Illinois Form VSD 976: Impaired Communication Certification – Illinois Secretary of State Form VSD 976, titled “Certification for Impaired Communication with a Peace Officer,” is the official document used by vehicle owners in Illinois to voluntarily notify the state that the owner, a child of the owner, or another approved driver of a registered vehicle has a health condition or disability that may impede effective communication with a peace officer. The form is issued by the Illinois Secretary of State’s Vehicle Services Department and supports the requirements of 625 ILCS 5/3-405.5 of the Illinois Vehicle Code.
The current version of the form (revised March 2026) is available as a fillable PDF on the official Illinois Secretary of State website. Completing and submitting Form VSD 976 allows the indicated communication impairment to be associated with the vehicle’s registration information for law-enforcement purposes while protecting the confidentiality of the specific diagnosis.
Purpose of Form VSD 976 Under Illinois Law
Under 625 ILCS 5/3-405.5, an application for vehicle registration must include space for the applicant to voluntarily indicate that the applicant, a child of the applicant, or another approved driver has a health condition or disability that may impede effective communication with a peace officer. The Secretary of State may request verification of that condition.
Form VSD 976 serves as that verification. Once processed, the Secretary of State provides the vehicle registration information (but not the specific diagnosis, unless authorized) to the Illinois State Police. The information is entered into the statewide Law Enforcement Agencies Data System (LEADS). When an officer runs the plate during a traffic stop, LEADS can alert the officer that the operator or a child passenger may have a communication impairment, promoting safer and more effective interactions.
The law explicitly limits disclosure: specific health information remains confidential for use only by the Secretary of State and the Illinois State Police, except as authorized by the individual.
Who Should Use Form VSD 976?
Any Illinois vehicle owner may use the form if the owner, a child of the owner, or another authorized driver of the registered vehicle has a communication impairment. Common qualifying conditions listed on the form include:
- Autism Spectrum Disorder
- Intellectual or Developmental Disability
- Hearing or Speech Impairments
- Mental Health Disorders
- Other conditions that impede effective communication (specified by the certifying professional)
The form is voluntary. It is intended for individuals who want law-enforcement officers to be aware of potential communication challenges during traffic stops or other interactions involving the registered vehicle.
How to Complete Form VSD 976?
The form contains two main sections that must both be completed.
Section A – To Be Completed by the Owner
- Owner’s full name
- Name of child or other authorized driver (if applicable)
- Complete address (street, city, ZIP)
- Daytime telephone number
- Owner’s signature and date
- List of the license plate number(s) for the vehicle(s) to which the notification should apply
Section B – To Be Completed by a Licensed Medical or Mental Health Professional
A licensed physician, licensed psychologist, or non-physician mental health professional must complete this section. Required information includes:
- Applicant’s name (and name of child or authorized driver if applicable)
- Communication-impaired diagnosis (check the appropriate box or specify “Other”)
- Certification statement confirming the impairment meets the standard under 625 ILCS 5/3-405.5
- Professional’s printed name, signature, address, license number, and telephone number
The form must be printed or typed clearly. Incomplete forms or those missing the professional certification will not be processed.
Where to Submit the Form?
Mail the completed Form VSD 976 and any required supporting documents to:
Special Plate Section
501 S. Second St.
Springfield, IL 62756
For additional assistance, call the Illinois Secretary of State Vehicle Services toll-free number at 800-252-8980 or visit the official website at ilsos.gov.
How the Information Is Used?
After processing, the vehicle registration data is shared with the Illinois State Police for inclusion in LEADS. Officers querying the plate receive an alert that a communication impairment may exist. The specific diagnosis is not disclosed unless the individual has authorized it. This system is designed solely to improve communication and safety during interactions; it does not affect driving privileges, insurance rates, or other vehicle-related rights.
Related Options for Communication Impairments in Illinois
Form VSD 976 is one of several tools available through the Illinois Secretary of State and the Illinois Department of Human Services:
- Driver’s License Designations – Codes such as J88 (Deaf or Hard of Hearing), J89 (Aphasia), and J91 (Mental Disability) can be added to a driver’s license or ID card. Some require a Medical Report Form. Request these at any Secretary of State facility.
- DHS Communication Wallet Card – Available to individuals with a Type 2 (developmental) or Type 5 (mental) disability who hold a Persons with Disabilities ID Card. The card can be presented to officers to explain communication needs.
- Illinois Blue Envelope Program – Scheduled to begin January 1, 2027. This voluntary program provides a distinctive blue envelope for holding license, registration, and insurance documents. Presenting the envelope signals that the individual may benefit from alternative communication techniques. No medical certification is required.
More details on these options are available on the official Persons with Communication Impairments page.
Download Illinois Form VSD 976
Download the official, current fillable PDF of Form VSD 976 directly from the Illinois Secretary of State:
Always obtain the form from the official .gov website to ensure you are using the most recent version. Forms should be downloaded and opened with Adobe Acrobat Reader for best results when filling fillable fields.
Frequently Asked Questions
Is there a fee for submitting Form VSD 976?
No fee is associated with the certification form itself.
Does the form expire?
The form does not list an expiration date. Contact the Special Plate Section if you need to update or remove the notification.
Can I submit the form for multiple vehicles?
Yes. List all relevant license plate numbers in Section A.
Will the specific diagnosis appear on my registration or be visible to officers?
No. Only an alert that a communication impairment may exist is provided through LEADS, unless you specifically authorize disclosure of the diagnosis.
Where can I get more help?
Call 800-252-8980 or visit ilsos.gov for the latest information and facility locations.
Conclusion
Illinois Form VSD 976 provides a simple, confidential way for vehicle owners to help ensure that peace officers are aware of potential communication barriers during traffic stops. By completing the owner section and obtaining professional certification, Illinois residents can support safer interactions while protecting their personal health information. Download the official form today, complete it accurately, and submit it to the Special Plate Section so the notification can be processed under state law.
For the most current guidance, always refer to the official Illinois Secretary of State website and the full text of 625 ILCS 5/3-405.5.