Form DL-80 "Non-commercial Driver's License Application for Change/Correction/Replacement" - Pennsylvania

What Is Form DL-80?

Form DL-80, Non-Commercial Driver's License Application For Change/Correction/Replacement, is a legal document used by Pennsylvania residents who need to replace their driver's license to drive non-commercial vehicles, or modify information in the existing license and update the official records.

Alternate Name:

  • Pennsylvania Driver License Change of Address Form.

This form was released by the Pennsylvania Department of Transportation (PennDOT) on July 1, 2020, with all previous editions obsolete. You can download a fillable Pennsylvania Driver License Change of Address Form through the link below.

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Form DL-80 Instructions

Follow these steps to complete the DL-80 Application:

  1. Check the box to choose the reason for applying - obtaining a duplicate or correcting the license;
  2. State your driver's license number, full name, date of birth, and contact information;
  3. Indicate what you need to replace (photo license, regular camera card, or update card) and select the reason for replacement - your documentation was lost, stolen, mutilated, never received, etc.
  4. Record information you want to add to the license to correct it - a new address, name, eye color, date of birth, height, social security number. You can also waive your privilege for a class M license;
  5. Add the donor resignation to your record if you wish. If you are younger than 18, written consent of your legal guardian is required on the form;
  6. Confirm you do not have a suspended or revoked license in any state, sign and date the form.

If you need a camera card or you never received your license, the document must be notarized. Find the applicable fee on the second page of the DL-80 Form and attach a money order or check payable to the PennDOT. Once the application is completed, send it to the Bureau of Driver Licensing, PO Box 68272, Harrisburg, PA 17106-8272.

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Download Form DL-80 "Non-commercial Driver's License Application for Change/Correction/Replacement" - Pennsylvania

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DL-80 (7-20)
NON-COMMERCIAL DRIVER’S LICENSE
APPLICATION FOR CHANGE / CORRECTION / REPLACEMENT
Bureau of Driver Licensing • P.O.Box 68272 • Harrisburg, PA 17106-8272
CHECK
CHANGE OR CORRECTION of Non-Commercial License. Complete Section
REPLACEMENT (DUPLICATE) – Complete Sections A, B, (C & D if applicable), E and F.
APPLICABLE
A, C and F. Notarization is not required. An update card will be issued.
All requests marked with an asterisk (*) MUST be notarized. Complete absence
BLOCK:
statement on reverse side if applicable.
A
YOU MUST COMPLETE ALL PARTS OF SECTION A
DRIVER’S LICENSE NUMBER
JR./ETC
LAST NAME
FIRST NAME
MIDDLE NAME
DATE OF BIRTH
E-MAIL ADDRESS (if applicable)
TELEPHONE NUMBER (
8:00A.M. - 4:30P.M.)
MONTH
DAY
YEAR
B
REPLACEMENT REQUIRED DUE TO REASON
APPLICATION FOR REPLACEMENT
(CHECK ONE)
(CHECK ONE)
LOST
MUTILATED
*REGULAR CAMERA CARD
PHOTO LICENSE
UPDATE CARD
STOLEN
CORRECTION
*“PHOTO-EXEMPT’’ CAMERA CARD
VALID W/O PHOTO LICENSE
*NEVER RECEIVED
OTHER ______________________
(No Fee Required)
_____________________________
(DL-82 MUST BE COMPLETED AND SUBMITTED ALONG WITH THIS FORM)
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.
NEW STREET ADDRESS
PA
STATE
ZIP CODE
CITY
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
REASON:
MARRIAGE
DIVORCE
OTHER (see reverse side)
(Please note all name changes must be done in person with original documents)
MIDDLE NAME
JR., ETC.
FIRST NAME
LAST
OTHER CHANGES
EYE COLOR
BLUE
BROWN
GREEN
HAZEL
PINK
BLACK
GRAY
DICHROMATIC
OTHER ________________
(Please check one):
ADD LENS RESTRICTION
OR
REMOVE LENS RESTRICTION -
(Please Note: Must include DL-102 Application completed by Health Care Provider)
CORRECTION OF DATE OF BIRTH
HEIGHT
SOCIAL SECURITY NUMBER
DROP PRIVILEGE
MONTH
DAY
YEAR
FEET
INCHES
DROP CLASS M
CONSENT OF PARENT, GUARDIAN, PERSON IN LOCO PARENTIS OR SPOUSE AT LEAST 18 YEARS OF AGE. Complete if
D
Applicant is less than 18 years of age to give consent for Applicant’s request for Organ Donor Designation.
X
I hereby certify that I am
Parent,
Guardian,
Person in Loco Parentis or
Spouse
SIGN
HERE
at least 18 years of age, of the applicant named herein, that the statements made herein are true and
correct to the best of my knowledge and that this application is made with my full consent.
(SIGNATURE OF PARENT, ETC.)
No person may hold more than one valid license at any time. If you have a license from another state, do not use this form. YOU MUST go
E
ALL MUST BE
to a Driver License Examination Center to surrender your out-of-state license and make application for a replacement PA license.
ANSWERED IF
1.
YES
NO - Is your driver’s license or driving privilege suspended or revoked in this state or any other state?
REPLACEMENT
2.
YES
NO - Do you have any pending criminal charges or driving violations in this state or any other state which may carry a possible penalty of
suspension or revocation of your driver’s license or driving privilege?
IS REQUESTED
If yes, give state_________ Date ______________ and Reason ___________________________________________________________
F
AUTHORIZATION AND CERTIFICATION
For Veterans wishing to add the Veterans Designation to their Driver’s License or ID Card: I certify under penalty of law that I am
AFFIDAVIT: This section must be notarized when applying
a qualified applicant and hereby request it be added to my product. I understand that misrepresentation will result in the cancellation of
for replacement of a Camera Card. You are entitled to a free
my driver’s license.
replacement ONLY if this application is completed within
I acknowledge that receiving a Pennsylvania Permit, License or ID card will cancel or invalidate any Permit, License or ID card from another state. I certify
90 days of the original date of issuance and the original
under penalty of law that all information given on this application is true and correct. I hereby authorize the Social Security Administration to
was never received due to loss in the mail.
release to the Department of Transportation information concerning my Social Security Identication Number for the purpose of identication. 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 that I have received notice of the provisions of Section 3709 of the Vehicle Code. (See reverse for provisions.)
SUBSCRIBED AND SWORN TO BEFORE ME:
I wish to contribute $3.00 to the Organ Donation Awareness Trust Fund (see reverse).
MO.
DAY
YEAR
I wish to contribute $3.00 to the Veterans’ Trust Fund. (see reverse)
X
Signature of Person Administering Oath
SIGN
HERE
S
(APPLICANT’S SIGNATURE IN INK)
DATE
E
SIGN IN PRESENCE OF NOTARY
WARNING: Misstatement of fact is a misdemeanor of the third degree punishable by a fine of up to $2,500 and/or imprisonment up to 1 year (18 PA C.S. Section 4904(b)).
A
Money
Payable to PennDOT (PennDOT Driver
TOTAL $
L
PAID BY:
Debit/Credit Card
Check
License Centers do not accept cash.)
Order
DL-80 (7-20)
NON-COMMERCIAL DRIVER’S LICENSE
APPLICATION FOR CHANGE / CORRECTION / REPLACEMENT
Bureau of Driver Licensing • P.O.Box 68272 • Harrisburg, PA 17106-8272
CHECK
CHANGE OR CORRECTION of Non-Commercial License. Complete Section
REPLACEMENT (DUPLICATE) – Complete Sections A, B, (C & D if applicable), E and F.
APPLICABLE
A, C and F. Notarization is not required. An update card will be issued.
All requests marked with an asterisk (*) MUST be notarized. Complete absence
BLOCK:
statement on reverse side if applicable.
A
YOU MUST COMPLETE ALL PARTS OF SECTION A
DRIVER’S LICENSE NUMBER
JR./ETC
LAST NAME
FIRST NAME
MIDDLE NAME
DATE OF BIRTH
E-MAIL ADDRESS (if applicable)
TELEPHONE NUMBER (
8:00A.M. - 4:30P.M.)
MONTH
DAY
YEAR
B
REPLACEMENT REQUIRED DUE TO REASON
APPLICATION FOR REPLACEMENT
(CHECK ONE)
(CHECK ONE)
LOST
MUTILATED
*REGULAR CAMERA CARD
PHOTO LICENSE
UPDATE CARD
STOLEN
CORRECTION
*“PHOTO-EXEMPT’’ CAMERA CARD
VALID W/O PHOTO LICENSE
*NEVER RECEIVED
OTHER ______________________
(No Fee Required)
_____________________________
(DL-82 MUST BE COMPLETED AND SUBMITTED ALONG WITH THIS FORM)
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.
NEW STREET ADDRESS
PA
STATE
ZIP CODE
CITY
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
REASON:
MARRIAGE
DIVORCE
OTHER (see reverse side)
(Please note all name changes must be done in person with original documents)
MIDDLE NAME
JR., ETC.
FIRST NAME
LAST
OTHER CHANGES
EYE COLOR
BLUE
BROWN
GREEN
HAZEL
PINK
BLACK
GRAY
DICHROMATIC
OTHER ________________
(Please check one):
ADD LENS RESTRICTION
OR
REMOVE LENS RESTRICTION -
(Please Note: Must include DL-102 Application completed by Health Care Provider)
CORRECTION OF DATE OF BIRTH
HEIGHT
SOCIAL SECURITY NUMBER
DROP PRIVILEGE
MONTH
DAY
YEAR
FEET
INCHES
DROP CLASS M
CONSENT OF PARENT, GUARDIAN, PERSON IN LOCO PARENTIS OR SPOUSE AT LEAST 18 YEARS OF AGE. Complete if
D
Applicant is less than 18 years of age to give consent for Applicant’s request for Organ Donor Designation.
X
I hereby certify that I am
Parent,
Guardian,
Person in Loco Parentis or
Spouse
SIGN
HERE
at least 18 years of age, of the applicant named herein, that the statements made herein are true and
correct to the best of my knowledge and that this application is made with my full consent.
(SIGNATURE OF PARENT, ETC.)
No person may hold more than one valid license at any time. If you have a license from another state, do not use this form. YOU MUST go
E
ALL MUST BE
to a Driver License Examination Center to surrender your out-of-state license and make application for a replacement PA license.
ANSWERED IF
1.
YES
NO - Is your driver’s license or driving privilege suspended or revoked in this state or any other state?
REPLACEMENT
2.
YES
NO - Do you have any pending criminal charges or driving violations in this state or any other state which may carry a possible penalty of
suspension or revocation of your driver’s license or driving privilege?
IS REQUESTED
If yes, give state_________ Date ______________ and Reason ___________________________________________________________
F
AUTHORIZATION AND CERTIFICATION
For Veterans wishing to add the Veterans Designation to their Driver’s License or ID Card: I certify under penalty of law that I am
AFFIDAVIT: This section must be notarized when applying
a qualified applicant and hereby request it be added to my product. I understand that misrepresentation will result in the cancellation of
for replacement of a Camera Card. You are entitled to a free
my driver’s license.
replacement ONLY if this application is completed within
I acknowledge that receiving a Pennsylvania Permit, License or ID card will cancel or invalidate any Permit, License or ID card from another state. I certify
90 days of the original date of issuance and the original
under penalty of law that all information given on this application is true and correct. I hereby authorize the Social Security Administration to
was never received due to loss in the mail.
release to the Department of Transportation information concerning my Social Security Identication Number for the purpose of identication. 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 that I have received notice of the provisions of Section 3709 of the Vehicle Code. (See reverse for provisions.)
SUBSCRIBED AND SWORN TO BEFORE ME:
I wish to contribute $3.00 to the Organ Donation Awareness Trust Fund (see reverse).
MO.
DAY
YEAR
I wish to contribute $3.00 to the Veterans’ Trust Fund. (see reverse)
X
Signature of Person Administering Oath
SIGN
HERE
S
(APPLICANT’S SIGNATURE IN INK)
DATE
E
SIGN IN PRESENCE OF NOTARY
WARNING: Misstatement of fact is a misdemeanor of the third degree punishable by a fine of up to $2,500 and/or imprisonment up to 1 year (18 PA C.S. Section 4904(b)).
A
Money
Payable to PennDOT (PennDOT Driver
TOTAL $
L
PAID BY:
Debit/Credit Card
Check
License Centers do not accept cash.)
Order
DL-80 (7-20)
The most current version of this form can be found at: www.dmv.pa.gov
• 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.
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.
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) and submit along with this form. NOTE: For Photo Exemption, you must be out of state for the entire next 60 days.
If your license is due to expire within six (6) months, DO NOT use this form. Complete form DL-143 (Renewal of a Non-Commercial Driver’s License).
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, P.O. Box 68615, Harrisburg, PA 17106-8615. After duplicate is issued, the original license is no longer valid.
REPLACEMENT OF
Application for replacement of a camera card or a product never received, the form must be notarized.
NON-COMMERCIAL
FEE: $30.50 - The Bureau will issue a camera card, which is a temporary Non-Commercial Driver’s License
PHOTO OR VALID W/O
valid for 60 days. During those 60 days, the driver must appear at a photo driver license center for the purpose
PHOTO NON-COMMERCIAL
of having a photo taken. If photo image is on file, the Bureau will issue a Photo Driver’s License. If license is
DRIVER’S LICENSE
endorsed with Class M, fee is $35.50.
*REGULAR OR “PHOTO
FEE: $5.00 if photo was not taken with the original camera card and this form must be notarized.
EXEMPT” CAMERA CARD
If license is endorsed with a Class M, fee is $10.00 and this form must be notarized.
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 a replacement fee is required. Refer to fees
above.
DESIGNATION
ORGAN DONATION
You have the opportunity to contribute $3.00 to the Fund. The additional $3.00 contribution must be added to
AWARENESS TRUST FUND
the fees above and included in your payment by check/money order. You must also check the block provided
(ODTF)
in Section F to ensure proper handling of your contribution.
When you are adding or removing the Veterans designation a replacement fee is required. Refer to fees
VETERANS DESIGNATION
above.
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, please add the donated amount to your payment. Also, please check the proper block on the form to
FUND (VTF)
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. Notarization is not required.
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.
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.

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