Fillable GEORGIA DEPARTMENT OF PUBLIC SAFETY LIGHT PERMIT SECTION

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GEORGIA DEPARTMENT OF PUBLIC SAFETY LIGHT PERMIT SECTION

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GEORGIA DEPARTMENT OF PUBLIC SAFETY
MOTOR CARRIER COMPLIANCE DIVISION
LIGHT PERMIT SECTION
404-624-7217
BEFORE COMPLETING THE APPLICATION
PLEASE READ THE FOLLOWING
DPS Rule 570-11-.02 (4)
Amber Lights - use as caution or warning devices
to warn motorists and the
general public of hazardous or emergency situations but such vehicles so designated
shall not use amber lights to respond to emergency situations.
TEMPORARY PERMIT
Make a copy of your payment (money order, cashier check, or company check ONLY)
and your application and this will act as your temporary permit. Place copies of
both in your vehicle until you receive your permit. It will take two weeks to
receive your permits.
PLEASE NOTE: No one may use the copies of the application and payment
as a temporary after two weeks of original request. If applicants do not
call after three weeks of NOT
receiving their permits, we will assume you
have received them.
PERMIT EXPIRATION
All permits expire one year from the date of issue.
PLACEMENT OF PERMIT ON THE VEHICLE
Permits should be placed on the passenger side of the front windshield in the bottom
corner.
Print Form
***ALL PRIVATELY OWNED VECHICLE PERMITS EXPIRE 1 YEAR FROM DATE APPROVED***
INSTRUCTIONS FOR EMERGENCY LIGHT PERMIT
Listed below are some brief guidelines for making application to use amber, red, or blue
lights. The Official Code of Georgia Annotated (40-8-90 through 96) prescribes the conditions
of this certification. Department of Public Safety Rules and Regulations 570-11-.01 through
.014 prescribe guidelines for making application for the use of emergency lights. Mail all
applications to the appropriate address indicated on the top of the form. Applications for
flashing lights are NOT accepted in person, all applications must be mailed. Please make
copies of this form and your payment to use as your temporary until you receive
your permit.
*There is currently a TWO-Week turn around time on the light permits.*
All applications must be filled out completely. PLEASE TYPE ON PRINT YOUR INFORMATION
1. Full name and address of the individual, company, or department.
2. Vehicle information- year, make, tag number, and VIN of all vehicles.
*If you are a attaching a company vehicle listing, please number your vehicle listing.*
3. Statement of use must be completed. If all vehicles are use for the same purposes, one
state will be sufficient for all vehicles. If not, please attach a separate statement detailing
each vehicle’s use.
4. Fee of $2.00 per vehicle
must be made payable to the Department of Public Safety in
the form of money order, cashier’s certified check, or business check. NO PERSONAL
CHECKS WILL BE ACCEPTED. All government owned vehicles and volunteer fire
personnel are exempt from this fee.
5. Application must be notarized and signed by the responsible party. If you are
applying for an Amber Light Permit, the application does not have to be
notarized.
6. Permit should be placed on the passenger side at the bottom corner of the front
windshield.
EXCEPTIONS/ADDITIONAL REQUIREMENTS
1. 1
st
Responders must be approved through Dept of Human Resources.
2. The Fire Chief, County Commissioner, Mayor, County Fire Marshal, County EMA
Director, or County Sheriff must complete and sign the Authorizer portion of application
for emergency personnel. No individual can sign his/her own application for this use.
3. No personal vehicles will be approved for blue lights.
4. All government owned marked fire and police vehicles are no longer required to have
permits. Government owned unmarked vehicles must possess a light permit.
5. All security vehicles must submit a copy of the security license issued by the Secretary of
State’s office.
6. ALL RED/BLUE light permit applications must be notarized.
Georgia Department of Public Safety
www.dps.georgia.gov
AMBER FLASHING OR REVOLVING LIGHT PERMIT APPLICATION
O.C.G.A. § 40-8-92
MAIL TO:
CONTACT US:
Department of Public Safety
Attn: Light Permit Section (404) 624 - 7211
P.O. Box 281439
Atlanta, GA 30384-1439 www.dps.georgia.gov
PLEASE PRINT OR TYPE
Name:
Vehicle Owned By:
(Full Name: Individual or Company)
Mailing
Address:
Company
City:
State:
Zip Code:
Individual
Telephone:
Government
Email:
DESCRIPTION OF VEHICLE(S) TO WHICH LIGHT IS TO BE OPERATED
Year Make Tag Vehicle ID Number ( VIN )
Department Use Only
Permit Number
1.
2.
3.
4.
5.
6.
7.
NOTE: Permits should be placed on the passenger side of the front windshield in the bottom corner.
MAKE PAYMENTS PAYABLE TO:
DEPT OF PUBLIC SAFETY
MONEY ORDER
CASHIER’S CHECK
COMPANY CHECK
NO PERSONAL CHECKS
CHECKS MUST BE DRAWN ON A US BANK
$2.00
Per Permit
Total Fee Enclosed:
$
STATEMENT OF USE
PLEASE CHECK EACH USE THAT APPLIES
The above-described vehicle(s) will be used for:
Wrecker/ Service Truck
Security
Construction
Oversize Load
Utility/Maintenance
Escort
Low Speed Vehicle
Other: ______________________
We, the undersigned, have read the foregoing application and affirm that all information submitted is
true and correct to the best of our knowledge and belief.
ALL PRIVATELY OWNED VEHICLE PERMITS EXPIRE 1 YEAR FROM DATE APPROVED
Date: _________________ Signature: ____________________________
DPS41‐A
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DESCRIPTION OF VEHICLE(S) TO WHICH LIGHT IS TO BE OPERATED CONT’D
Year Make Tag Vehicle ID Number
Department Use Only
Sticker Number
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GEORGIA DEPARTMENT OF PUBLIC SAFETY LIGHT PERMIT SECTION

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Completed 6 July 2021

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