Form DL-180C at a glance
What it is: This is the Parent or Guardian Certification Form.
Who signs: Signature of parent, guardian, person in loco parentis or spouse at least 18 years of age.
A filled-in Form DL-180C example: a parent certifies a teen's driving hours
How to fill out Form DL-180C, box by box
Minor's name and learner's permit number
Print the name of the minor and the learner's permit number.
Supervised driving, distracted driving and signature
By signing you hereby certify that this minor applicant has completed at least 65 hours of supervised practical driving experience, including (except for a motorcycle permit applicant *) 10 hours of nighttime driving and 5 hours of inclement weather driving. This behind-the-wheel experience was given by a licensed driver(s) 21 years of age or older. For the motorcycle permit applicant marked with the *, completion of a Pennsylvania Motorcycle Safety Program basic rider course is required for motorcycle permit applicants in lieu of the 10 hours of nighttime driving and 5 hours of inclement weather driving and counts toward the 65-hour requirement.
By signing you certify that this minor has printed or viewed educational materials provided on PennDOT's website on the dangers of distracted driving.
Sign in presence of notary, driver license examiner, end-of-course skill test teacher, certified third party examiner, or motorcycle safety instructor.
Print name as it appears in signature.
Notary or license examiner
Notarized Signature required ONLY if parent or guardian is not accompanying the teen driver to the Driver License Center for their Skills Test.
Subscribed and sworn to before me: mo. day year; signature of person administering oath; seal.
Sign in presence of notary or driver license examiner; enter the exam center and the examiner # or instructor #.
Sources
[1] Form DL-180C (6-25), Parent or Guardian Certification Form, Pennsylvania Department of Transportation (the Official source link on this page).
