Transcription of PennDOT - Non-Commercial Learner's Permit Application
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PennDOT - Non-Commercial Learner's Permit Application
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.
Payable to PennDOT (PennDOT Driver License Centers do not . accept cash.) PERMIT(S) DESIRED: CHECK DESIRED PERMIT(S) FEE. 4-Year Driver's License. $30.50. 2-Year Driver's License (Age 65 & Over) $20.00. LICENSE REQUIRED: MUST CHECK ONE. FEE. I, wish the gender designation on my Driver’s License/ ID Card to read
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