Form DL-54B "Photo Identification Card Application for Change/Correction/Replacement/Renew" - Pennsylvania

What Is Form DL-54B?

This is a legal form that was released by the Pennsylvania Department of Transportation - a government authority operating within Pennsylvania. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 1, 2019;
  • The latest edition provided by the Pennsylvania Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DL-54B by clicking the link below or browse more documents and templates provided by the Pennsylvania Department of Transportation.

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Download Form DL-54B "Photo Identification Card Application for Change/Correction/Replacement/Renew" - Pennsylvania

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DL-54B (7-21)
PHOTO IDENTIFICATION CARD
APPLICATION FOR CHANGE/CORRECTION/REPLACEMENT/RENEW
Bureau of Driver Licensing, P.O. Box 68272, Harrisburg, PA 17106-8272
CHECK APPLICABLE BLOCK:
REPLACEMENT (DUPLICATE) — Complete Sections A, B, C, and D (if applicable), E and F (if applicable). All requests must be notarized.
1.
RENEWAL, CHANGE or CORRECTION — Complete Section A, C, and D (if applicable), E and F (if applicable). Notarization is not required.
2.
A
YOU MUST COMPLETE ALL PARTS OF SECTION A
JR./ETC
LICENSE/PERMIT/ID NUMBER
LAST NAME
FIRST NAME
MIDDLE NAME
E-MAIL ADDRESS (if applicable)
TELEPHONE NUMBER (
DATE OF BIRTH
8:00A.M. - 4:30P.M.)
MONTH
DAY
YEAR
B
REASON REPLACEMENT REQUIRED: (Check One):
LOST
STOLEN
NEVER RECEIVED
MUTILATED
CHANGE
CORRECTION
OTHER
Pennsylvania strongly supports organ and tissue donation because of its life-saving and life-enhancing opportunities.
ORGAN DONOR DESIGNATION:
ADD (Parental consent in Section D required if under 18)
REMOVE
C
CHANGE OR CORRECTION ONLY (Important information on reverse side)
ADDRESS 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.
STREET ADDRESS
PA
CITY
STATE
ZIP CODE
If you are a registered voter in PA, would you like us to notify your county voter registration office of this change?
YES
NO
If you are not a registered voter, you may contact your county voter registration office.
NAME CHANGE
(Please note all name changes must be done in person with original documents)
REASON:
MARRIAGE
DIVORCE
OTHER (see reverse side)
MIDDLE NAME
JR., ETC.
FIRST NAME
LAST
OTHER CHANGES
EYE COLOR
(Please check one):
BLUE
BROWN
GREEN
HAZEL
PINK
BLACK
GRAY
DICHROMATIC
OTHER __________________
CORRECTION OF DATE OF BIRTH
HEIGHT
SOCIAL SECURITY NUMBER
FEET
INCHES
MONTH
DAY
YEAR
D
MUST BE COMPLETED IF APPLICANT IS UNDER THE AGE OF 18 APPLYING FOR A LEARNER'S PERMIT OR ORGAN DONOR DESIGNATION
I hereby certify that I am a
Parent,
Person in Loco Parentis, or
Spouse at least 18 years of age, and
  Guardian,
I Do give consent
I Do not give consent for applicant's request for Organ Donor designation.
(Signature of Parent, Guardian, Person in Loco Parentis, or Spouse at least 18 years of age.)
(Date)
F
E
AUTHORIZATION AND CERTIFICATION
NOTARY (see instructions on back)
For Veterans wishing to add the Veterans Designation to their Driver's License or ID Card: I certify under penalty of law
This section must be notarized when applying for a
that I am a qualified applicant and hereby request it be added to my product. I understand that misrepresentation will result in
replacement (duplicate) Pennsylvania Identification
the cancellation of my identification card.
Card. You are entitled to a free replacement ONLY if
I acknowledge that receiving a Pennsylvania Permit, License or ID card will cancel or invalidate any Permit, License
this application is completed within 90 days of the
or ID card from another state. I certify under penalty of law that all information given on this application is true and correct.
original date of issuance and the original was never
I hereby authorize the Social Security Administration to release to the Department of Transportation information concerning
received due to loss in the mail.
my Social Security Identification Number for the purpose of identification. 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 hereby acknowledge this day
SUBSCRIBED AND SWORN TO BEFORE
that I have received notice of the provisions of Section 3709 of the Vehicle Code. (See reverse for provisions.)
ME:
MO.
DAY
YEAR
I wish to contribute $3.00 to the Organ Donation Awareness Trust Fund.(see reverse)
SIGNATURE OF PERSON ADMINISTERING OATH
I wish to contribute $3.00 to the Veterans' Trust Fund. (see reverse)
X
SIGN
HERE
S
Applicant's Signature in Ink
(Date)
SIGN IN
E
WARNING: Misstatement of fact is a misdemeanor of the third degree punishable of up to $2,500 and/or imprisonment up to 1 year (18 Pa C.S. Section 4904(b)).
PRESENCE OF NOTARY
A
PAID BY:
Credit/Debit Card
Check
Money Order
TOTAL
$
L
Payable to PennDOT
(PennDOT Driver License Centers do not accept cash.
DL-54B (7-21)
PHOTO IDENTIFICATION CARD
APPLICATION FOR CHANGE/CORRECTION/REPLACEMENT/RENEW
Bureau of Driver Licensing, P.O. Box 68272, Harrisburg, PA 17106-8272
CHECK APPLICABLE BLOCK:
REPLACEMENT (DUPLICATE) — Complete Sections A, B, C, and D (if applicable), E and F (if applicable). All requests must be notarized.
1.
RENEWAL, CHANGE or CORRECTION — Complete Section A, C, and D (if applicable), E and F (if applicable). Notarization is not required.
2.
A
YOU MUST COMPLETE ALL PARTS OF SECTION A
JR./ETC
LICENSE/PERMIT/ID NUMBER
LAST NAME
FIRST NAME
MIDDLE NAME
E-MAIL ADDRESS (if applicable)
TELEPHONE NUMBER (
DATE OF BIRTH
8:00A.M. - 4:30P.M.)
MONTH
DAY
YEAR
B
REASON REPLACEMENT REQUIRED: (Check One):
LOST
STOLEN
NEVER RECEIVED
MUTILATED
CHANGE
CORRECTION
OTHER
Pennsylvania strongly supports organ and tissue donation because of its life-saving and life-enhancing opportunities.
ORGAN DONOR DESIGNATION:
ADD (Parental consent in Section D required if under 18)
REMOVE
C
CHANGE OR CORRECTION ONLY (Important information on reverse side)
ADDRESS 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.
STREET ADDRESS
PA
CITY
STATE
ZIP CODE
If you are a registered voter in PA, would you like us to notify your county voter registration office of this change?
YES
NO
If you are not a registered voter, you may contact your county voter registration office.
NAME CHANGE
(Please note all name changes must be done in person with original documents)
REASON:
MARRIAGE
DIVORCE
OTHER (see reverse side)
MIDDLE NAME
JR., ETC.
FIRST NAME
LAST
OTHER CHANGES
EYE COLOR
(Please check one):
BLUE
BROWN
GREEN
HAZEL
PINK
BLACK
GRAY
DICHROMATIC
OTHER __________________
CORRECTION OF DATE OF BIRTH
HEIGHT
SOCIAL SECURITY NUMBER
FEET
INCHES
MONTH
DAY
YEAR
D
MUST BE COMPLETED IF APPLICANT IS UNDER THE AGE OF 18 APPLYING FOR A LEARNER'S PERMIT OR ORGAN DONOR DESIGNATION
I hereby certify that I am a
Parent,
Person in Loco Parentis, or
Spouse at least 18 years of age, and
  Guardian,
I Do give consent
I Do not give consent for applicant's request for Organ Donor designation.
(Signature of Parent, Guardian, Person in Loco Parentis, or Spouse at least 18 years of age.)
(Date)
F
E
AUTHORIZATION AND CERTIFICATION
NOTARY (see instructions on back)
For Veterans wishing to add the Veterans Designation to their Driver's License or ID Card: I certify under penalty of law
This section must be notarized when applying for a
that I am a qualified applicant and hereby request it be added to my product. I understand that misrepresentation will result in
replacement (duplicate) Pennsylvania Identification
the cancellation of my identification card.
Card. You are entitled to a free replacement ONLY if
I acknowledge that receiving a Pennsylvania Permit, License or ID card will cancel or invalidate any Permit, License
this application is completed within 90 days of the
or ID card from another state. I certify under penalty of law that all information given on this application is true and correct.
original date of issuance and the original was never
I hereby authorize the Social Security Administration to release to the Department of Transportation information concerning
received due to loss in the mail.
my Social Security Identification Number for the purpose of identification. 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 hereby acknowledge this day
SUBSCRIBED AND SWORN TO BEFORE
that I have received notice of the provisions of Section 3709 of the Vehicle Code. (See reverse for provisions.)
ME:
MO.
DAY
YEAR
I wish to contribute $3.00 to the Organ Donation Awareness Trust Fund.(see reverse)
SIGNATURE OF PERSON ADMINISTERING OATH
I wish to contribute $3.00 to the Veterans' Trust Fund. (see reverse)
X
SIGN
HERE
S
Applicant's Signature in Ink
(Date)
SIGN IN
E
WARNING: Misstatement of fact is a misdemeanor of the third degree punishable of up to $2,500 and/or imprisonment up to 1 year (18 Pa C.S. Section 4904(b)).
PRESENCE OF NOTARY
A
PAID BY:
Credit/Debit Card
Check
Money Order
TOTAL
$
L
Payable to PennDOT
(PennDOT Driver License Centers do not accept cash.
DL-54B (7-21)
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:
o US Armed Forces
o Federal Government
o Pennsylvania State Government
Relationship to person meeting exemption (check one):
o Spouse
o Dependent Child
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 E.
Return your completed and signed application with your check or money order made payable to “PennDOT”, to: Bureau of Driver Licensing,
P.O. Box 68272, Harrisburg, PA 17106-8272.
If you find or recover your original license after you have submitted this application for a duplicate, return the original license with a letter of
explanation to: Bureau of Driver Licensing, PO Box 68615, Harrisburg, PA 17106-8615. After the duplicate is issued, the original license is
no longer valid.
REPLACEMENT/
APPLICATION FOR REPLACEMENT OF A CAMERA CARD OR A PRODUCT NEVER
RENEWAL OF
RECEIVED MUST BE NOTARIZED IN SECTION F.
PHOTO ID
REPLACEMENT OF A
FEE: $5.00 - if photo was not taken with the original camera card.
PHOTO ID OR PHOTO
FEE: $31.50 - if photo was taken with the original Camera Card. If photo image is on file, the Bureau will issue a
ID CAMERA CARD
Photo Identification Card.
RENEWAL OF PHOTO ID
Fee: $32.50
UPDATE CARD
No Fee. (update cards are not issued if requesting a change of Organ Donor designation status)
ORGAN DONOR
When you are adding or removing the Organ Donor designation, the form must be notarized and a replacement fee
is required.
DESIGNATION
ORGAN DONATION
You have the opportunity to contribute $3.00 to the Fund. The additional $3.00 contribution must be added to the fees
AWARENESS TRUST
above and included in your payment by check/money order. You must also check the block provided in Section E to
ensure proper handling of your contribution.
FUND (ODTF)
You have the opportunity to make a tax deductible contribution to the VTF. Your contribution will help support
VETERANS’ TRUST
programs and projects for pennsylvania veterans and their families. Since this additional $3.00 is not part of the fee,
FUND (VTF)
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 be carried
with the Pennsylvania Identification Card. Notarization is not required.
ONLY
NAME CHANGE - If you desire to use your birth name, you must present your state issued birth certificate with a raised seal. If your name changed
by permission of court, you must present a Certified Copy of the Court Order. If you desire to use your spouse's surname, you must present your
marriage certificate. If you desire to use another name, you must present your Social Security Card, together with 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, banking records, or baptismal certificate.
To report errors on your driver's license relating to name, date of birth or social security number, please contact PennDOT's Customer
Care Center at 717-412-5300. TTY callers - please dial 711 to reach us.
If you are required to present supporting documentation to correct your record, all documents must be originals and presented in person
at a PennDOT Driver License Center.
• For NAME corrections, you must present your state issued birth certificate with a raised seal, a Certified Copy of the Court
Order or your marriage certificate.
• For DATE OF BIRTH corrections, you must present state issued birth certificate with raised seal.
• For SOCIAL SECURITY NUMBER corrections, you must present your Social Security Card.
*Note: All name changes must be made in person at a Driver License Center. All documents must be original.
GENDER CHANGE - If requesting a gender change, a DL-32 (Request for Gender Designation Change) application must be completed along
with this application and submitted in person to a Driver License Center for processing.
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.
Visit us at www.dmv.pa.gov or call us at 717-412-5300. TTY callers -- please dial 711 to reach us
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