DL-21SC - PennDOT 2026

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4.3 out of 5

59 votes

The document DL-21SC (4-18) is a self-certification form for drivers in Pennsylvania to declare their vehicle status, whether they will operate the vehicle, do not own any vehicles, or have inoperable vehicles. It includes sections for driver and vehicle information, statements of ownership or operability, and vendor verification. The form must be completed accurately to avoid legal penalties and is submitted via email to the Pennsylvania Department of Transportation.

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Click ‘Get Form’ to open the DL-21SC in the editor.
In Section A, enter your full name, address, and driver license number. Ensure you include both your physical address and any P.O. Box if applicable.
Proceed to Section B to list all vehicles. Fill in the plate number, title number, VIN, and year/make for each vehicle you operate or that is inoperable. If applicable, check the box indicating a violation occurred prior to 10/1/03.
In Section C, select the appropriate statement regarding your vehicle(s). Print your name, sign in ink, and date the form. Be mindful that misstatements can lead to serious penalties.
If you're a vendor completing Section D, verify the information provided by the customer before signing and dating this section.
Finally, email the completed form to RA-PDIGNINTSELFCERTS@pa.gov directly from our platform for 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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What is a DL 21 in PA?

The Declaration of Compliance is a department-controlled form that Ignition Interlock vendors will utilize to docHub that an individual has not had any incidents, as defined by law (see 75 Pa. C.S. Sections 3805(c)(2) (relating to issuance of unrestricted license) and 3805(h.