Form DL-17 at a glance
What it is: DL-17 (12-21) is the STATEMENT OF NON-OWNERSHIP OF VEHICLE(S) of the PA Department of Transportation, Bureau of Driver Licensing.
Who signs: Enter the Date. Sign in ink on the Signature line.
Where and when to file: Submit this form 30 days prior to the eligibility date that is listed in your restorations requirement letter.
A filled-in Form DL-17 example: a filer states he owns no vehicle
How to fill out Form DL-17, box by box
Driver's license number and name
All information must be completed: enter the Driver's License Number, Last Name, Jr/etc, First Name and Middle Name.
Date of birth, telephone number and e-mail address
Date of birth must be listed: enter the Month, Day and Year. Enter the Telephone Number (8:00 a.m. to 4:30 p.m.) and the E-mail Address (if applicable).
Change or correction of address
A Post Office Box number may be used in addition to the actual residence address, but cannot be used as the only address.
Under Change or Correction of Address, enter the New Street Address, City, State and Zip Code.
Voter registration box
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.
Signing the statement
After I, enter Please Print Name; you do not own any motor vehicle(s) currently registered in the Commonwealth of Pennsylvania. You certify that all information given on this statement is true and correct. If using a Messenger Service, you authorize the Department to furnish them with your driving record for the purpose of processing this form.
Enter the Date. Sign in ink on the Signature line.
Common questions about Form DL-17
Is there a deadline?
Submit this form 30 days prior to the eligibility date that is listed in your restorations requirement letter. 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.
Is there a penalty?
Misstatement of fact (18 PA CS Section 4904(b)) is a misdemeanor of the third degree punishable by a fine of up to $2,500.00 and/or imprisonment up to one year (checked October 22, 2026).
Sources
[1] Form DL-17 (12-21), Statement of Non-Ownership of Vehicle(s), PA Department of Transportation (the Official source link on this page).