Fillable Form Pennsylvania Change of Address

Pennsylvania Change of Address is used if your non-commercial driver's license is lost, stolen, mutilated or never received, this can also be used for changing or correcting your license information

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What is the Pennsylvania Change of Address Form?


Form DL-80, Non-Commercial Driver’s License Application for Change / Correction / Replacement, or most commonly referred to as the Pennsylvania Change of Address Form is a state-level form by the Pennsylvania Department of Transportation (PennDOT). Residents of the state of Pennsylvania who are eligible to use it submit it to the said department to request a change of address in their driving-related documents.


 


The Pennsylvania Change of Address Form may also be used to apply for a driver’s license replacement or apply for correction in driving-related documents.


 


Where to get the Pennsylvania Change of Address Form?


The Pennsylvania Department of Transportation provides a blank copy of the Pennsylvania Change of Address Form. You may also visit the official website of the Pennsylvania Department of Motor Vehicles (DMV) to get the most current version of the form. You may be able to download and print a copy that you can fill out manually. If you prefer to electronically fill out Form DL-80 for your convenience, you may do so on PDFQuick.


 


How to fill out the Pennsylvania Change of Address Form?


The Pennsylvania Change of Address Form is a single-page fillable document that contains six sections:


  • Section A — It requires your personal and driver-related information.

  • Section B — It is to be used when you are applying for a replacement.

  • Section C — It is to be used when you are applying for change or correction only.

  • Section D — It is to be used when an applicant is less than 18 years old.

  • Section E — It contains yes-or-no questions you need to answer.

  • Section F — It requires the signature of the applicant to certify the application.

    •  


    Complete Form DL-80 accurately and correctly to avoid any problems or delays with your request to change your address. Do not deliberately provide any false information as doing so is unlawful and may result in penalties or imprisonment or both.


     


    Section A


    Driver’s License Number


    Enter your complete driver’s license.


     


    Name


    Enter your full legal name, including Last Name, First Name, Middle Name, and Suffix.


     


    Date of Birth


    Enter your date of birth in the following format: Month, Day, Year.


     


    Telephone Number


    Enter your active telephone number that can be contacted from 8:00 am to 4:30 pm.


     


    Email Address


    Enter an active email address if applicable.


     


    Section B


    Application For Replacement


    Mark the appropriate box to determine the replacement you are applying for. You may select:


  • Regular Camera Card

  • Photo License

  • Update Card

    •  


    If you marked “Regular Camera Card”, select also one that applies:


  • Photo-Exempt Camera Card

  • Valid w/o Photo License

    • Note: You must also submit Form DL-82, Out-of-State Address / Photo-Exemption, with this form.


     


    Replacement Required Due to Reason


    Mark the appropriate box to determine the reason why you need a replacement. You may select:


  • Lost

  • Stolen

  • Never Received — No fee required.

  • Mutilated

  • Correction

  • Other — Specify the reason.

    •  


    Organ Donor Designation


    Mark the appropriate box to determine your organ donor designation. You may select:


  • Add — Parental consent in Section D is required if you are under 18 years old.

  • Remove

    •  


    Section C


    Address Change


    Enter your new address, including New Street Address, City, State, and ZIP Code, if you want to change your address in your driving-related documents.


     


    Mark “Yes” if you would like the Pennsylvania Department of Transportation to notify your county voter registration of your change of you address or name; otherwise, mark “No.”


     


    If you are not a registered voter, you may contact your county voter registration office.


     


    Other Changes


    Eye Color


    Mark the appropriate box to determine your natural eye color. You may select:


  • Blue

  • Brown

  • Green

  • Hazel

  • Pink

  • Black

  • Gray

  • Dichromatic

  • Other — Specify the color.

    •  


    Mark the appropriate box to determine lens restriction. You may select:


  • Add Lens Restriction

  • Remove Lens Restriction

    • Note: You must include Form DL-102, Report of Eye Examination, completed by Health Care Provider.


     


    Correction of Date of Birth


    Enter your correct date of birth in the following format: Month, Day, Year.


     


    Height


    Enter your correct height in feet and inches.


     


    Social Security Number


    Enter your correct Social Security Number (SSN).


     


    Drop Privilege


    Mark the “Drop Class M” to drop privilege.


     


    Section D


    Mark the appropriate box to determine the relationship of the individual giving consent to the applicant. You may select:


  • Parent

  • Guardian

  • Person in Loco Parentis

  • Spouse

    •  


    Signature of Parent


    Affix the signature of the individual giving consent.


     


    Section E


    Item 1. Mark “Yes” if your driver’s license or driving privilege was suspended or revoked in this state or any other state; otherwise, mark “No.”


     


    Item 2. Mark “Yes” if you have any pending criminal charges or driving violations in this state or any other state which may carry a possible penalty of suspension of your driver’s license or driving privilege; otherwise, mark “No.”


     


    If you marked “Yes”, you must enter the following:


  • Name of state

  • Date

  • Reason

    •  


    Section F


    Mark the appropriate box if you are a veteran who wishes to add the Veteran Designation to your driver’s license or identification card.


     


    Mark the appropriate box if you wish to contribute $1.00 to the Organ Donation Awareness Trust Fund.


     


    Mark the appropriate box to contribute $3.00 to the Veterans’ Trust Fund.


     


    Applicant’s Signature


    Affix your signature in ink.


     


    Date


    Enter the date you signed the form.


     


    Paid By


    Mark the appropriate box to determine how you paid the application. You may select:


  • Check

  • Money Order — Payable to PennDOT

    •  


    Total


    Enter the amount paid in dollars.


     


    Reminders when using the Pennsylvania Change of Address Form:


  • For an application for a replacement of a camera card or if a product was never received, the form must be notarized.

  • Updating the card has no fee. Take note that update cards are not issued if requesting a change of Organ Donor designation status.

  • When you are adding or removing the Organ Donor designation on your card, a replacement fee is required.

  • When you are adding or removing the Veterans designation, a replacement fee is required.

    • Table of Contents
    Fillable Form Pennsylvania Change of Address