Outline
The DL-43 form plays a crucial role in the process of obtaining a Pennsylvania driver's license or identification card for individuals who are unable to present the standard identification documents. This form is specifically designed for those who may not have access to traditional forms of ID due to various circumstances, such as homelessness or other significant life challenges. By completing the DL-43, applicants can provide alternative documentation to verify their identity and residency, which is essential for ensuring that everyone has access to driving privileges or state-issued identification. The form requires personal information, including the applicant's name, address, and date of birth, along with a declaration of their unique situation. Understanding the requirements and the proper way to fill out this form is vital for anyone seeking to navigate the complexities of Pennsylvania's licensing system. Additionally, the DL-43 is an important tool in promoting inclusivity and ensuring that all residents can participate in daily life, whether through driving or simply having an official means of identification.
Sample - DL-43 Form
INFORMATION FORM (ALL APPLICANTS please answer questions 1 through 10)
YES NO
1. Are you a citizen of the United States?
2. If you are a US citizen, would you like to register to vote? If registered, would you like to update your voter information?
By providing my electronic signature, I understand the personal information on my application form and my electronic signature will be used for submitting
my voter’s registration application to the Texas Secretary of State’s office. Wanting to register to vote, I authorize the Department of Public Safety to
transfer this information to the Texas Secretary of State.
3. Do you wish to donate $1.00 to the Blindness Education Screening and Treatment Program?
4. Do you want to support the Glenda Dawson Donate Life Texas donor registry? If yes, please indicate a donation amount of $1 or more $ .00
5. Would you like to register as an organ donor?
6. Do you want to support survivors of sexual assault? If yes, please indicate a donation amount of $1 or more $ .00 to help fund the testing
of sexual assault evidence collection kits (rape kits).
7. Do you want to support Texas Veterans? If yes, please indicate your donation amount $ .00
8. Do you have a health condition that may impede communication with a peace officer? If yes, please list
(physician must complete form DL-101 prior to the issuance of a DL/ID).
9. a) Do you want a Veteran designator on your driver license or identification card? (proof of Honorable discharge required; acceptable documents
are DD214/5, NGB22, VA disability letter, proof of service/verification of honorable service card)
b) Are you a 60% disabled Veteran receiving compensation and want to waive the application fee? (see 9a for documents required)
10. In the event of injury or death would you like to provide two (2) emergency contacts? If yes, please list:
a) Name Telephone Number Address
b) Name Telephone Number Address
For all Driver License Renewals complete MEDICAL questions 11 to 17. Answers to the questions below are for the confidential use of the Department.
11. Do you currently have or have you ever been diagnosed with or treated for any medical condition that may affect your ability to safely operate a
motor vehicle?
Examples, including but not limited to: Diagnosis or treatment for heart trouble, stroke, hemorrhage or clots, high blood pressure, emphysema (within past two years)
progressive eye disorder or injury (i.e., glaucoma, macular degeneration, etc.) loss of normal use of hand, arm, foot or leg blackouts, seizures, loss of consciousness
or body control (within the past two years) difficulty turning head from side to side loss of muscular control stiff joints or neck inadequate hand/eye
coordination medical condition that affects your judgment dizziness or balance problems missing limbs
If you answered YES above, has your condition IMPROVED or DETERIORATED since your last application for an original/renewal remake of your driver license?
12. Do you have a mental condition that may affect your ability to safely operate a motor vehicle? If yes, please explain:
13. Have you ever had an epileptic seizure, convulsion, loss of consciousness, or other seizure?
14. Do you have diabetes requiring treatment by insulin?
15. Do you have any alcohol or drug dependencies that may affect your ability to safely operate a motor vehicle or have you had any episodes
of alcohol or drug abuse within the past two years?
16. Within the past two years, have you been treated for any other serious medical conditions?
Explain:
17. Have you EVER been referred to the Texas Medical Advisory Board for Driver Licensing?
Any male United States citizen or immigrant who is at least 18 years of age but less than 26 years of age submitting this application consents to registration with the
United States Selective Service System. You must be registered to qualify for federal student aid (to include Pell grant), job training, federal employment, and citizenship
if an immigrant. In Texas, you must be registered to qualify for state college student aid or state employment. If convicted, failure to register with the Selective Service is
a felony punishable by up to five years in prison and/or a $250,000 fine. If not registered by age 26, you can no longer register and could permanently lose those benefits
associated with registration. For alternative options for applicants who object to conventional military service for religious or other conscientious reasons information is
available at: http://www.sss.gov/FactSheets/FSaltsvc.pdf
.
I do solemnly swear, affirm, or certify that I am the person named herein and that the statements on this information form are true and correct. I further certify my resi-
dence address is a (check one): ( ) single family dwelling, ( ) apartment, ( ) motel, ( ) temporary shelter. I agree to immediately report to the Texas Department of
Public Safety any changes in my medical condition which may affect my ability to safely operate a motor vehicle.
DL-43 (Rev. 1/18) SIGNATURE OF APPLICANT DATE
APPLICANT INFORMATION
LAST NAME:
FIRST NAME:
MIDDLE NAME:
SUFFIX:
MAIDEN NAME:
DATE OF BIRTH (mm/dd/yyyy): — —
SSN: — —
SEX: (Mark One) MALE FEMALE WEIGHT: lbs.
EYE COLOR: HEIGHT: ft. in.
RACE/ETHNICITY: (I) American Indian/Alaska Native
(A) Asian/Pacific Islander (B) Black (H) Hispanic (O) Other (W) White
APPLICATION FOR RENEWAL/REPLACEMENT/CHANGE
OF A TEXAS DRIVER LICENSE OR IDENTIFICATION CARD
DL or ID NUMBER
(Replacement also called Duplicate)
CONTACT INFORMATION
HOME PHONE:
OTHER PHONE:
EMAIL:
ADDRESS INFORMATION
RESIDENCE ADDRESS:
CITY: STATE:
ZIP CODE: COUNTY:
MAILING ADDRESS:
CITY: STATE:
ZIP CODE: COUNTY:
INFORMACIÓN SOBRE EL SOLICITANTE (TODOS LOS SOLICITANTES favor de contestar las preguntas 1 a 10)
SI NO
1. ¿Es usted ciudadano de los Estados Unidos?
2. Si usted es ciudadano de los Estados Unidos, ¿le gustaría registrarse para votar? Si ya está registrado, ¿le gustaría actualizar su información de votante?
Al proporcionar mi firma electrónica, comprendo que la información personal en mi solicitud, junto con mi firma electrónica, se usará para enviar mi
solicitud de registro electoral a la oficina de la Secretaría del Estado de Texas. Deseo registrarme para votar; por lo tanto, autorizo al Departamento
de Seguridad Pública para transferir esta información a la Secretaría del Estado de Texas.
3. ¿Desea usted donar $1.00 al Programa de Educación, Evaluación y Tratamiento de la Ceguera?
4. ¿Desea apoyar el Programa de Registro de Texas-Glenda Dawson Donar Vida? En caso afirmativo, indicar una cantidad de la donación
de $1 o más $ .00
5. ¿Desea registrarse como donador de órganos?
6. ¿Quieres apoyar a los sobrevivientes de asalto sexual? Si es así, porfavor indique la cantidad de donación de $1 o más $ .00 para
ayudar a financiar la recopilación de evidencia de asalto sexual (kit de violación)
7. ¿Desea apoyar los Veteranos de Texas? Si la respuesta es sí, por favor, indique la cantidad de su donación $ .00
8. ¿Tiene usted alguna afección médica que le pueda impedir la comunicación con un oficial de la policía? En caso afirmativo, por favor indique
(el médico debe llenar el formulario DL-101 antes de emitir una licencia de conducir o tarjeta de identificación).
9. a) Desea una insignia de Veterano en su licencia de conducir o su tarjeta de identificación? (Se requiere comprobante de baja honorable; los
documentos aceptables son DD214/5, NGB22, carta de discapacidad del VA, prueba de servicio/verificación de la tarjeta de servicio honorable)
b) ¿Es usted un Veterano que recibe 60% de compensación por discapacidad y desea quedar exento de los derechos de solicitud?
(vea el punto 9a para conocer qué documentos se requieren).
10. En caso de sufrir lesiones o la muerte, ¿le gustaría proporcionar dos (2) contactos para emergencias? En caso afirmativo, por favor indique:
a) Nombre Número telefónico Domicilio
b) Nombre Número telefónico Domicilio
Para todas las Renovaciones de Licencia de Conducir, complete las preguntas MÉDICAS 11 a 17.
Las respuestas a las siguientes preguntas son para uso confidencial del Departamento.
11. ¿Tiene actualmente o alguna vez ha sido diagnosticado con o tratado por alguna enfermedad que pueda afectar su capacidad de
operar un vehículo motorizado de manera segura?
Ejemplos, incluyendo pero no limitado a: Diagnóstico o tratamiento por problemas cardíacos, derrame cerebral, hemorragia o coágulos, presión arterial alta, enfisema (en los últi-
mos dos años) enfermedad progresiva o lesión de la vista (como glaucoma, degeneración macular, etc.) pérdida del uso normal de la mano, brazo, pie o pierna desvanec-
imientos, ataques, pérdida de la consciencia o control del cuerpo (en los últimos dos años) dificultad para voltear la cabeza de un lado a otro pérdida de control muscular artic-
ulaciones o cuello rígidos coordinación inadecuada de mano/ojo afección médica que altere su juicio mareos o problemas de equilibrio pérdida de algún miembro
Si respondió SÍ a la pregunta anterior, ¿su afección ha MEJORADO o EMPEORADO desde su última solicitud de original/renovación de licencia de conducir?
12. ¿Tiene usted un condición mental que puede afectar su capacidad para operar con seguridad un vehículo motorizado? Si su respuesta es si,
por favor de explicar:
13. ¿Alguna vez ha tenido un ataque epiléptico, convulsión, pérdida de la consciencia u otro ataque?
14. ¿Tiene diabetes que requiera tratamiento con insulina?
15. ¿Tiene alguna dependencia del alcohol o de drogas que pudiera afectar su capacidad de operar un vehículo motorizado de manera
segura o ha tenido algún episodio de abuso de drogas o alcohol en los últimos dos años?
16. En los últimos dos años, ¿ha recibido tratamiento por alguna otra afección médica grave?
Explique:
17. ¿Alguna vez ha sido remitido al Comité Asesor Médico de Licencias de Conducir de Texas?
Cualquier hombre ciudadano o inmigrante de los Estados Unidos entre 18 y 26 años de edad que presente esta solicitud otorga su consentimiento para ser registrado
en el Sistema de Servicio Militar Selectivo de los Estados Unidos. Usted debe estar registrado para tener derecho a recibir ayuda federal estudiantil (incluso la beca
Pell Grant), capacitación laboral, empleo federal y la ciudadanía si es inmigrante,. En Texas, usted debe estar registrado para tener derecho a recibir ayuda estudiantil
universitaria o empleo con el Estado. No registrarse en el Servicio Militar Selectivo es un delito mayor. Si es declarado culpable de ello, podría ser castigado hasta con
cinco años de prisión y/o una multa de 250,000 dólares. Si no se ha registrado antes de cumplir 26 años, ya no se podrá registrar y podría perder permanentemente los
beneficios asociados con el registro. Para conocer otras opciones alternativas para solicitantes que se oponen al servicio militar convencional por motivos religiosos u otros
motivos de conciencia, podrá encontrar información disponible en: http://www.sss.gov/FactSheets/FSaltsvc.pdf
.
Juro solemnemente, afirmo o certifico que soy la persona que se indica en el presente documento y que las declaraciones en esta solicitud son verdaderas y correctas. Además
certifico que mi domicilio de residencia es (marque una opción): ( ) casa residencial, ( ) apartamento, ( ) hotel, ( ) sitio de refugio temporal. Estoy de acuerdo en informar
inmediatamente al Departamento de Seguridad Pública de Texas cualquier cambio en mi condición médica que pueda afectar mi capacidad para conducir de manera segura
un vehículo motorizado.
DL-43 (Rev. 1/18) FIRMA DEL ASPIRANTE FECHA
INFORMACIÓN DEL SOLICITANTE
APELLIDO:
PRIMER NOMBRE:
SEGUNDO NOMBRE:
SUFIJO:
APELLIDO DE SOLTERA:
FECHA DE NACIMIENTO (mm/dd/aaaa):
NÚMERO DE SEGURO SOCIAL: — —
SEXO: (Marque uno) HOMBRE MUJER PESO: en libres.
COLOR DE LOS OJOS: ESTATURA: pies pulg.
RAZA/ETNIA: (I) Amerindio/Nativo de Alaska (A) Asiático/nativo
de las Islas del Pacífico (B) Negro (H) Hispano (O) Otro (W) Blanco
SOLICITUD PARA RENOVAR, REEMPLAZAR, Ó HACER
CAMBIOS EN LA LICENCIA DE CONDUCIR O TARJETA DE
IDENTIFICACIÓN DEL ESTADO DE TEXAS
NUMERO DE LICENCIA O DE TARJETA DE IDENTIFICACIÓN:
(El reemplazo también es llamado duplicado)
INFORMACIÓN DE CONTACTO
NÚMERO DE TELÉFONO:
TELÉFONO SECUNDARIO:
CORREO ELECTRÓNICO:
SU DOMICILIO
DOMICILIO DONDE RESIDE:
CIUDAD: ESTADO:
CÓDIGO POSTAL: CONDADO:
DOMICILIO POSTAL (Lugar donde recibe su correspondencia):
CIUDAD: ESTADO:
CÓDIGO POSTAL: CONDADO:
Form Information
| Fact Name | Description |
|---|---|
| Purpose | The DL-43 form is used for specific state licensing purposes, often related to driver's license applications or renewals. |
| Governing Law | This form is governed by state motor vehicle regulations, which vary by state. |
| Eligibility | Individuals must meet certain criteria, such as age and residency, to complete the DL-43 form. |
| Submission Process | The completed DL-43 form must be submitted to the appropriate state department of motor vehicles (DMV) for processing. |
Detailed Guide for Filling Out DL-43
Filling out the DL-43 form is a straightforward process. Once completed, you will be ready to submit it as required. Follow these steps to ensure you fill it out correctly.
- Begin by downloading the DL-43 form from the appropriate website or office.
- Open the form and read the instructions carefully.
- Fill in your personal information, including your name, address, and date of birth.
- Provide your driver's license number, if applicable.
- Answer any questions related to your driving history and health conditions.
- Review all the information you have entered for accuracy.
- Sign and date the form where indicated.
- Submit the completed form to the designated office or online portal.
Obtain Answers on DL-43
-
What is the DL-43 form?
The DL-43 form is a document used in the state of Pennsylvania for individuals applying for a non-driver identification card. This form is essential for those who do not possess a driver's license but need a valid form of identification for various purposes, such as voting, travel, or accessing services.
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Who is eligible to apply for a DL-43 form?
Any resident of Pennsylvania who does not hold a valid driver's license can apply for a DL-43 form. This includes individuals of all ages, including minors. Parents or guardians can assist children in completing the application process.
-
What information is required to complete the DL-43 form?
The DL-43 form requires several pieces of information, including:
- Full name
- Date of birth
- Social Security number
- Address
- Identification documents, such as a birth certificate or passport
Providing accurate information is crucial for the successful processing of the application.
-
How can I submit the DL-43 form?
Applicants can submit the DL-43 form in person at a Pennsylvania Department of Transportation (PennDOT) office. It is also possible to mail the completed form to the appropriate PennDOT address, but in-person submission is generally recommended for faster processing.
-
What is the fee for obtaining a DL-43 form?
There is a nominal fee associated with obtaining a non-driver identification card. The fee may vary based on the applicant's age and the duration of the ID card's validity. Check the PennDOT website for the most current fee schedule.
-
How long does it take to receive the DL-43 form after submission?
After submitting the DL-43 form, applicants typically receive their non-driver identification card within 2 to 4 weeks. Processing times may vary depending on the volume of applications being handled by PennDOT.
Common mistakes
Filling out the DL-43 form can be a straightforward process, but many individuals encounter pitfalls that can lead to delays or complications. One common mistake is failing to provide accurate personal information. This includes not only the name and address but also the date of birth. Any discrepancies can cause significant issues, especially when verifying identity.
Another frequent error is neglecting to sign the form. The signature is a crucial component, as it certifies that the information provided is true and accurate. Without a signature, the form may be deemed incomplete, resulting in a rejection of the application.
Many applicants also forget to check for required documentation. The DL-43 form often requires accompanying documents, such as proof of residency or identification. Omitting these documents can lead to processing delays or outright denial of the application.
In addition, individuals sometimes misinterpret the instructions regarding fees. The DL-43 form may require a fee for processing, and failing to include the correct amount can result in complications. Ensuring that the payment is accurate and submitted with the form is essential for a smooth application process.
Another common mistake is not reviewing the form before submission. Simple typographical errors or overlooked fields can lead to significant issues. Taking the time to double-check all entries can prevent unnecessary delays.
Lastly, applicants often underestimate the importance of keeping copies of submitted forms. Failing to retain a copy can create challenges if there are questions or issues later in the process. Having a record of what was submitted can be invaluable for resolving any disputes or misunderstandings.
Documents used along the form
The DL-43 form is an essential document often used in various applications, particularly in the context of driver's license renewals and applications. Alongside this form, several other documents are typically required to ensure a complete submission. Below is a list of commonly associated forms and documents that may be needed.
- Identification Documents: These documents, such as a passport or state-issued ID, verify the applicant's identity. They help confirm that the information provided on the DL-43 form is accurate and truthful.
- Proof of Residency: A utility bill, lease agreement, or bank statement may serve as proof of residency. This document demonstrates that the applicant resides at the address provided on the DL-43 form.
- Social Security Card: A Social Security card or a document showing the applicant's Social Security number is often required. This ensures that the applicant is properly identified in the system and helps prevent identity fraud.
- Vision Test Certification: Some states require a vision test to be completed before renewing a driver's license. A certification from an eye care professional may be necessary to confirm that the applicant meets the vision standards set by the state.
Having these documents ready can streamline the application process and help avoid delays. Always check with your local Department of Motor Vehicles (DMV) for specific requirements, as they can vary by state.
Similar forms
The DL-43 form is a specific document used in certain legal and administrative processes. There are several other documents that share similarities with the DL-43 form in terms of purpose, function, or the information they require. Below are six documents that resemble the DL-43 form:
- DL-44 Form: This form is used for a different type of driver's license application. Like the DL-43, it collects personal information and verifies the applicant's identity.
- DL-45 Form: This document is utilized for renewing a driver's license. Similar to the DL-43, it requires proof of residency and may ask for previous license information.
- DL-46 Form: This form is related to a change of address for a driver's license. It parallels the DL-43 in that it ensures the state has up-to-date contact information for the license holder.
- DL-47 Form: This is a request for a duplicate driver's license. Like the DL-43, it necessitates the submission of identification and personal details to confirm the applicant's identity.
- DL-48 Form: This document is for reporting a lost or stolen driver's license. It shares the same foundational purpose of maintaining accurate records and protecting the individual's identity.
- DL-49 Form: This form is used for updating personal information on a driver's license, such as name changes. It is similar to the DL-43 in that it requires supporting documentation to validate the changes being made.
Dos and Don'ts
When filling out the DL-43 form, it's essential to approach the process carefully. Here are some important do's and don'ts to keep in mind:
- Do read the instructions thoroughly before starting.
- Do ensure that all information is accurate and complete.
- Do use black or blue ink when filling out the form.
- Do double-check for any spelling errors or typos.
- Don't leave any required fields blank.
- Don't use correction fluid or tape on the form.
By following these guidelines, you can help ensure that your DL-43 form is processed smoothly and efficiently.
Misconceptions
The DL-43 form is often misunderstood. Here are eight common misconceptions about this form, along with clarifications to help you better understand its purpose and requirements.
-
Misconception 1: The DL-43 form is only for individuals applying for a driver's license.
This form is used for various purposes, including identification and vehicle registration, not just for obtaining a driver's license.
-
Misconception 2: You can submit the DL-43 form online.
Currently, the DL-43 form must be submitted in person at designated offices. Online submissions are not accepted.
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Misconception 3: The DL-43 form is the same in all states.
Each state has its own version of the DL-43 form, with specific requirements and procedures that may vary.
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Misconception 4: Filling out the DL-43 form is optional for vehicle registration.
In most cases, completing the DL-43 form is a mandatory step in the vehicle registration process.
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Misconception 5: You can use any identification when submitting the DL-43 form.
Specific forms of identification are required, and they must meet the criteria set by the issuing authority.
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Misconception 6: The DL-43 form can be completed in any language.
The form must be filled out in English, as it is the standard language used by most state agencies.
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Misconception 7: The DL-43 form does not require any supporting documents.
Applicants must provide supporting documentation, such as proof of residency and identification, when submitting the form.
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Misconception 8: Once submitted, the DL-43 form cannot be changed or corrected.
If errors are made on the form, applicants can request a correction process through the issuing office.
Understanding these misconceptions can help streamline the application process and ensure compliance with requirements. Stay informed to avoid unnecessary delays.
Key takeaways
The DL-43 form is essential for individuals seeking to apply for a Pennsylvania driver's license or identification card. Here are some key takeaways to keep in mind when filling out and using this form:
- Ensure you have the correct version of the DL-43 form. It can be obtained online or at a local Department of Transportation (PennDOT) office.
- Provide accurate personal information, including your full name, date of birth, and address. Any discrepancies can delay processing.
- Be prepared to present identification documents. Acceptable forms include a birth certificate, passport, or Social Security card.
- Fill out the form completely. Missing information can lead to rejection or requests for additional documentation.
- Check for any fees associated with the application. Payment methods may vary by location.
- Submit the form in person at a PennDOT office. Online submission is typically not an option for this form.
- Keep a copy of the completed form for your records. This can be helpful for future reference or if issues arise.
- Understand the processing time. It may take several weeks to receive your license or ID card after submission.
- Be aware of any additional requirements, such as vision tests or knowledge exams, that may apply to your situation.
- If you encounter issues, contact PennDOT directly for assistance. They can provide guidance and clarify any questions you may have.