Transcription of NON-COMMERCIAL LEARNER'S PERMIT APPLICATION YOU …
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NON-COMMERCIAL LEARNER'S PERMIT APPLICATION YOU …
LICENSE REQUIRED FEE4-Year Photo$ Photo (Age 65 & Over)$ 'S LICENSE NUMBER: ALL QUESTIONS must BE ANSWERED (Check [4] Applicable Block) YES NOTHIS FORM IS VALID FOR 1 YEAR FROM THE DATE OF PHYSICAL EXAMINATIONThe physical date may not be more than 6 months prior to your 16th AND CERTIFICATION1. Have you ever held or possessed a Driver's License (DL)/ LEARNER'S PERMIT (LP)/Photo Identification Card (ID) from PA or any other state?..If yes, State: _____ DL/LP/ID #: _____ Name if different than above: _____ State: _____ DL/LP/ID #: _____ Name if different than above: _____ State: _____ DL/LP/ID #: _____ Name if different than above: _____2.
license required fee 4-year photo $30.50 2-year photo (age 65 & over) $20.00 driver's license number/i.d. number: all questions must be answered
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