Form Dl 59 PDF Details

Form Dl 59 is a document used to declare legal residency in the United States. This form is used by individuals who are not U.S. citizens, and need to declare their legal status in order to live and work in the United States. The form can be filed with either the Department of Homeland Security or the Department of State, depending on your specific situation. There are several different types of Form Dl 59, so make sure you select the correct form for your needs. Filing this form can be complicated, so it's best to consult with an immigration lawyer if you have any questions.

Below is the details concerning the form you were looking for to complete. It will tell you how much time it will require to complete form dl 59, exactly what parts you will need to fill in, and so forth.

QuestionAnswer
Form NameForm Dl 59
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesSinceyouwererequiredtowaitatle, form dl59, DL-59, dl 59 form pa

Form Preview Example

DL-59 (12-21)

APPLICATION FOR CHANGE FROM A JUNIOR DRIVER’S

 

 

 

 

 

 

LICENSE TO A REGULAR NON-COMMERCIAL LICENSE

 

Bureau of Driver Licensing • P.O. Box 68272 • Harrisburg, PA 17106-8272

 

 

CHECK APPLICABLE

 OPTION 1: Free Update Card to be carried with your Junior Driver’s License. Form must be notarized

 

 

BLOCK:

 

 OPTION 2: Replacement License. Form must be notarized (SEE REVERSE FOR FEES)

A

DRIVER INFORMATION

 

 

Type or Print All Information

 

 

 

 

 

 

 

 

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pennsylvania strongly supports organ and tissue donation because of its life-saving and life-enhancing opportunies.

 

ADD (Parental consent required if under 18)

 

 

 

REMOVE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BADDRESS CHANGE -  A Post Office 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

 

 

This application will also serve as a request to update your voter registration unless you check this box:

 

 

If you are not registered to vote, you will receive an application to register. You must be a U.S. citizen to register to vote in Pennsylvania.

C

ELIGIBILITY ASSESSMENT

Yes If yes, Section E must be completed.

 

 

1.

Have you successfully completed a Driver’s Training Course(s) consisting of 30 hours of classroom theory

 

 

 

and 6 hours of behind-the-wheel instruction approved by the Departments of Education and Transportation?

No If no, you are not eligible to apply.

 

 

2.

Have you held your current Pennsylvania Junior Driver’s License for at least 1 year?

Yes

 

 

No If no, you are not eligible to apply.

 

 

 

 

 

 

 

3.

Have you ever been involved in a crash in which you were partially or fully responsible during the past 1 year?

Yes If yes, you are not eligible to apply.

 

 

No

 

 

 

 

 

 

 

4.

Have you been convicted of any violation of the Vehicle Code during the past 1 year?

Yes If yes, you are not eligible to apply.

 

 

 

 

 

No

D

 

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. I understand that misrepresentation will result in the cancellation of my driver’s license.

 

 

 

I acknowledge that receiving a Pennsylvania Permit, License or ID card will cancel or invalidate any Permit, License or ID card from another state. I certify under penalty of law that the information contained herein is true and correct. I hereby acknowledge this day that I have received notice of the provisions of Section 3709 of the Vehicle Code (see reverse for provisions). If using a Messenger Service, I hereby authorize the Department to furnish them with my driving record for the purpose of processing this form.

I wish to contribute $3.00 to the Organ Donation Awareness Trust Fund (see reverse).

 

INSTRUCTIONS

I wish to contribute $3.00 to the Veterans' Trust Fund (see reverse).

 

 

 

 

If requesting an Update Card retain your current Junior Driver’s

 

X

 

 

License. When your application is processed, an Update Card will be

SIGN

 

 

HERE

 

 

issuedwhich,uponreceipt,shouldbecarriedwithyourJuniorLicense.

 

APPLICANT’S SIGNATURE IN INK (AS IN SECTION A)

DATE

 

 

 

WARNING: Misstatement of Fact is a misdemeanor of the third degree punishable by a fine of up to $2,500 and/or imprisonment up to 1 year (18 Pa. C, Section 4904 [b]).

PAID BY:

Debit/Credit Card

Check

Money Order

do not accept cash.)

TOTAL  $

 

 

 

 

Payable to PennDOT (PennDOT Driver License Centers

 

EAPPROVED DRIVER EDUCATION

I certify that the applicant was enrolled and successfully completed an Approved Driver Training Course in my school consisting of (check appropriate box[es]):

 

 

30 hours of classroom theory and 6 hours behind-the-wheel 

 

 6 hours of behind-the-wheel

 

SIGN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HERE

 

 

 

 

 

 

 

 

 

 

X

 

 

 

(name of the approved school district,

 

(county of school)

(school year of

 

 

(signature of school official)

 

private driver training school or other approved school)

 

 

 

driver education)

 

30 hours of classroom theory only: Check if the student completed an approved driver training classroom theory course with another school. List the name of the school, county where the school is located and attach a copy of your Certificate of Completion from that school.

(name of the approved school district, private driver training school or other approved school) (school year of driver education)

(county of school)

FAFFIDAVIT OF CONSENT - THIS FORM MUST BE NOTARIZED

 

SUBSCRIBED AND

 

I hereby certify that I am the applicant’s

 

 

 

 

 

 

 

 

 

 

 

SWORN TO BEFORE ME

MO.        DAY        YEAR

 

PARENT

GUARDIAN

 

 

 

 

 

PERSON IN LOCO PARENTIS

SPOUSE

 

 

SIGNATURE OF PERSON ADMINISTERING OATH

 

 

I am at least 18 years of age. The applicant has held a valid PA Junior Driver’s

 

 

 

 

 

 

 

 

License for 1 year and this application is made with my full consent.

 

E

 

 

 

 

 

 

X

 

 

 

 

S

 

 

 

SIGN

 

 

 

 

 

SIGN IN PRESENCE OF NOTARY

HERE

 

 

 

 

A

 

(signature of parent, guardian or person in loco parentis or spouse at least 18 years of age)

 

 

 

 

 

IN INK

 

 

 

 

L

 

 

 

 

 

 

 

 

 

 

 

 

(print name as it appears in signature above)

 

DL-59 (12-21)

The most current version of this form can be found at: www.dmv.pa.gov COMPLETE ALL of Sections A, C, D, E, and F. Complete Section B only if you are changing information.

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 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

THIS FORM MUST BE NOTARIZED IN SECTION F

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, make sure you check the box at the top in Section D.

*FEE:

$31.50

- The Bureau will issue a Regular Non-Commercial Photo Driver’s License.

 

$36.50

- Regular Non-Commercial Photo Driver’s License with Class M.

NO FEE: Free Update Card to carry with your Junior Driver’s License.

To obtain an unrestricted license before you are 18 years of age, you MUST:

Hold your valid Pennsylvania Driver’s License for 1 year from issue date;

Maintain a crash and conviction free record for the past 1 year; and

Complete an approved driver’s education course. If necessary, attach a certificate of completion as listed in Section E.

You are automatically a Regular License holder when you turn 18 years of age.

In order to be eligible for a regular license, you must have held your PA junior license for 1 year. If you are unsure when you passed the driving test, it should show on your junior license as the “Issued” date. (If you have a duplicate license, the “Issued” date does not reflect the day you passed your testing.)

Since you were required to wait at least six months before you could take your driving test, and you are also required to have held your PA junior license privileges for at least 1 year, you are not eligible for a regular license if you are less than 17 1/2 years of age.

This form requires 3 signatures:

1.The junior license holder signs as the applicant in Section D.

2.A school official certifying completion of an Approved Driver Training Course signs in Section E. A current listing of acceptable.

Approved Driver Education Course providers can be found online at the following website: www.pde.state.pa.us, and enter keyword “Approved Driver Education”.

3.The junior license holder’s parent, guardian, person in loco parentis, or spouse at least 18 years of age signs in Section F. The signature must be notarized in Section F.

Return your completed and signed application to:

“PennDOT”, The Bureau of Driver Licensing, P.O. Box 68272, Harrisburg, PA 17106-8272

Organ Donation Awareness Trust Fund (ODTF): You have the opportunity to contribute $3.00 to the Fund. The additional $3.00 contribution must be added to your payment. You must also check the block provided to ensure proper handling of your contribution. The ODTF provides for the development and implementation of donor awareness programs and funds shall be appropriated subject to the approval of the Governor.

Veterans’ Trust Fund (VTF): You have the opportunity to make a tax deductible contribution to the VTF. Your contribution will help support programs and projects for Pennsylvania veterans and their families. Since this additional $3.00 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.

PennDOT is required to obtain the Licensee’s height and eye color under the provisions of Section 1510(a) of the Pennsylvania Vehicle Code. This information will be used as identifying information in an attempt to minimize driver license fraud.

Change your address or renew your driver’s license online at www.dmv.pa.gov

Section 3709A 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.

“LICENSE FRAUD IS A SERIOUS CRIME”

FRAUDULENTLY ALTERING, EXHIBITING OR LOANING YOUR LICENSE IS A SERIOUS CRIME. VIOLATORS ARE SUBJECT TO PROSECUTION AND CANCELLATION OF THEIR DRIVER’S LICENSES.

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portion of fields in dl 59 form

Provide the demanded data in the INSTRUCTIONS, DATE, hours, of, behind, the, wheel TOTAL, name, of, the, approved, school, district county, of, school school, year, of, driver, education signature, of, school, official X, SIGN HERE, school, year, of, driver, education and county, of, school section.

stage 2 to filling out dl 59 form

You'll have to include specific data inside the box YEAR, DAY, SIGNATURE, OF, PERSON, ADMINISTERING, OATH SIGN, IN, PRESENCE, OF, NOTARY SEAL, I, hereby, certify, that, Iam, the, applicants PARENT, PERSON, IN, LOCO, PARENT, IS GUARDIAN, SPOUSE and IN, INK

Entering details in dl 59 form stage 3

Please describe the rights and responsibilities of the sides within the Federal, Government US, Armed, Forces THIS, FORM, MUST, BE, NOTARIZED, IN, SECTION, F and FEE box.

part 4 to filling out dl 59 form

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