Transcription of APPLICATION FOR INITIAL IDENTIFICATION CARD
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APPLICATION FOR INITIAL IDENTIFICATION CARD
DL-54A (6-18). APPLICATION FOR INITIAL IDENTIFICATION card Bureau of Driver Licensing Box 68272 Harrisburg, PA 17106-8272. ALL SECTIONS MUST BE COMPLETED. A LAST NAME FIRST NAME MIDDLE NAME. DATE OF BIRTH HEIGHT SOCIAL SECURITY NUMBER OR DRIVER'S LICENSE NUMBER SEX Telephone Number (8:00 to 4:30 ). MONTH DAY YEAR FEET INCHES. EYE COLOR (please check one): BLUE BROWN GREEN HAZEL PINK BLACK GRAY DICHROMATIC OTHER _____. CURRENT STREET ADDRESS - A Post Office Box number may be used in addition to the actual residence address, but cannot be used as the only address. PA. CITY STATE ZIP CODE. If this is a change of address and you are a registered voter in PA, would If you are not a registered voter, you may you like us to notify your county voter registration office of this change? YES NO contact your county voter registration office. PA strongly supports organ and tissue donation because of its life-saving and life-enhancing opportunities ADD (Parental consent required if under 18) REMOVE.
signature of examiner date badge no. exam center last name. first name middle name. date of birth sex. inches. jr./etc. height social security number or driver's license number
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