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Get PA DL-31CD 2019-2021

For more information please see pages 2 and 3. ALL NEW APPLICANTS MUST SUBMIT A SELF CERTIFICATION FORM (DL-11CD) A DRIVER'S LICENSE NUMBER LAST NAME JR/ETC FIRST NAME MIDDLE NAME DATE OF BIRTH Month Day Year SOCIAL SECURITY NUMBER TELEPHONE NUMBER (8:00 A.M.-4:30 P.M.) E-MAIL ADDRESS States where you have been licensed in the previous 10 years. See reverse page for instructions (explained in number 1.) State B Driver's License Number Name (if different than above).

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