![]() If you are applying for a change or correction on your application only, there is no fee required.You may refer to the instructions section of the form about the replacement fees details. The Pennsylvania Driver’s License Replacement Form collects fees upon application if you are applying for a replacement.Make sure that you also apply for a replacement immediately upon the loss of your driver’s license as it is illegal to drive a non-commercial vehicle without a driver’s license, and may result in several penalties and sanctions.If your lost or stolen license is about to expire within six (6) months, do not fill out this form and only complete the form DL-143, Renewal of Non-Commercial Driver’s License. ![]() Guidelines in filling out the Pennsylvania Driver’s License Replacement Form Mark the appropriate box to determine your type of payment. I wish to contribute $3.00 to the Veterans’ Trust Fund.Īffix your signature and enter the date of signing.I wish to contribute $3.00 to the Organ Donation Awareness Trust Fund.For veterans wishing to add the Veterans Designation to their Driver’s License or ID Card: I certify under penalty of law that I am a qualified applicant and hereby request it be added to my product.Mark the appropriate boxes to determine the situations you are authorizing. Mark “Yes” if you have any pending criminal charges or driving violations in this state or any other state otherwise, mark “No.”.Mark “Yes” if your driver’s license or driving privilege is suspended or revoked in this state or any other state otherwise, mark “No.”.All must be answered if replacement is requested. Mark the appropriate box to determine your relationship with the minor. Your parent or guardian must fill out this section if you are below 18 years of age. Section D - Consent of Parent, Guardian, Person in Loco Parentis or Spouse at least 18 Years of Age You may select:Įnter your correct date of birth, in the following format: MM/DD/YYYY.Ĭheck the box if you are dropping Class M. Mark the appropriate box to determine your natural eye color. The name changes must be done by the person with the original documents. You may select:Įnter your new last name, name extension, if applicable, first name, and middle name. Mark the appropriate box to determine the reason for your change of name. Mark “Yes” if you would like to notify your county voter registration office of this change otherwise, mark “No.” If you are not a registered voter, you may directly contact your county voter registration office. You may add your Post Office Box number but it cannot be used as your only address. This section requires information you wish to replace your original records with.Įnter your new Pennsylvania street address, city, state, and zip code. Mark “Add” if you agree to add organ donor designation otherwise, mark “Remove.” Other - Specify the type of replacement.Mark the appropriate box to determine the reason for the replacement. to 4:00 P.M.įor a replacement, mark the appropriate box for your application. Section A - You must complete all parts of Section A.Įnter your existing driver’s license number.Įnter your Last Name, First Name, Middle Name, and suffix, if applicable.Įnter your date of birth in the following format: MM/DD/YYYY.Įnter your telephone number that is available from 8:00 A.M. Change or Correction - Answer sections A, C, and F only, and notarization is not required. ![]() All requests with an asterisk need to be notarized.
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