Dl 21sc form 2004-2026

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40 votes

The document DL-21SC (12-04) is a self-certification form for individuals who own or operate vehicles and are required to install an ignition interlock device. It includes sections for driver information, vehicle details, ownership statements, and vendor verification. The form must be completed accurately to avoid legal penalties, and it provides instructions for obtaining eligibility for restoration of driving privileges.

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Click ‘Get Form’ to open the dl 21sc form 2004 in the editor.
In Section A, enter your full name, driver license number, and address. Ensure that you include both your physical address and any P.O. Box if applicable.
Proceed to Section B where you will list all vehicles you own or have permission to operate. Fill in the plate number, title number, VIN, and year/make for each vehicle.
In Section C, check the appropriate box indicating ownership status. If claiming economic hardship, ensure to attach your income documentation as instructed.
Finally, complete Section D after a vendor verifies your information. Print your name, sign in ink, and date the form before submission.

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Versions	Form popularity	Fillable & printable
2018	4.3 Satisfied (59 Votes)
2017	4.7 Satisfied (36 Votes)
2007	4.6 Satisfied (108 Votes)
2004	4 Satisfied (40 Votes)

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Is Ignition Interlock mandatory in PA?

Pennsylvania law makes the Ignition Interlock requirement mandatory for first-time and repeat DUI offenders with high blood alcohol levels and for individuals who receive an operating privilege suspension as a result of a chemical test refusal violation or conviction for illegally operating a motor vehicle not equipped

What is a DL 21 in PA used for?

DL-21 refers to a Form. It is the form the clerk of a court of record of Pennsylvania sends to the Department of transportation regarding judgment of conviction, acquittal or other disposition of charges under 75 Pa. C.S. (relating to vehicle code) .

What is the new DUI law in PA?

New PA DUI Laws 2022. PA House Bill 773 (2022), also known as Deanas Law, was approved by Governor Tom Wolf on July 11, 2022 and became EFFECTIVE NOVEMBER 9, 2022 (120 days from July 11, 2022). 2022 Act 29 increases the grading and penalties of DUI convictions for certain repeat DUI offenders.

dl21sc form

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How long is a PA DL valid for?

A Pennsylvania drivers license is valid for four years, expiring on the day after your birthday. PennDOT sends an invitation to renew three months prior to expiration. Residents who are 65 or older have the option of renewing their license every two years, instead of standard four years.

Can I submit a DL-17 form online?

To submit the DL-17 form, you can email it to the specified PennDOT email address provided in your restoration letter. Alternatively, fax the completed form to the designated number listed. You may also opt for online submission if available, or send it via physical mail to PennDOTs driver services office.