The DL-80 Pennsylvania form serves a crucial function for residents looking to change, correct, or replace their non-commercial driver's licenses. It outlines a detailed process, managed by the Bureau of Driver Licensing, through which individuals must navigate to ensure their driving records are accurate and up to date. With sections that require careful completion and, in certain cases, notarization, this form is an essential tool for maintaining the validity and accuracy of Pennsylvania drivers' licenses.
The DL-80 form, a crucial document provided by the Pennsylvania Department of Transportation, is designed for individuals looking to make changes, corrections, or request a replacement for their non-commercial driver’s license. This form, easily identifiable by its code DL-80 (3-11), must be filled out with either blue or black ink and contains several sections that cater to diverse needs such as organ donor designation, name change due to marriage or divorce, update of personal information like address or eye color, and corrections including date of birth or Social Security Number discrepancies. Importantly, specific scenarios necessitate the notarization of the form, especially for replacing a lost or never received camera card. Additionally, the form facilitates the opportunity to contribute to the Organ Donation Awareness Trust Fund, emphasizing the broader social responsibility intersecting with administrative processes. With a detailed instruction set on its reverse side and penalties for misstatement underlined, the DL-80 form encapsulates a comprehensive approach to maintaining accurate and current driver license information for Pennsylvania residents, thereby ensuring legal compliance and the smooth functioning of related bureaucratic procedures.
DL-80 (3-11)
NON-COMMERCIAL DRIVER’S LICENSE
APPLICATION FOR CHANGE / CORRECTION / REPLACEMENT PLEASE TYPE OR PRINT IN BLUE OR BLACK INK ALL INFORMATION
Bureau of Driver Licensing • P.O.Box 68272 • Harrisburg, PA 17106-8272
CHECK APPLICABLE BLOCK:
PLEASE READ IMPORTANT INFORMATION ON THE REVERSE SIDE.
REPLACEMENT (DUPLICATE) – Complete Sections A, B, (C & D if applicable),
CHANGE OR CORRECTION of Non-Commercial License.
E and F. All requests marked with an asterisk (*) MUST be notarized.
Complete Section A, C and F. Notarization is not required.
Complete absence statement on reverse side if applicable.
An update card will be issued.
A YOU MUST COMPLETE ALL PARTS OF SECTION A
DRIVER’S LICENSE NUMBER
LAST NAME
JR./ETC
FIRST NAME
MIDDLE NAME
DATE OF BIRTH
TELEPHONE NUMBER (8:00A.M. - 4:30P.M.)
E-MAIL ADDRESS (if applicable)
MONTH
DAY
YEAR
B
APPLICATION FOR REPLACEMENT (CHECK ONE)
REPLACEMENT REQUIRED DUE TO REASON (CHECK ONE)
ORGAN DONOR
*REGULAR CAMERA CARD
PHOTO LICENSE
UPDATE CARD
LOST
MUTILATED
DESIGNATION
STOLEN
CORRECTION
ADD (parental consent in
*“PHOTO-EXEMPT’’ CAMERA CARD
VALID W/O PHOTO LICENSE
*NEVER RECEIVED
OTHER ______________________
Section D required
if under 18)
(STATEMENT ON REVERSE MUST BE COMPLETED AND SIGNED)
(No Fee Required)
_____________________________
REMOVE
CCHANGE OR CORRECTION ONLY (Important information on reverse side)
ADDRESS CHANGE -A Post Ofice Box number may be used in addition to the actual residence address, but cannot be used as the only address. See reverse if using an out-of-state address.
NEW
STREET
ADDRESS
CITY
STATE
PA
ZIP CODE
If you are a registered voter in PA, would you like us to notify your county voter registration office of this change?
YES
NO
If you are not a registered voter, you may contact your county voter registration office.
NAME CHANGE
OTHER (see reverse side)
REASON:
MARRIAGE
DIVORCE
LAST
JR., ETC.
OTHER CHANGES
EYE COLOR (Please check one):
BLUE
BROWN
GREEN
HAZEL
PINK
BLACK
GRAY
DICHROMATIC
OTHER ________________
CORRECTION OF DATE OF BIRTH
HEIGHT
SOCIAL SECURITY NUMBER
DROP PRIVILEGE
FEET
INCHES
DROP CLASS M
CONSENT OF PARENT, GUARDIAN, PERSON IN LOCO PARENTIS OR SPOUSE AT LEAST 18 YEARS OF AGE. Complete if
D Applicant is less than 18 years of age to give consent for Applicant’s request for Organ Donor Designation.
I hereby certify that I am a
SIGN
Parent,
Guardian,
Person in Loco Parentis
Spouse at least 18 years of age and I:
HERE
Do give consent
Do not give consent for applicant’s request for Organ Donor Designation.
X
(SIGNATURE OF PARENT, ETC.)
E
ALL MUST BE
No person may hold more than one valid license at any time. If you have a license from another state, do not use this form. YOU MUST go
to a Driver License Examination Center to surrender your out-of-state license and make application for a replacement PA license.
ANSWERED IF
1.
NO - Is your driver’s license or driving privilege suspended or revoked in this state or any other state?
REPLACEMENT
2.
NO - Have you been arrested or cited in this state or any other state for any violation which carries a possible penalty of suspension or
IS REQUESTED
revocation of your driver’s license or driving privilege?
If yes, give state_________ Date ______________ and Reason ___________________________________________________________
FAUTHORIZATION AND CERTIFICATION
I certify under penalty of law that all information given on this application is true and correct. I hereby
AFFIDAVIT: This section must be notarized when applying for replacement of a
authorize the Social Security Administration to release to the Department of Transportation information
Camera Card. You are entitled to a free replacement ONLY if this application is
concerning my Social Security Identication Number for the purpose of identication. If using a Messenger
completed within 90 days of the original date of issuance and the original was
Service, I hereby authorize the Department to furnish them with my driving record for the purpose of
never received due to loss in the mail.
processing this form. I hereby acknowledge this day that I have received notice of the provisions of Section
SUBSCRIBED AND SWORN
3709 of the Vehicle Code. (See reverse for provisions.)
FEE PAID
TO BEFORE ME:
MO.
I wish to contribute $1.00 to the Organ Donation
SEND CHECK
IN THIS
Signature of Person Administering Oath
Awareness Trust Fund (see reverse).
AMOUNT
SEE REVERSE FOR FEES
S
WARNING: Misstatement of fact is
SIGN IN PRESENCE OF NOTARY
a misdemeanor of the third degree
punishable by a ine of up to $2,500
A
and/or imprisonment up to 1 year
L
(18 PA C.S. Section 4904(b)).
(APPLICANT’S SIGNATURE IN INK)
For More Drivers License Information - http://pa-license.com
APPLICANT INFORMATION
•Photo Exemption: Complete form as indicated. Sign both Section ‘’F’’ and the statement below. PennDOT will send you a camera card and further instructions.
During the next 60 days I will be absent from PA for the following reason:
Military
School
Work
Travel
Within 45 days of my return I will apply for a driver’s license containing my photo.
XSIGN
SIGNATURE HERE
•OUT-OF-STATE ADDRESS CHANGE. We may not issue driver license products to an out-of-state address, except in the case of an employee of the federal or state government, armed forces personnel, and immediate members of their families, whose workplace is located outside of Pennsylvania. If this exception applies to you, please check the appropriate box and include documentation of your status with this application. Attach a letter from your employer on their letterhead to document your status, or attach a copy of your current Photo ID issued by your employer. If you are the immediate family of a person meeting one of the allowable exceptions, attach the documentation of the person employed. Additionally, you must indicate your relationship to that person.
I certify that my workplace is located out of state and I am employed by, or am the immediate family of a person employed by:
US Armed Forces
Federal Government
Pennsylvania State Government
Relationship to person meeting exemption (check one):
Spouse
Dependent Child
•Return your completed and signed application with check or money order made payable to "PennDOT", to: Bureau of Driver Licensing, P.O. Box
68272, Harrisburg, PA 17106-8272.
•If your license is due to expire within six (6) months, DO NOT use this form. Complete form DL-143 (Renewal of a Non-Commercial Driver’s License).
•If you ind or recover your original license after you have submitted this application for a duplicate, return the original license with a letter of explanation to: Bureau of Driver Licensing, P.O. Box 68615, Harrisburg, PA 17106-8615. After duplicate is issued, the original license is no longer valid.
REPLACEMENT OF
APPLICATION FOR REPLACEMENT OF A CAMERA CARD OR A PRODUCT NEVER RECEIVED MUST
NON-COMMERCIAL:
BE NOTARIZED IN SECTION F.
PHOTO OR VALID W/O
FEE: $13.50 - The Bureau will issue a camera card, which is a temporary Non-Commercial Driver’s License
valid for 60 days. During those 60 days, the driver must appear at a photo driver license center for the
PHOTO NON-COMMERCIAL
purpose of having a photo taken. If photo image is on ile, the Bureau will issue a Photo Driver’s License.
DRIVER’S LICENSE
If license is endorsed with Class M, fee is $18.50.
*REGULAR OR “PHOTO
FEE: $5.00 if photo was not taken with the original camera card.
EXEMPT” CAMERA CARD
If license is endorsed with a Class M, fee is $10.00.
No Fee. (update cards are not issued if requesting a change of Organ Donor designation status)
*ORGAN DONOR
When you are adding or removing the Organ Donor designation, the form must be notarized and a
replacement fee is required. Refer to fees above.
ORGAN DONATION
You have the opportunity to contribute $1.00 to the Fund. The additional $1.00 contribution must be added to
the fees above and included in your payment by check/money order. You must also check the block provided
AWARENESS TRUST FUND
in Section F to ensure proper handling of your contribution.
(ODTF)
CHANGE/CORRECTION
ONLY
NO FEE REQUIRED — The Bureau will issue an update card relecting the change/correction which must be carried with the driver’s license. Notarization is not required.
NAME CHANGE - If your name changed by permission of court, attach a Certiied Copy of the Court Order. If you desire to use a name other than your
(1) birth name, (2) spouse’s surname, or (3) a name given through a Court Order, you must provide a copy of your Social Security Card (or records), together with copies of documents from two other sources issued in the desired name such as: Tax Records, Selective Service Card, Voter Registration
Card, Passport, any form of Photo I.D. issued by a governmental agency, or state issued Birth Certiicate.
IF YEAR OF BIRTH on driver’s license is incorrect, attach a copy of your oficial birth certiicate.
IF Social Security Number is incorrect, attach copy of your Social Security Card.
PROVISIONS OF SECTION 3709 OF THE VEHICLE CODE
Section 3709 provides for a ine of up to $300 for dropping, throwing or depositing, upon any highway, or upon any other public or private property without the consent of the owner thereof or into or on the waters of this Commonwealth, from a vehicle, any waste paper, sweepings, ashes, household waste, glass, metal, refuse or rubbish or any dangerous or detrimental substance, or permitting any of the preceding without immediately removing such items or causing their removal.
For any violation of Section 3709, I may be subject to a ine of up to $300 upon conviction, including any violation resulting from the conduct of any other
persons present within any vehicle of which I am the driver.
When it comes to updating your non-commercial driver’s license in Pennsylvania, whether it’s due to a need for change, correction, or replacement, the DL-80 form plays a critical role. This form is designed to guide you through the process of making such requests efficiently. Filling out the DL-80 form correctly ensures that the Pennsylvania Department of Transportation (PennDOT) can process your application without unnecessary delays. Here are the step-by-step instructions to fill out the DL-80 Pennsylvania form accurately.
Upon submission, your application will undergo review by PennDOT. If additional information or clarification is needed, you may be contacted. The processing time can vary; thus, it's advisable to submit the application well in advance of when the update or replacement is needed. Once processed, any changes will be reflected on an update card or a replacement driver's license will be issued, depending on your request. Remember, maintaining accurate and current information on your driver's license is not only a legal requirement but also critical for your identification and safety.
What is the DL-80 form in Pennsylvania?
The DL-80 form is a document used by the Pennsylvania Department of Transportation (PennDOT) for individuals looking to apply for a change, correction, or replacement of their Non-Commercial Driver’s License. This form can be used for various needs, including updating personal information, applying for a duplicate license, or changing organ donor status.
When do I need to get my DL-80 form notarized?
Notarization is required on the DL-80 form when applying for a replacement of a camera card, or if a product, like a Photo Driver’s License, was never received. It is expressly stated that any request marked with an asterisk (*) must be notarized. Additionally, if you are contributing $1.00 to the Organ Donation Awareness Trust Fund while applying for an Organ Donor designation change, notarization is also necessary.
How much does it cost to process a DL-80 form for a replacement license or correction?
The cost associated with processing the DL-80 form varies depending on the specific type of replacement or correction needed. For a replacement Photo Non-Commercial Driver's License, the fee is $13.50. If the license is endorsed with Class M, the fee increases to $18.50. For corrections or changes that do not require issuing a new photo, no fee is required. However, specific endorsements or designations, like the Organ Donor status, may have different fees.
Can I change my name with the DL-80 form?
Yes, you can apply for a name change using the DL-80 form. If your name has changed due to marriage, divorce, or a court order, you must attach the relevant documentation, such as a certified copy of the court order or marriage certificate. Additionally, proper identification reflecting the new name, such as a Social Security card or passport, should be provided to verify the change.
What should I do if I find or recover my original license after I have submitted the DL-80 form for a duplicate?
If you find or recover your original license after submitting an application for a duplicate using the DL-80 form, you must return the original license to the Bureau of Driver Licensing with a letter of explanation. Once a duplicate license is issued, the original license is considered invalid and must be surrendered.
How do I report a change of address with the DL-80 form?
To report a change of address using the DL-80 form, complete the section designated for address changes. Provide your new street address, city, state, and ZIP code. If you are a registered voter in Pennsylvania, you have the option to request PennDOT to notify your county voter registration office of the change in address. An out-of-state address change is possible under specific conditions outlined in the form, primarily for certain federal or state employees and their immediate family members, with proper documentation required.
What is the organ donation opportunity mentioned in the DL-80 form?
The DL-80 form includes an opportunity to contribute to the Organ Donation Awareness Trust Fund (ODTF). By checking the appropriate box in Section F and adding $1.00 to your payment, you can make a contribution to this fund. This contribution is entirely voluntary and is in addition to any fees required for processing the form. The ODTF supports education and awareness programs about organ and tissue donation and transplantation in Pennsylvania.
When filling out the DL-80 form in Pennsylvania, which is used for various changes to a non-commercial driver's license, including replacements and corrections, individuals often make a range of mistakes. These mistakes can lead to delays in processing or even the rejection of the application. To ensure a smooth process, it's important to be aware of common pitfalls.
By avoiding these common errors and closely following instructions, applicants can ensure their DL-80 form is processed efficiently and without unnecessary complications.
When dealing with legal documents like the DL-80 form in Pennsylvania, individuals often find themselves needing additional forms to fully complete their request or update their records. The DL-80 form is primarily utilized for non-commercial drivers looking to change, correct, or replace their driver's license in various scenarios, including updates to personal information and replacement of a lost or damaged license. Given the interconnected nature of legal and personal documentation, a range of supplementary forms can play a crucial role alongside the DL-80 form.
Beyond the completion of the DL-80 form itself, these additional forms ensure that individuals can manage their driving records, personal identification, and vehicle ownership comprehensively within Pennsylvania. The process often requires attentive detail to which forms are needed and how they interrelate, underscoring the importance of a well-maintained and up-to-date personal record. Always check the latest requirements and forms directly through the Pennsylvania Department of Transportation to ensure compliance and accuracy in your applications.
When filling out the DL-80 (Non-Commercial Driver’s License Application for Change/Correction/Replacement) form for Pennsylvania, it's essential to approach the process carefully to ensure accuracy and compliance. Here are some dos and don’ts to consider:
When dealing with paperwork from government agencies, it's easy to get tangled in misconceptions, especially with documents like the DL-80 form in Pennsylvania. This form, which deals with changes, corrections, or replacements for non-commercial driver’s licenses, has its fair share of myths circulating around it. Let’s clear up a few of these misunderstandings.
Understanding these facts about the DL-80 form can streamline the process of updating or replacing your license, saving you time and hassle. When in doubt, always refer to the most current information directly from PennDOT or reach out for professional guidance.
Understanding the DL-80 Pennsylvania form is crucial for anyone looking to apply for a change, correction, or replacement of their non-commercial driver's license. This document serves a variety of purposes and has specific requirements for completion. Here are four key takeaways to assist individuals in navigating this process efficiently:
By closely following the instructions provided on the DL-80 form and ensuring all necessary documentation is provided, applicants can successfully process their requests for changes, corrections, or replacements to their Pennsylvania non-commercial driver's license.
Tax Appeal - Offers a structured way for representatives to present arguments and evidentiary documents supporting the taxpayer's case to the Board.
Pw 382 Pennsylvania - It demands details regarding the services provided following the incident, shedding light on necessary medical or rehabilitation measures undertaken.