DL-59 (7-16)
APPLICATION FOR CHANGE FROM A JUNIOR DRIVER’S
LICENSE TO A REGULAR NON-COMMERCIAL LICENSE
A
CHECK APPLICABLE
BLOCK:
Bureau of Driver Licensing • P.O. Box 68272 • Harrisburg, PA 17106-8272
OPTION 1: Free Update Card to be carried with your Junior Driver’s License. Form must be notarized
OPTION 2: Replacement License. Form must be notarized (SEE REVERSE FOR FEES)
DRIVER INFORMATION
Type or Print All Information
DRIVER’S LICENSE NUMBER
LAST NAME
JR./ETC
FIRST NAME
MIDDLE NAME
DAY
E-MAIL ADDRESS (if applicable)
TELEPHONE NUMBER (8:00A.M. - 4:30P.M.)
DATE OF BIRTH
MONTH
YEAR
Pennsylvania strongly supports organ and tissue donation because of its life-saving and life-enhancing opportunies.
ADD (Parental consent required if under 18)
REMOVE
B
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
CITY
C
STATE
ELIGIBILITY ASSESSMENT
PA
ZIP CODE
1.Have you successfully completed a Driver’s Training Course(s) consisting of 30 hours of classroom theory and 6 hours of
behind-the-wheel instruction approved by the Departments of Education and Transportation?
Yes If yes, Section E must be completed.
No If no, you are not eligible to apply.
2.Have you held your current Pennsylvania Junior Driver’s License for at least 1 year?
Yes
No If no, you are not eligible to apply.
3.Have you ever been involved in a crash in which you were partially or fully responsible during the past 1 year?
Yes If yes, you are not eligible to apply.
No 4.Have you been convicted of any violation of the Vehicle Code during the past 1 year?
Yes If yes, you are not eligible to apply.
No
D
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 certify under penalty of law that the information contained herein is true and correct. I hereby acknowledge this day that I have received notice of theprovisions of Section 3709 of the
Vehicle Code (see reverse for provisions). 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 wish to contribute $1.00 to the Organ Donation Awareness Trust Fund (see reverse).
INSTRUCTIONS
If requesting an Update Card retain your current Junior Driver’s
License. When your application is processed, an Update Card will be
issued which, upon receipt, should be carried with your Junior License.
I wish to contribute $3.00 to the Veterans' Trust Fund (see reverse).
X
SIGN
HERE
E
APPLICANT’S SIGNATURE IN INK (AS IN SECTION A)
DATE
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, Section 4904 [b]).
APPROVED DRIVER EDUCATION
I certify that the applicant was enrolled and successfully completed an Approved Driver Training Course in my school consisting of
(check appropriate box[es]): 30 hours of classroom theory and 6 hours behind-the-wheel 6 hours of behind-the-wheel
X
SIGN
HERE
(name of the approved school district,
(county of school)
private driver training school or other approved school)
(school year of
driver education)
(signature of school official)
30 hours of classroom theory only: Check if the student completed an approved driver training classroom theory course with another school.
List the name of the school, county where the school is located and attach a copy of your Certificate of Completion from that school.
F
(name of the approved school district, private driver training school or other approved school)
(school year of driver education)
(county of school)
AFFIDAVIT OF CONSENT - THIS FORM MUST BE NOTARIZED
SUBSCRIBED AND
▼
SWORN TO BEFORE ME MO. DAY YEAR
S
E
A
L
SIGNATURE OF PERSON ADMINISTERING OATH
I hereby certify that I am the applicant’s
PARENT
GUARDIAN
PERSON IN LOCO PARENTIS
SPOUSE
I am at least 18 years of age. The applicant has held a valid PA Junior Driver’s
License for 1 year and this application is made with my full consent.
SIGN IN PRESENCE OF NOTARY
X
SIGN
HERE
(signature of parent, guardian or person in loco parentis or spouse at least 18 years of age)
IN INK
(print name as it appears in signature above)
DL-59 (7-16)
The most current version of this form can be found at: www.dmv.pa.gov
COMPLETE ALL of Sections A, C, D, E, and F. Complete Section B only if you are changing information.
OUT-OF-STATE ADDRESS CHANGE.
the case of an employee of federal
is located outside of Pennsylvania.
documentation of your status with this
We may not issue driver license products to an out-of-state address, except in
or state government, armed forces personnel, or their families, whose workplace
If this exception applies to you, please check the appropriate box and include
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:
US Armed Forces Federal Government Relationship to person meeting exemption (check one):
Pennsylvania State Government
Spouse Dependent Child
THIS FORM MUST BE NOTARIZED IN SECTION F
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 D.
*FEE: $28.50 - The Bureau will issue a Regular Non-Commercial Photo Driver’s License.
$33.50 - Regular Non-Commercial Photo Driver’s License with Class M.
NO FEE: Free Update Card to carry with your Junior Driver’s License.
To
obtain an unrestricted license before you are 18 years of age, you MUST:
• Hold your valid Pennsylvania Driver’s License for 1 year from issue date;
• Maintain a crash and conviction free record for the past 1 year; and
• Complete an approved driver’s education course. If necessary, attach a certificate of completion as listed in Section E.
You are automatically a Regular License holder when you turn 18 years of age.
• In order to be eligible for a regular license, you must have held your PA junior license for 1 year. If you are unsure when you passed
the driving test, it should show on your junior license as the “Issued” date. (If you have a duplicate license, the “Issued” date does not
reflect the day you passed your testing.)
• Since you were required to wait at least six months before you could take your driving test, and you are also required to have held your
PA junior license privileges for at least 1 year, you are not eligible for a regular license if you are less than 17 1/2 years of age.
• This form requires 3 signatures:
1. The junior license holder signs as the applicant in Section D.
2. A school official certifying completion of an Approved Driver Training Course signs in Section E. A current listing of acceptable.
Approved Driver Education Course providers can be found online at the following website: www.pde.state.pa.us, and enter keyword
“Approved Driver Education”.
3. The junior license holder’s parent, guardian, person in loco parentis, or spouse at least 18 years of age signs in Section F. The
signature must be notarized in Section F.
Return your completed and signed application to:
“PennDOT”, The Bureau of Driver Licensing, P.O. Box 68272, Harrisburg, PA 17106-8272
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.
P e n n D O T i s re q u i re d t o o b t a i n t h e L i c e n s e e ’s h e i g h t a n d e y e c o l o r u n d e r t h e p ro v i s i o n s o f S e c t i o n 1 5 1 0 ( a ) o f t h e
Pennsylvania Vehicle Code. This information will be used as identifying information in an attempt to minimize driver
license fraud.
Change your address or renew your driver’s license online at www.dmv.pa.gov
Section 3709A 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.
“LICENSE FRAUD IS A SERIOUS CRIME”
FRAUDULENTLY ALTERING, EXHIBITING OR LOANING YOUR LICENSE IS A SERIOUS CRIME. VIOLATORS ARE SUBJECT TO
PROSECUTION AND CANCELLATION OF THEIR DRIVER’S LICENSES.