Form DL-143 "Non-commercial Driver's License Application for Renewal" - Pennsylvania

What Is Form DL-143?

Form DL-143, Non-Commercial Driver's License Application for Renewal, is a legal document signed by Pennsylvania drivers to renew their driver's licenses. Since a license is valid for four years, three months prior to its expiration the Pennsylvania Department of Transportation (PennDOT) will send the driver an Invitation to Renew.

The latest version of the form was issued on July 1, 2020, with all previous editions obsolete. You can download a fillable Pennsylvania Form DL-143 through the link below.

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Form DL-143 Instructions

To fill out Form DL-143, follow these steps:

  1. State your driver's license number, full name, date of birth, telephone number, and e-mail address;
  2. Specify a change or correction to your personal details. If you need to change personal data, you may indicate a new address or name, correct eye color, date of birth, height, or social security number. You can also drop a Class M license. Note that for corrections, you must present supporting documentation to correct your PennDOT record - birth certificate, marriage certificate, or social security card;
  3. If you have an out-of-state driver's license, your driving privilege is suspended or revoked, or you have driving violations, answer "yes" to applicable questions and explain the situation;
  4. Confirm the information in the form is correct, sign and date the form. Choose whether to pay the fees using a debit or credit card, check, and money order, and calculate the total fees using a table on the second page of the application.

If you need to certify any corrections, submit the application in person in the Driver License Center. Otherwise, you may mail PA Form DL-143 to the Bureau of Driver Licensing, P.O. Box 68272, Harrisburg, PA 17106-8272 or renew your license online via the PennDOT website if you have no changes or corrections that would update the license.

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Download Form DL-143 "Non-commercial Driver's License Application for Renewal" - Pennsylvania

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DL-143 (7-20)
NON-COMMERCIAL DRIVER'S LICENSE
APPLICATION FOR RENEWAL
DO NOT Renew if license is under suspension and you have recently surrendered it.
Bureau of Driver Licensing, P.O. Box 68272, Harrisburg, PA 17106-8272
A
LAST NAME
JR./ETC
DRIVER'S LICENSE NUMBER
FIRST NAME
MIDDLE NAME
DATE OF BIRTH
TELEPHONE NUMBER (8:00 A.M.-4:30 P.M.)
E-MAIL ADDRESS (if applicable)
Month
Day
Year
B
CHANGE OR CORRECTION ONLY (Important information on reverse side)
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.
ADDRESS -
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
(Please note all name changes must be done in person with original documents)
REASON:
MARRIAGE
DIVORCE
OTHER (see reverse side)
JR., ETC.
LAST NAME
FIRST NAME
MIDDLE NAME
OTHER CHANGES
EYE COLOR (Please check one):
BLUE
BROWN
GREEN
HAZEL
PINK
BLACK
GRAY
DICHROMATIC
OTHER_______________________
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:
FEET
MONTH
DAY
YEAR
INCHES
Drop Class M
C
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 to a Driver License Center
to surrender your out-of-state license and complete an application for a PA License.
1.
YES
NO - Do you hold a valid driver's license issued by any other state?
If yes, give: State ___________ Expiration Date ________________________________
Driver's License No.________________________________________________________
2.
YES
NO - Is your driver's license or driving privilege suspended or revoked in this state or any other state?
3.
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?
If yes, give state_____________ Date _______________ and Reason _________________________________________________________________________
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.
D
AUTHORIZATION AND CERTIFICATION (Sign and Enter Fee)
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 a qualified applicant and hereby request it
be added to my product. I understand that misrepresentation will result in the cancellation of my driver's license.
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 under
penalty of law that all information given on this application is true and correct. I hereby authorize the Social Security Administration to release to the Department of Transportation
information concerning 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 that I have received notice of the provisions of Section 3709 of the Vehicle Code.
(See reverse for provisions.)
I wish to contribute $3.00 to the Organ Donation Awareness Trust Fund. If checked here, include the additional $3.00 in the amount entered in the Fee Paid block. (see reverse)
I wish to contribute $3.00 to the Veterans' Trust Fund. (see reverse)
X
SIGN
HERE
DATE
APPLICANT'S SIGNATURE IN INK
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]).
Payable to PennDOT (PennDOT Driver License
PAID BY:
Debit/Credit Card
Check
Money Order
TOTAL $
Centers do not accept cash.)
DL-143 (7-20)
NON-COMMERCIAL DRIVER'S LICENSE
APPLICATION FOR RENEWAL
DO NOT Renew if license is under suspension and you have recently surrendered it.
Bureau of Driver Licensing, P.O. Box 68272, Harrisburg, PA 17106-8272
A
LAST NAME
JR./ETC
DRIVER'S LICENSE NUMBER
FIRST NAME
MIDDLE NAME
DATE OF BIRTH
TELEPHONE NUMBER (8:00 A.M.-4:30 P.M.)
E-MAIL ADDRESS (if applicable)
Month
Day
Year
B
CHANGE OR CORRECTION ONLY (Important information on reverse side)
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.
ADDRESS -
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
(Please note all name changes must be done in person with original documents)
REASON:
MARRIAGE
DIVORCE
OTHER (see reverse side)
JR., ETC.
LAST NAME
FIRST NAME
MIDDLE NAME
OTHER CHANGES
EYE COLOR (Please check one):
BLUE
BROWN
GREEN
HAZEL
PINK
BLACK
GRAY
DICHROMATIC
OTHER_______________________
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:
FEET
MONTH
DAY
YEAR
INCHES
Drop Class M
C
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 to a Driver License Center
to surrender your out-of-state license and complete an application for a PA License.
1.
YES
NO - Do you hold a valid driver's license issued by any other state?
If yes, give: State ___________ Expiration Date ________________________________
Driver's License No.________________________________________________________
2.
YES
NO - Is your driver's license or driving privilege suspended or revoked in this state or any other state?
3.
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?
If yes, give state_____________ Date _______________ and Reason _________________________________________________________________________
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.
D
AUTHORIZATION AND CERTIFICATION (Sign and Enter Fee)
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 a qualified applicant and hereby request it
be added to my product. I understand that misrepresentation will result in the cancellation of my driver's license.
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 under
penalty of law that all information given on this application is true and correct. I hereby authorize the Social Security Administration to release to the Department of Transportation
information concerning 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 that I have received notice of the provisions of Section 3709 of the Vehicle Code.
(See reverse for provisions.)
I wish to contribute $3.00 to the Organ Donation Awareness Trust Fund. If checked here, include the additional $3.00 in the amount entered in the Fee Paid block. (see reverse)
I wish to contribute $3.00 to the Veterans' Trust Fund. (see reverse)
X
SIGN
HERE
DATE
APPLICANT'S SIGNATURE IN INK
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]).
Payable to PennDOT (PennDOT Driver License
PAID BY:
Debit/Credit Card
Check
Money Order
TOTAL $
Centers do not accept cash.)
DL-143 (7-20)
The most current version of this form can be found at: www.dmv.pa.gov
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.
INSTRUCTIONS
• 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 D.
• COMPLETE sections A, B (if applicable), C, and D.
• Return your completed and signed application, along with your check or money order payable to "PennDOT", to the: Bureau of Driver
Licensing, P.O. Box 68272, Harrisburg, PA 17106-8272.
FEE INFORMATION
FEE: $30.50 - The Bureau will issue a camera card, which is a temporary Non-Commercial Driver’s
RENEWAL OF A 4 YEAR
License valid for 60 days. During those 60 days, the driver must appear at a photo driver license center
NON-COMMERCIAL
for the purpose of having a photo taken.
DRIVER’S LICENSE
If license is endorsed with Class M, fee is $50.50.
FEE: $20.00 - The Bureau will issue a camera card, which is a temporary Non-Commercial Driver’s
RENEWAL OF A 2 YEAR
License valid for 60 days. During those 60 days, the driver must appear at a photo driver license center
NON-COMMERCIAL
for the purpose of having a photo taken. If license is endorsed with Class M, fee is $30.00.
DRIVER’S LICENSE
NOTE: Drivers age 65 and over have the option of requesting a two (2) year driver's license.
ORGAN DONATION
You have the opportunity to contribute $3.00 to the Fund. The additional $3.00 contribution must be
AWARENESS TRUST
added to the fees above and included in your payment by check/money order. You must also check the
FUND (ODTF)
block provided in Section F to ensure proper handling of your contribution.
You have the opportunity to make a tax deductible contribution to the VTF. Your contribution will help
VETERANS’ TRUST
support programs and projects for pennsylvania veterans and their families. Since this additional $3.00
FUND (VTF)
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
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.
Change your address or renew your driver's license online at www.dmv.pa.gov
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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