Form Dl-54a - Application For Initial Identification Card (Page 2 of 2) in pdf

DL-54A (8-15)

You must be at least 10 years of age or older to obtain a Pennsylvania Identification Card.

If you are under 18 years of age your parent, guardian, person in loco parentis, or spouse who is 18 years of age or older must

accompany you. Proper Identification is required and if the last names are different, verification of relationship is needed.

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 the federal or state government, armed forces personnel, and immediate members of 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

SECTION B

If you check block 1, you must apply in person at a driver License center with the identity and residency documents listed below.

If you check block 2 or block 3, you can mail your completed and signed application.

SECTION C

Veterans Designation: You have the opportunity to add the veterans designation to your identification card, 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 Id card, make sure you check the box at the top in Section C.

NOTE: Driver License Centers do not accept cash or credit cards. You must pay by check or money order.

If mailing your application along with your check or money order (if applicable) made payable to PenndOT, send to the: Bureau of Driver

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

TO MEET IDENTIFICATION REqUIREMENTS You MUST Present the Following:

U.S. CITIZENS -

You must bring the Original Social Security Card (card cannot be laminated) AND ONE of the following:

• Birth Certificate with raised seal (U.S. issued by an authorized government agency, including U.S. territories or

Puerto Rico. Non-U.S. Birth Certificates will not be accepted.) No other birth documents will be accepted.

• Certificate of U.S. Citizenship (USCIS Form N-560)

• Certificate of Naturalization (USCIS Form N-550 or N-570)

• valid U.S. Passport (Only valid U.S. Passports and original documents will be accepted.)

✦ If you have an Out-of-State Driver's License, it must be presented with one of the above forms of identification.

NOTE: If the name on your original document differs from your current name, you must provide an original Marriage

Certificate, Divorce Decree, or Court Order document.

NON-U.S. CITIZENS -

You must bring all of the following:

• Original Social Security Card (card cannot be laminated), or letter from SSA indicating that SSA did not make a decision

yet, or SSA rejection letter

• Written verification of attendance from school

(Student Status Only)

• valid Passport

• Written verification from employer (Employment Status Only)

• All original (USCIS) documents

TO MEET RESIDENCY REqUIREMENTS You MUST Present TWO of the Following (for customers 18 years of age or older):

• Lease Agreements

• Tax Records

• Mortgage documents

• Current Weapons Permit

(for U. S. Citizens Only)

• Current Utility Bills (water, gas, electric, cable, phone, etc.) • W-2 form

Note: If you reside with someone, and have no bills in your name, you will still need to provide two proofs of residency. One proof

is to bring the person with whom you reside along with their driver's License or Photo Id to the driver License Center. You will also

need to provide a second proof of residency such as official mail (bank statement, tax notice, magazine, etc.) that has your name

and address on it. the address must match that of the person with whom you reside.

Organ Donor Awareness Trust Fund (ODTF): You have the opportunity to contribute $1.00 to the fund. The additional $1.00

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.

The department is required to obtain the Licensee's Social Security number, height and eye color under the provisions of Sections

1510(a) and/or 1609(a)(4) of the Pennsylvania vehicle Code. This information will be used as identifying information in an attempt to

minimize driver license fraud. federal law permits the use of the Social Security number by state licensing officials for purposes of

identification.

Visit us at or call us at:

In state: 1-800-932-4600

Tdd: 1-800-228-0676

Out-of-State 1-717-412-5300

Tdd Out-of-State: 1-717-412-5380

✦

Form Dl-54a - Application For Initial Identification Card Page 2

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