Form Dl-901 - Non-Commercial Driver'S License / Identification Card / Learner'S Permit Application To Renew / Replace / Change / Correct Page 2

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DL-901 (4-14)

Change your address or renew your Non-Commercial Driver's License online at

The most current version of this form can be found on our website.

• 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/ID card, make sure you check the box at the top in Section F.

• All applicants must complete Sections A, B, (C & D if applicable), E, F. Section G must be completed if applying for a product marked with an

asterisk (*) in section B or if section D is completed.

• Section D MUST be completed if applicant is under the age of 18.

• Take your completed and signed application, along with your check or money order payable to "PennDOT" to the nearest Driver Licensing site. For

the location nearest you, visit our website at: .

• If you have not taken or successfully completed the Road Test within three (3) years of your physical examination date, you MUST start over with

another Non-Commercial Learner's Permit Application including a physical and retake the Knowledge Test.

• Out-of-State Address/Photo Exemption - If requesting an out of state address or photo exemption you must complete an Out-Of-State Address/Photo

Exemption Form (DL-82). NOTE: For Photo Exemption, you must be out of state for the entire next 60 days.

Return your completed and signed application with check or money order made payable to: “PennDOT” to: Bureau of Driver Licensing, P.O. Box 68272,

Harrisburg, PA 17106-8272.

NOTE: If you find or recover your original product after you have submitted this application for a duplicate, return the original license with a letter of explanation to

Bureau of Driver Licensing, P.O. Box 68615, Harrisburg, PA 17106-8615. After duplicate is issued, the original license is no longer valid.

NOTARY

This form must be notarized if: 1. Requesting a product that was never received, 2. Requesting a camera card (If you are requesting a camera card due to

renewing your driver's license/photo identification, this form does not need to be notarized.), 3. You are under 18 years of age applying for a learner's permit or

organ donor designation. The notarization section must be signed in the presence of a notary or Driver License Examiner.

FEE INFORMATION

You are entitled to a free replacement ONLY if this application is completed within 90 days of the original date of issuance and the original was never

received due to loss in the mail. If you checked "never received" in Section B, form must be notarized.

RENEWAL LICENSES

DUPLICATE

LEARNER'S PERMITS

Renew 4-Year License . . . . . . . . . . . . . . . . . . . . $29.50

Duplicate Camera Card (License or I.D.) . . . .$5.00

Add/Extend/Replace Non-Commercial

Renew 4-Year License w/Class M . . . . . . . . . . . $49.50

Duplicate Camera Card w/Class M . . . . . . $10.00

Class A, B, or C Permit . . . . . . . . . . . . . . . . . . . . . $5.00

Renew 2-Year License (age 65+) . . . . . . . . . . . $19.00

Duplicate License/I.D.. . . . . . . . . . . . . . . . . $27.50

IDENTIFICATION CARD RENEWALS

Renew 2-Year License w/Class M (age 65+) . . . .$29.00

Duplicate License w/Class M . . . . . . . . . . . $32.50

I.D. cards expiring on or before March 31, 2014 . .$13.50

I.D. cards expiring on or after April 1, 2014 . . . . . .$27.50

NOTE: Update Cards, No Fee. (update cards are not issued if requesting a change of Organ Donor Designation Status)

ORGAN DONATION 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.

CHANGE/CORRECTION

NO FEE REQUIRED — The Bureau will issue an update card reflecting the change/correction which must

ONLY

be carried with the driver’s license.

NAME CHANGE - If your name changed by permission of court, attach a Certified Copy of the Court Order. If you desire to use a name other than your (1) birth

name, (2) spouse’s surname, or (3) a name given through a Court Order, you must provide a copy of your Social Security Card (or records), together with copies

of documents from two other sources issued in the desired name such as: Tax Records, Selective Service Card, Voter Registration Card, Passport, any form of

Photo I.D. issued by a governmental agency, or state issued Birth Certificate.

IF YEAR OF BIRTH on driver’s license is incorrect, attach a copy of your official birth certificate.

IF Social Security Number is incorrect, attach copy of your Social Security Card.

CLASS INFORMATION

CLASS C (Minimum age 16) Required to operate a single non-commercial* vehicle not over 26,001 pounds gross vehicle weight rating (such as passenger car,

station wagon, or small truck) or any such vehicle, except those requiring a motorcycle classification, that does not meet the definition of Class A or Class B. (Class

C permit does not include any other class.)

CLASS B (Minimum Age 18) Required to operate a non-commercial* single vehicle of 26,001 pounds or more gross vehicle weight rating or any such vehicle

towing a trailer not over 10,000 pounds gross weight. (Class B permit includes Class C).

CLASS A (Minimum Age 18) Required to operate a combination non-commercial* vehicle with a gross vehicle weight rating of 26,001 pounds or more, provided

the gross vehicle rating of the vehicle being towed is in excess of 10,000 pounds. (Class A permit includes Classes B and C.)

*The term includes an implement of husbandry, certain motorized construction equipment not intended for on-road use, or any motor home or trailer operated

solely for personal use.

CLASS M If adding, extending, changing, or correcting a Class M, you MUST complete a Motorcycle Learner's Permit Application (DL-5).

NOTE: The holder of a Non-Commercial Class A, B, or C driver's license will also be authorized to drive a moped.

PROVISIONS OF SECTION 3709 OF THE VEHICLE CODE

Section 3709 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.