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Blank DL-43 PDF Form

The DL-43 form is a crucial document used in the process of obtaining a Pennsylvania driver's license or identification card. This form collects essential information to verify your identity and residency. To ensure a smooth application process, consider filling out the DL-43 form by clicking the button below.

Article Guide

The DL-43 form is an important document for individuals seeking to apply for or renew a Pennsylvania driver's license. This form serves as a key part of the application process, ensuring that all necessary information is collected in a clear and organized manner. It includes sections for personal identification, residency verification, and any relevant medical information. Applicants must provide details such as their full name, date of birth, and address, along with proof of identity and residency. The DL-43 form is also crucial for those who have previously held a license and are looking to reinstate their driving privileges after a suspension or revocation. Understanding the requirements and completing the form accurately can significantly streamline the application process, making it easier for individuals to get back on the road.

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APPLICATION FOR RENEWAL/REPLACEMENT/CHANGE

(Replacement also called Duplicate)

OF A TEXAS DRIVER LICENSE OR IDENTIFICATION CARD

DL or ID NUMBER

APPLICANT INFORMATION

CONTACT INFORMATION

LAST NAME:

HOME PHONE:

FIRST NAME:

OTHER PHONE:

MIDDLE NAME:

EMAIL:

SUFFIX:

ADDRESS INFORMATION

MAIDEN NAME:

RESIDENCE ADDRESS:

DATE OF BIRTH (mm/dd/yyyy):

—

CITY:

STATE:

SSN:

—

ZIP CODE:

COUNTY:

SEX: (Mark One)

MALE

FEMALE

WEIGHT: lbs.

MAILING ADDRESS:

EYE COLOR:

HEIGHT: ft.

in.

RACE/ETHNICITY:

(I)

American Indian/Alaska

Native

CITY:

STATE:

(A) Asian/Pacific Islander

(B) Black (H) Hispanic (O) Other

(W) White

ZIP CODE:

COUNTY:

INFORMATION FORM (ALL APPLICANTS please answer questions 1 through 10)

1. YES NO

Are you a citizen of the United States?

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.

Do you wish to donate $1.00 to the Blindness Education Screening and Treatment Program?

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

Would you like to register as an organ donor?

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).

.00

Do you want to support Texas Veterans?

If yes, please indicate your donation amount $

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).

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)

10.

Are you a 60% disabled Veteran receiving compensation and want to waive the application fee? (see 9a for documents required)

In the event of injury or death would you like to provide two (2) emergency contacts? If yes, please list:

Name

Telephone Number

Address

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

16.

of alcohol or drug abuse within the past two years?

Within the past two years, have you been treated for any other serious medical conditions?

17.

Explain:

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

➤ PDF File

Form Specifications

Fact Name	Description
Form Purpose	The DL-43 form is used for driver's license applications and renewals in certain states.
Governing Law	The use of the DL-43 form is governed by state motor vehicle laws.
Eligibility	Applicants must meet age and residency requirements to qualify for a driver's license.
Identification Requirements	Applicants are required to provide proof of identity and residency.
Fees	A fee is typically required when submitting the DL-43 form for processing.
Submission Method	The form can often be submitted online, by mail, or in person at designated offices.
Processing Time	Processing times may vary by state, often taking several weeks.
Renewal Frequency	Driver's licenses must be renewed periodically, typically every 4 to 8 years.
State Variations	Each state may have specific variations of the DL-43 form, reflecting local laws.

DL-43: Usage Guidelines

Filling out the DL-43 form is straightforward. After completing the form, you will need to submit it to the appropriate authority. Make sure to double-check your information for accuracy before submission.

Start by downloading the DL-43 form from the official website or obtaining a physical copy.
Read the instructions provided with the form carefully.
Fill in your personal information, including your full name, address, and date of birth.
Provide your driver's license number, if applicable.
Indicate the reason for filling out the form.
Complete any additional sections as required, ensuring all fields are filled out accurately.
Review your completed form for any mistakes or missing information.
Sign and date the form at the designated area.
Submit the form according to the instructions provided, either online or by mail.

Your Questions, Answered

What is the DL-43 form?

The DL-43 form is an application used for obtaining a Pennsylvania driver’s license or identification card. It is essential for individuals who are applying for a new license, renewing an existing one, or requesting a replacement. This form helps the Pennsylvania Department of Transportation (PennDOT) process your application efficiently.

Who needs to fill out the DL-43 form?

Anyone who wants to apply for a Pennsylvania driver’s license or ID card must complete the DL-43 form. This includes new applicants, individuals renewing their licenses, and those who need to replace a lost or stolen card. Make sure to fill it out completely to avoid delays.

Where can I obtain the DL-43 form?

The DL-43 form can be downloaded from the PennDOT website. You can also pick up a physical copy at any PennDOT driver’s license center. Make sure to have the latest version of the form to ensure your application is processed correctly.

What information do I need to provide on the DL-43 form?

You will need to provide personal information such as your full name, address, date of birth, and Social Security number. Additionally, you may need to include details about any previous licenses or identification cards you have held. Ensure all information is accurate to prevent issues.

Is there a fee associated with the DL-43 form?

Yes, there is a fee for processing your application. The amount varies based on whether you are applying for a new license, renewing, or replacing an ID card. Check the PennDOT website for the most current fee schedule to avoid surprises.

How do I submit the DL-43 form?

You can submit the DL-43 form in person at a PennDOT driver’s license center. Some applications may also allow for online submission, depending on your situation. Make sure to check the submission options available to you.

What happens after I submit the DL-43 form?

After you submit the DL-43 form, PennDOT will review your application. If everything is in order, you will receive your driver’s license or ID card in the mail. If there are any issues, PennDOT will contact you for clarification or additional information.

Can I track the status of my DL-43 application?

Yes, you can track the status of your application through the PennDOT website. They provide a tracking feature that allows you to see where your application stands in the process. This can help you stay informed and plan accordingly.

What should I do if my DL-43 form is rejected?

If your DL-43 form is rejected, you will receive a notification explaining the reasons. You can correct any issues and resubmit your application. It’s important to address the concerns outlined in the notification to ensure a successful application next time.

Common mistakes

Incomplete Information: Many individuals fail to provide all the necessary details on the DL-43 form. This can include missing sections or neglecting to fill out required fields. Each piece of information is crucial for processing the application accurately.
Incorrect Personal Information: Errors in personal information, such as misspelled names, incorrect addresses, or wrong dates of birth, are common. These mistakes can lead to delays in processing or even rejection of the application.
Failure to Sign: Some applicants forget to sign the form before submission. A missing signature can render the application invalid, causing unnecessary delays and requiring resubmission.
Not Reviewing Before Submission: Skipping the review process can result in overlooking mistakes. Taking a moment to double-check the form can prevent errors that might complicate the application process.

Documents used along the form

The DL-43 form is commonly associated with various processes, particularly those related to driver's license applications and renewals. When navigating the requirements for obtaining or renewing a driver's license, several other forms and documents may be necessary. Below is a list of these documents, each serving a unique purpose in the application process.

DL-44 Form: This is the application for a new driver's license or an identification card. It gathers essential information about the applicant, such as personal details and residency status.
DL-60 Form: Used for reporting a lost or stolen driver's license. This form helps to ensure that the license is canceled to prevent identity theft.
DL-15 Form: This form is for requesting a duplicate driver's license. It is necessary when a license is damaged but not lost or stolen.
DL-16 Form: This is the application for a temporary driver's license. It may be issued while waiting for a new or renewed license to arrive.
DL-46 Form: This form is used for changing an address on a driver's license. Keeping your address current is crucial for legal compliance.
Medical Examination Report: A document that may be required to ensure that the applicant meets health standards necessary for safe driving.
Proof of Identity: Documents such as a birth certificate or passport may be needed to verify the applicant's identity.
Proof of Residency: Utility bills or lease agreements can serve as proof of residency, confirming the applicant's address.
Social Security Card: This document is often required to verify the applicant's Social Security number, which is essential for identification purposes.
Payment Receipt: A receipt for any fees paid during the application process is necessary for record-keeping and verification.

Understanding these documents is crucial for a smooth application process. Each form plays a specific role in ensuring that all necessary information is collected and verified, helping to facilitate the issuance of a driver's license or identification card. Being prepared with the right documents can significantly reduce delays and complications.

Similar forms

The DL-43 form is a specific document used primarily for driver’s license applications. Several other documents serve similar purposes in various contexts. Here’s a list of seven documents that are comparable to the DL-43 form:

Form I-9: This document is used for verifying the identity and employment authorization of individuals in the U.S. It requires personal information and identification, similar to the DL-43.
Form W-4: This form helps employers determine the correct amount of federal income tax to withhold from an employee's paycheck. Like the DL-43, it requires personal information and is crucial for official processes.
Passport Application (Form DS-11): This form is used to apply for a U.S. passport. It also requires personal identification and serves as an official identification document, much like the DL-43.
Voter Registration Form: This document registers individuals to vote. It asks for personal details and is essential for civic participation, paralleling the identification purpose of the DL-43.
Social Security Application (Form SS-5): This form is used to apply for a Social Security card. It requires similar personal information and serves as a vital identification tool.
State ID Application: Similar to the DL-43, this form is used to obtain a state-issued identification card. It requires personal information and is often used when a driver’s license is not needed.
Medical History Form: Often required by healthcare providers, this document collects personal health information. Like the DL-43, it is essential for processing and identification in a specific context.

Dos and Don'ts

When filling out the DL-43 form, it’s important to follow certain guidelines to ensure that your application is processed smoothly. Here are five things to consider doing and avoiding:

Do double-check your personal information for accuracy.
Do read all instructions carefully before starting the form.
Do use black or blue ink to fill out the form.
Do sign and date the form where required.
Do keep a copy of the completed form for your records.

Don't leave any required fields blank.
Don't use correction fluid or tape on the form.
Don't submit the form without reviewing it for errors.
Don't forget to check the submission deadline.
Don't hesitate to ask for help if you are unsure about any part of the form.

Misconceptions

The DL-43 form is often misunderstood. Here are four common misconceptions about this form, along with clarifications.

Misconception 1: The DL-43 form is only for driver's license renewals.

This is incorrect. The DL-43 form can also be used for various purposes, including changing personal information, applying for a new license, or requesting a duplicate license.

Misconception 2: You can submit the DL-43 form online.

Many believe that the DL-43 form can be submitted electronically. However, it typically requires a physical submission at a designated office or through the mail, depending on the state’s regulations.

Misconception 3: Completing the DL-43 form guarantees approval for a driver's license.

Filling out the DL-43 form does not guarantee that the application will be approved. Approval depends on meeting specific eligibility requirements and passing any necessary tests.

Misconception 4: The DL-43 form is the same in every state.

This is false. Each state may have its own version of the DL-43 form, with different requirements and procedures. It is essential to check the specific guidelines for your state.

Key takeaways

When filling out and using the DL-43 form, there are several important points to keep in mind. This form is essential for various purposes, and understanding it can streamline your experience. Here are some key takeaways:

Understand the Purpose: The DL-43 form is typically used for specific requests related to driver’s licenses or identification cards.
Gather Required Information: Before starting, make sure you have all necessary personal information at hand, such as your full name, address, and date of birth.
Check for Accuracy: Carefully review all entries to ensure accuracy. Mistakes can lead to delays or complications.
Follow Instructions: Read the instructions on the form thoroughly. They provide guidance on how to fill it out correctly.
Provide Supporting Documents: Be prepared to submit any additional documents that may be required, such as proof of identity or residency.
Submit on Time: Pay attention to deadlines for submission. Late submissions can affect your application process.
Keep Copies: Always make copies of the completed form and any supporting documents for your records.
Check for Updates: Regulations and requirements can change. Stay informed about any updates related to the DL-43 form.
Contact Support if Needed: If you have questions or need assistance, don’t hesitate to reach out to the appropriate support services.
Track Your Application: After submission, keep track of your application status to ensure everything is progressing as expected.

By following these key takeaways, you can navigate the process of filling out and using the DL-43 form with confidence. Remember, attention to detail is crucial.