BB2 Application Form for a disabled person

Form BB2

Application for a disabled person’s parking badge for organisations that transport disabled people.

You should return this form to the Hampshire County Council Blue Badge Unit.
Please read the accompanying 'BB2 notes' before completing the form. This information will help you to answer the questions correctly.
Throughout the application form there are links to the relevant section in the BB2 notes. You can access these notes by clicking on the appropriate link.
(To return to this application you must use the back button on your browser to prevent you losing information already completed.)
Complete this form online and print using your browser's printing options or the print button at the end of the form.
Please ensure that all the text fields you have completed are visible when you print the form.

Someone who is authorised to apply on behalf of your organisation must complete this form (Please see the relevant section in the BB2 notes). Please complete a separate form for each vehicle that qualifies.

Part 1: Details of the organisation

1	Name of organisation

2	Postcode

3	Your address






4	Telephone number

Part 2: Details of the person authorised to apply for a blue badge

(Please see the relevant section in the BB2 notes)

5	Your surname

6	Your first names

7	Your title
	If 'Other' please state

8	Position within organisation

Part 3: Details of the vehicle

9	Vehicle registration number

10	Vehicle taxation class

11	Date the vehicle was acquired by your organisation
	Date the vehicle was acquired by your organisation

12	Is the vehicle adapted for wheelchairs (with a ramp or a ramp lift)?
		Yes No

13	How many passengers can the vehicle carry?
	How many passengers can the vehicle carry?	This figure must include the driver

14	How many times a week, on average, is the vehicle used to transport disabled people?

Part 4: Details of the passengers

We can only issue badges to organisations that regularly transport people who would qualify for a blue badge in their own right. (Please see the relevant section in the BB2 notes.)

15 How many people who would qualify for a badge in their own right are carried each week?

If you are renewing or replacing your badge, please go to Part 5. If you are applying for a new badge, please go to Part 6.

Part 5: Details for renewing or replacing a badge

16	Expiry date of current badge
	Expiry date of current badge

17	I want to renew my badge

18	I want a replacement badge because my badge

	is lost	please give the police incident number


	has been stolen	please give police incident number


	has been defaced	please enclose your badge

	has become illegible	please enclose your badge

Part 6: Declaration and signature

The information I have given on this form is true and correct to the best of my knowledge. I understand that you may check any of the information I have given at any time.

I understand that the Blue Badge Unit will store this information on paper and on computer, and I agree that when necessary it can be shared with other organisations that work with Hampshire County Council. I also understand that the Blue Badge Unit will keep the information secure and confidential and that I can ask to see information held about my organisation at any time (in accordance with the Data Protection Act 1998).

If the vehicle is withdrawn from service, or my organisation no longer qualifies for a parking badge, I undertake to return the badge to the Blue Badge Unit at the address below.



Signed

Date



Name



Please return your form to:
Blue Badge Unit
The Castle
Winchester
Hampshire
SO23 8UH

Have you: (Please see the relevant section in the BB2 notes)
	enclosed a copy of your organisation’s stamp or logo?

	enclosed a cheque or postal order for £2 made payable to Hampshire County Council?

Office Use Box
Date application received			Client reference number
	Date GP form BB3 sent to GP
	Date completed form BB3 received		Badge number
	Date badge issued	Initials
	Date application refused		Badge expiry date
	Details entered on system
	Details entered on spreadsheet

15	How many people who would qualify for a badge in their own right are carried each week?