![]() If you are a veteran and wish to add the Veteran’s Designation to your driver’s license or ID card, check this box. If you checked “yes” for any of the above, enter the State in which the violation or criminal charge happened, the date it was given, and the reason for the violation or criminal charge. If you have any pending criminal charges or driving violations in PA or any other state that may carry a penalty of suspension or revocation of your driver’s license, check “yes”.If your driver’s license has been suspended or revoked in PA or any other state, check “yes”.If you are requesting a replacement license, you must answer all of these questions. Status of Driving Privilege or Driver’s License Have your parent, spouse, or guardian sign the form in the space provided. ![]() Mark the box that indicates the relation of the applicant (person filling out this form) to the person giving their consent. If you are over 18 years of age, skip this section. If you are under 18 years old and wish to be marked as a designated organ donor, a Parent, Guardian, Person in Loco Parentis (person acting in place of a parent), or Spouse (at least 18 years of age) must give their consent. (Enter the color in the space provided).Įnter your correct height in feet and inches.Ĭheck this mark if you wish to drop your class M privilege. Mark the appropriate box that indicates your eye color. Note: This must be done in person and with the appropriate legal documents that indicate the change of name. You may select:Įnter the new name that will be put on your driver’s license. If you are changing the name that will be put on your driver’s license, mark the appropriate box that indicates the reason for the change. If you are not a registered voter, contact your county voter registration notice. If you are a registered voter, mark “yes” if you would like your county voter registration office to be notified of your change in address. Otherwise, check “no.”Įnter your new street address, city, and zip code. If you wish to be designated as an organ and tissue donor, check “yes”.
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