the vehicle information section. Write down the make, model, year, and plate number of your vehicle.
  6. Also, include the Vehicle Identification Number (VIN) in the specified space.
  7. For the next section, to be filled out by your physician, check off the medical condition from the list provided that necessitates sun-screening material for your vehicle.
  8. Your physician must describe the condition requiring sun-screening and recommend treatment.
  9. If the condition is dermatological and photo testing has been done, your physician must indicate whether this is true and provide the wavelength that elicits photosensitivity. If not, they must specify the action spectra.
  10. The physician must provide their name, business address, including street or P.O. Box, city, state, zip code, medical license number, and the state and date of licensure.
  11. Ensure your physician signs and dates the form, certifying the information as correct under penalty of law.
  12. Review the completed form for accuracy and completeness. Any incomplete or inaccurately filled sections can lead to rejection.
  13. Upon final review, return the completed form to the address provided: New Jersey Motor Vehicle Commission, West Deptford Regional Service Center, 215 Crown Point Road, Suite 100, West Deptford, NJ 08086.

Completing the MR-15 form accurately and submitting it as instructed is crucial for the approval process. Be mindful that this application does not instantly grant permission for sun-screening material. Approval is subject to review by the Motor Vehicle Commission. Once approved, applicants will receive a “Medical Exemption for Vehicle Sun-Screening Certificate,” which specifies the allowed sun-screening material for their vehicle. Remember, the installation of unauthorized sun-screening materials or failure to comply with New Jersey tint regulations can result in fines, removal of the material, or failure to pass inspection.

Listed Questions and Answers

New Jersey MR-15 Form FAQ

What is the purpose of the New Jersey MR-15 form?

The New Jersey MR-15 form enables individuals with certain medical conditions that are exacerbated by sun exposure to legally apply sun-screening material to their vehicle's windows. These conditions include, but are not limited to, poly morphous light eruption, persistent light reactivity, actinic reticuloid, porphyrins, solar urticaria, and lupus erythematosus. The form must be fully completed by the applicant and their physician, and upon approval, the Motor Vehicle Commission (MVC) will issue a "Medical Exemption for Vehicle Sun-Screening Certificate."

How does one apply for sun-screening material exemption using the MR-15 form?

Applying for an exemption involves several steps as follows:

  1. Complete the MR-15 form, including both the applicant’s information and the physician’s certification regarding the medical condition requiring sun-screening.
  2. Ensure all information is accurate and complete to avoid rejection.
  3. Submit the completed form to the MVC at the address provided on the form.
  4. Wait for the MVC to review and approve the application. Upon approval, a Medical Exemption for Vehicle Sun-Screening Certificate will be issued.

What are the regulations regarding the application of sun-screening material under the exemption?

New Jersey has specific regulations concerning the application of sun-screening materials even under medical exemptions:

  • Sun-screening material may only be applied to the windshield above the AS-1 line to reduce light transmittance to below 70%.
  • The material can be applied to the uppermost portion of the front side windows, provided it reduces visible light transmittance to below 35%.
  • The sun-screening material applied to the windshield or front side windows must not result in a light transmittance level exceeding 8%.
  • Only clear film sun-screening materials are permitted.
These regulations are designed to ensure that the application of sun-screening materials does not impair visibility or road safety.

What happens to the sun-screening material exemption upon the sale or transfer of the vehicle?

Upon the sale or transfer of a vehicle that has been granted a Medical Exemption for Vehicle Sun-Screening, the owner is responsible for several things:

  • The owner must remove the sun-screening material applied under the exemption before the sale or transfer of the vehicle.
  • The Medical Exemption for Sun-Screening Certificate must be returned to the MVC.
These requirements help ensure that every vehicle on the road adheres to New Jersey's sun-screening material regulations, unless exempted for a new, valid medical reason by a subsequent owner.

Common mistakes

Filling out the New Jersey Motor Vehicle Commission's MR-15 form for a medical exemption to apply vehicle sun-screening can be intricate. Applicants often stumble upon several common mistakes that could lead to the rejection of their application. Awareness and avoidance of these errors can streamline the process, ensuring a smoother path to obtaining the necessary medical exemption for sun-screening materials.

  1. Failing to complete the entire form: Applicants sometimes overlook sections or leave fields blank, assuming they are not relevant or optional. Every section of the form, however, is required unless explicitly stated otherwise.

  2. Not obtaining or providing accurate physician information: The form requires detailed information about your physician, including their medical license number and the state of licensure. Inaccuracies in this data can lead to delays or denial of the application.

  3. Omitting the description of the patient's condition requiring sun-screening: A detailed explanation of the medical necessity for sun-screening materials is crucial. Generic or vague descriptions may not be sufficient for approval.

  4. Incorrect or unclear specification of the type of sun-screening material: The application must specify the type of sun-screening material to be applied. Failing to identify the material clearly or selecting a type that does not comply with New Jersey regulations will result in the application's rejection.

  5. Not adhering to the requirements for the sun-screening material application on vehicle windows: The regulations specify where and how much of the sun-screening material can be applied. Applications suggesting non-compliant usage will not be approved.

  6. Forgetting to sign and date the application: The application must be signed and dated by both the applicant and the physician. An unsigned or undated form is incomplete and will be rejected.

  7. Providing an expired medical license number for the physician: Ensure that the medical license number provided is current. Expired credentials can invalidate the application.

  8. Misunderstanding the regulations for medical sun-screening material: The form details the legal requirements for sun-screening material's application. Misinterpretation of these regulations can lead to non-compliant applications.

  9. Failure to update or renew the exemption when applicable: Upon selling the vehicle or transferring license plates, the certificate of exemption must be returned to the MVC. Neglect in this responsibility can result in penalties.

Aiming for accuracy and thoroughness when completing the MR-15 form is imperative. Avoiding these common mistakes not only facilitates a seamless application process but also helps in achieving the desired outcome without unnecessary delays.

Documents used along the form

Understanding the New Jersey Motor Vehicle Commission's requirements for medical exemption for sun-screening material can be complex, requiring specific documentation and adherence to guidelines. Along with the New Jersey MR-15 form, applicants often need to gather additional forms and documents to ensure their application is complete and in compliance with state regulations. The following forms and documents, while critical in the application process for a sun-screening exemption, also play significant roles in various other motor vehicle-related procedures in New Jersey.

  1. Medical Certification for Disability Exceptions (Form BA-49): This form is required for individuals seeking exemption from standard vehicle features due to a medical disability. It's similar in nature to the MR-15, focusing on providing accommodations for those with specific health conditions.
  2. Application for Vehicle Registration (Form BA-49): Needed for registering a vehicle in New Jersey. It's essential for owners seeking a medical exemption for sun-screening, as the vehicle must be properly registered under their name.
  3. Universal Title Application (Form OS/SS-UTA): Used when applying for a new vehicle title in New Jersey, important for ensuring the vehicle associated with a sun-screening exemption is correctly titled to the applicant.
  4. Physician’s Statement for Medical Review Unit (Form MR-5): A detailed form where a physician can provide comprehensive medical information about a patient, possibly supporting the need for sun-screening material due to a medical condition.
  5. Driver History Abstract Request (Form DO-21): Allows individuals to request their driving record, which may be necessary for a comprehensive review during the sun-screening material exemption application process.
  6. License Plate Application (Form SP-41): Used to apply for special license plates in New Jersey, including plates that signify medical exemptions or conditions that could support the case for needing sun-screening material.
  7. Application for Driver’s License (Form BA-208): Used for applying or re-applying for a New Jersey driver’s license, necessary for ensuring the applicant is legally allowed to operate the vehicle they are seeking to apply sun-screening material to.
  8. Temporary Vehicle Tag Application (Form SP- temporary. Enables vehicle owners to acquire a temporary license plate while waiting for permanent plates, useful in situations where immediate use of the vehicle with sun-screening material is necessary for health reasons.

Gathering and completing these forms and documents can be a critical step toward securing a Medical Exemption for Vehicle Sun-Screening Certificate in New Jersey. Each document serves a specific purpose in the broader context of vehicle registration, ownership, and operation, ensuring that applicants meet all necessary legal and medical criteria for exemptions. By understanding and preparing these materials in advance, individuals seeking exemptions can navigate the application process more smoothly, ensuring compliance with New Jersey's Motor Vehicle Commission regulations.

Similar forms

The ADA (Americans with Disabilities Act) accommodation request form is notably parallel to the New Jersey MR-15 form, in that both are designed to facilitate necessary adjustments due to medical or disability-related needs. The ADA form typically requires detailed information about the individual's condition and the specific accommodations requested, much like the MR-15 form requires a detailed account of the medical condition needing sun-screening materials and the specific treatment recommended. Both forms also necessitate certification from a professional - a physician in the case of the MR-15 form and usually a medical or disability specialist for ADA requests.

The HIPAA (Health Insurance Portability and Accountability Act) authorization form shares similarities with the MR-15 form, especially in handling sensitive medical information. This form allows for the release of an individual's health information to specified parties, akin to how the MR-15 form involves sharing detailed medical information with the Motor Vehicle Commission. Both documents demand specific and informed consent, ensuring that personal and medical details are handled with due care and confidentiality, stressing the importance of privacy and informed consent in health-related disclosures.

The Application for Disabled Parking Placard/Plate found in many states mirrors the New Jersey MR-15 form in its purpose to address mobility or health conditions through vehicle modifications, albeit for different needs. Where the MR-15 form addresses the need for sun-screening materials for medical reasons, the disabled parking application allows individuals with disabilities to obtain parking privileges. Both require verification of the condition by a healthcare professional and aim to facilitate the applicant's daily life, highlighting the intersection of health needs and vehicle use.

The Special Dietary Needs Form, used in settings like schools and hospitals, although not directly related to vehicle modifications, shares the core concept of catering to individuals' health requirements. Like the MR-15 form, it necessitates a detailed description of the medical condition (e.g., allergies or specific dietary needs) and often requires a physician's confirmation. Both forms serve as formal requests to modify a standard provision—be it food or vehicle regulations—to accommodate health-related needs, emphasizing customization for health and safety.

The Request for Reasonable Accommodation under Fair Housing mirrors the intent behind the MR-15 form by aiming to modify living or operating conditions for health reasons. This request facilitates modifications to housing units or policies to accommodate individuals with disabilities, akin to how the MR-15 form seeks to modify vehicle regulations for health purposes. Both forms require detailed explanations of the necessity for the request, backed by professional verification, underlining the need for adjustments in standard practices to foster inclusivity and accessibility.

The FMLA (Family Medical Leave Act) certification for a serious health condition has parallels with the MR-15 form, as both involve the formal documentation of a health condition by a healthcare provider. The FMLA certification supports an individual's request for leave due to a serious health condition affecting them or a family member, similar to how the MR-15 form supports the request for vehicle sun-screening due to specific medical conditions. Each form contributes to a framework where health conditions are acknowledged and accommodated in different spheres of life, underlining the society’s commitment to health and wellbeing.

Lastly, tax deduction forms for medical and dental expenses share a conceptual link with the MR-15 form, as they both involve documenting health-related expenses for official approval. Tax forms require individuals to list and prove their medical expenditures to claim deductions, much like the MR-15 form requires detailed medical information and physician certification to approve the application of sun-screening materials for health reasons. Both processes involve formal recognition of health-related needs and expenses, offering financial or practical accommodations to support individuals in managing their health conditions.

Dos and Don'ts

Filling out the New Jersey MR-15 Form, a request for medical exemption to apply vehicle sun-screening, is a process that demands accuracy and attention to detail. Below are eight essential dos and don’ts to guide you through the process:

  • Do ensure that you and your physician complete all sections of the application. Every question provides important information that aids in the evaluation of your request.
  • Do visit the New Jersey Motor Vehicle Commission (MVC) website for a list of licensed tinting facilities. Only these approved facilities should be used to apply sun-screening materials to your vehicle.
  • Do check the specific medical conditions listed within the form carefully. Your physician must validate that you suffer from one of these conditions to qualify for the exemption.
  • Do make a copy of your completed application for your records before submitting it. Keeping a record can be helpful for follow-up communications or in case of any discrepancies.
  • Don’t leave any section incomplete. Incomplete or missing information is a common reason for the rejection of the application.
  • Don’t apply sun-screening materials to your vehicle before receiving the "Medical Exemption for Vehicle Sun-Screening Certificate." Doing so could subject you to removal, fines, and failure to pass New Jersey inspection.
  • Don’t forget to adhere to the specific requirements detailed in the form regarding the placement and visibility of the sun-screening material. These regulations are crucial for ensuring compliance with New Jersey guidelines.
  • Don’t neglect to remove the sun-screening materials before selling or transferring the exempted vehicle, as required. Failing to do so can result in issues for both you and the new owner.

Following these guidelines will streamline the process of applying for a medical exemption for vehicle sun-screening in New Jersey, helping you to navigate the requirements with ease and comply with state laws.

Misconceptions

Misconceptions about the New Jersey MR-15 Form for Medical Exemptions to Apply Vehicle Sun-Screening

In New Jersey, the MR-15 Form is a crucial document for drivers requiring medically necessary sun-screening materials on their vehicles. Despite its importance, several misconceptions persist regarding its use and regulations. Let's clarify some of the most common misunderstandings.

  • Any medical condition qualifies for an exemption: The form explicitly lists qualifying medical conditions such as poly morphous light eruption, persistent light reactivity, and lupus erythematosus. Not all medical conditions are eligible for sun-screening exemptions.

  • Immediate permission is granted upon application: The application process requires review and approval by the Motor Vehicle Commission (MVC). Simply submitting the form does not grant immediate permission to apply sun-screening materials.

  • Certificate allows for any type of tint: The MR-15 Form and subsequent "Medical Exemption for Vehicle Sun-Screening Certificate" restrict the type of sun-screening material to be applied, including its placement and the percentage of visible light transmission.

  • The exemption is permanent: An exemption must be revisited upon the sale or transfer of the vehicle. The certificate is not transferable and the sun-screening materials must be removed if the vehicle is sold or if license plates are transferred.

  • Exemptions apply to all vehicle windows: Regulations specify that sun-screening materials are to be applied only to certain portions of the vehicle, such as above the windshield's AS-1 line and the uppermost portion of the front side windows, not all windows.

  • Approval is assured with physician endorsement: Even with a physician's certification, the MVC reviews each application to ensure compliance with all requirements. Approval is not guaranteed, especially if the application is incomplete or if the condition doesn't meet the specified criteria.

  • Any tinting facility can apply the approved materials: The state of New Jersey mandates that only licensed tinting facilities perform the application of sun-screening materials. Using unlicensed facilities can lead to fines, failed inspections, and the revocation of the exemption.

It is essential for applicants to fully understand the specifics of the MR-15 Form and the associated legal requirements. Misunderstandings can lead to compliance issues, potential fines, and the inconvenience of removing unauthorized materials. For the most accurate and up-to-date information, visiting the official New Jersey Motor Vehicle Commission website is recommended.

Key takeaways

  • The New Jersey Motor Vehicle Commission (MVC) requires a completed application for anyone seeking to use sun-screening material on their vehicle for medical reasons.

  • Applications missing information or not fully completed will be rejected, highlighting the importance of a thorough review before submission.

  • Approval of the application does not automatically grant permission to apply sun-screening materials; such modifications must meet New Jersey's standards and receive explicit approval.

  • Illegally installed sun-screening materials may lead to removal orders, financial penalties, and failure during vehicle inspection.

  • Upon selling the vehicle or transferring its license plates, the Medical Exemption for Vehicle Sun-Screening Certificate must be returned to the MVC.

  • The MVC issues a Medical Exemption for Vehicle Sun-Screening Certificate upon approval, specifying the acceptable type of sun-screening material and designated windows.

  • Approved applicants are obligated to remove the medically exempted sun-screening material if the vehicle is sold or transferred.

  • Specific regulations outline the permissible application of sun-screening materials, such as placement above the windshield's AS-1 line and visibility restrictions.

  • All sun-screening materials applied to exempted vehicles must be clear film, ensuring compliance with New Jersey's visibility standards.

  • Physicians must certify the medical necessity for sun-screening materials, specifying the condition and, if applicable, the wavelength causing photosensitivity.

  • The MVC website provides a list of licensed tinting facilities, aiding applicants in finding compliant service providers.

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