Form Dl-143 - Non-Commercial Driver'S License Application For Renewal Page 2

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DL-143 (12-16)

The most current version of this form can be found at:

OUT-Of-STATE ADDRESS. We may not issue driver license products to an out-of-state address, except in the case of an

employee of federal or state government, armed forces personnel, or 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

INSTRUCTIONS

• Veterans Designation: You have the opportunity to add the veterans designation to your driver's license, which clearly indicates you

are a veteran of the United States Armed Forces. To qualify, you must have served in the United States Armed Forces, including a reserve

component or the National Guard, and have been discharged or released from such service under conditions other than dishonorable. If you

are requesting to add the veterans designation to your license/ID card, make sure you check the box at the top in Section D.

• COMPLETE sections A, B (if applicable), C, and D.

• Return your completed and signed application, along with your check or money order payable to "PennDOT", to the: Bureau of Driver

Licensing, P.O. Box 68272, Harrisburg, PA 17106-8272.

FEE INFORMATION

FEE: $30.50 - The Bureau will issue a camera card, which is a temporary Non-Commercial Driver’s

RENEWAL OF A 4 YEAR

License valid for 60 days. During those 60 days, the driver must appear at a photo driver license center

NON-COMMERCIAL

for the purpose of having a photo taken.

DRIVER’S LICENSE

If license is endorsed with Class M, fee is $50.50.

FEE: $20.00 - The Bureau will issue a camera card, which is a temporary Non-Commercial Driver’s

RENEWAL OF A 2 YEAR

License valid for 60 days. During those 60 days, the driver must appear at a photo driver license center

NON-COMMERCIAL

for the purpose of having a photo taken. If license is endorsed with Class M, fee is $30.00.

DRIVER’S LICENSE

NOTE: Drivers age 65 and over have the option of requesting a two (2) year driver's license.

ORGAN DONATION

You have the opportunity to contribute $1.00 to the Fund. The additional $1.00 contribution must be

AWARENESS TRUST

added to the fees above and included in your payment by check/money order. You must also check the

FUND (ODTF)

block provided in Section F to ensure proper handling of your contribution.

You have the opportunity to make a tax deductible contribution to the VTF. Your contribution will help

VETERANS’ TRUST

support programs and projects for pennsylvania veterans and their families. Since this additional $3.00

FUND (VTF)

is not part of the fee, please add the donated amount to your payment. Also, please check the proper

block on the form to ensure your contribution is handled properly.

CHANGE/CORRECTION

NO FEE REQUIRED — The Bureau will issue an update card reflecting the change/correction which must

be carried with the Pennsylvania Identification Card. Notarization is not required.

ONLY

NAME CHANGE - If you desire to use your birth name, you must present your state issued birth certificate with a raised seal. If your name

changed by permission of court, you must present a Certified Copy of the Court Order. If you desire to use your spouse’s surname, you

must present your marriage certificate. If you desire to use another name, you must present your Social Security Card, together with 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, banking records, or baptismal certificate.

To report errors on your driver’s license relating to name, date of birth or social security number, please contact PennDOT’s

Customer Care Center at 1-800-932-4600.

If you are required to present supporting documentation to correct your record, all documents must be originals and

presented in person at a PennDOT Driver License Center.

· For NAME corrections, you must present your state issued birth certificate with a raised seal, a Certified Copy of the Court

Order or your marriage certificate.

· For DATE OF BIRTH corrections, you must present state issued birth certificate with raised seal.

· For SOCIAL SECURITY NUMBER corrections, you must present your Social Security Card.

*Note: All name changes must be made in person at a Driver License Center. All documents must be original.

Change your address or renew your driver's license online at

PROVISIONS OF SECTION 3709 OF THE VEHICLE CODE

Section 3709 provides for a fine 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 fine 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.