Online Dl 17 Form PDF Details

Are you applying for a driver’s license in California? Do you need to complete the DL 17 form, also known as the Driver License and Identification Card Application? Completing this form is an essential step during the process of getting your license. Keep reading to find out more about what information is needed on the DL 17 form, how to submit it correctly, and why it’s so important!

QuestionAnswer
Form NameOnline Dl 17 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other names17 dl, dl 17 form penndot, pa form dl 17, can i submit a dl 17 form online

Form Preview Example

DL-17 (12-19)

STATEMENT OF NON-OWNERSHIP OF VEHICLE(S)

PA Department of Transportation • Bureau of Driver Licensing P.O. Box 68693 • Harrisburg, PA 17106-8693

THIS FORM SHOULD BE SUBMITTED 30 DAYS PRIOR TO THE ELIGIBILITY DATE THAT IS LISTED IN YOUR RESTORATIONS REQUIREMENT LETTER

NOTE: THIS FORM IS ONLY VALID FOR 60 DAYS FROM THE DATE THE FORM WAS SIGNED. IF THE FORM EXPIRES PRIOR TO AN INDIVIDUAL’S

DRIVING PRIVILEGE BEING RESTORED, A NEW DL-17 IS REQUIRED.

ALL INFORMATION MUST BE COMPLETED

DRIVER’S LICENSE NUMBER

LAST NAME

JR/ETC

FIRST NAME

MIDDLE NAME

DATE OF BIRTH (must be listed)

TELEPHONE NUMBER (8:00 a.m. to 4:30 p.m.)

E-MAIL ADDRESS (if applicable)

Month

Day

Year

 

 

 

 

 

 

 

CHANGE OR CORRECTION OF ADDRESS

ADDRESS CHANGE - A Post Office Box number may be used in addition to the actual residence address, but cannot be used as the only address.

NEW

STREET

ADDRESS

CITY

STATE

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.

I,

 

, hereby state that I

 

PLEASE PRINT NAME

do not own any motor vehicle(s) currently registered in the Commonwealth of Pennsylvania. I certify that all information given on this statement is true and correct. If using a Messenger Service, I hereby authorize the Department to furnish them with my driving record for the purpose of processing this form.

SIGNATURE IN INK

DATE

WARNING: Misstatement of fact is a misdemeanor of the third degree punishable by a fine of up to $2,500.00 and/or imprisonment up to one year (18 PA C.S. Section 4904(b)).

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Filling out section 2 in dl 17 form

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