Self-certification of vehicle(s) to be operated or inoperable 2026

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The document outlines the process for applying for an Ignition Interlock Limited License (IILL) in Pennsylvania, which allows individuals with suspended or revoked driving privileges due to DUI violations to operate vehicles equipped with an ignition interlock system. It includes sections for driver information, vehicle details, and instructions for completing the petition. The document also specifies required fees, documentation, and the legal implications of providing false information.

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Begin by accessing the self-certification form on our platform. Click ‘Get Form’ to open it in the editor.
In Section A, provide your driver information. Fill in your full name, driver license number, and address. Ensure that you include a valid street address as a P.O. Box cannot be used alone.
Move to Section B where you will list all vehicles you intend to operate. For each vehicle, enter the plate number, title number, VIN, and year/make of the vehicle.
In Section C, complete the statement confirming that you will only operate the listed vehicles. Print your name, sign in ink, and date the form.
Section D must be completed by an authorized representative of the ignition interlock vendor after installation. They will provide their details and sign off on this section.

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Versions	Form popularity	Fillable & printable
2023	4.6 Satisfied (33 Votes)
2021	4.3 Satisfied (61 Votes)
2018	4.8 Satisfied (29 Votes)
2017	4.2 Satisfied (30 Votes)

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dl9108 form

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