DL-21SC (5-17) 2026

1. Click ‘Get Form’ to open the DL-21SC (5-17) in the editor.
2. Begin with Section A: Driver Information. Enter your full name, address, driver license number, city, state, and zip code. Ensure all information is accurate and typed in blue or black ink.
3. Move to Section B: Vehicle Information. List all vehicles you own or have permission to operate. Include the plate number, title number, VIN, and year/make for each vehicle. If applicable, check the box indicating a violation occurred prior to 10/1/03.
4. In Section C: Statement of Ownership/Non-Ownership, check the appropriate box regarding ownership status. Print your name and provide your signature and date. If applying for a hardship exemption or stating vehicles are inoperable, follow the additional instructions provided.
5. Finally, if you are a vendor completing Section D, verify the information from Sections B and C before signing and dating this section.

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