Get Dl-21sc (5-17)

The DL-21SC (5-17) form is crucial for users seeking to certify vehicle ownership or operation while applying for ignition interlock device installation. This guide provides comprehensive steps to assist you in accurately completing the form online to ensure your submission is complete and correct.

Follow the steps to fill out the DL-21SC (5-17) form online.

1. Click ‘Get Form’ button to obtain the DL-21SC (5-17) and open it in the online editor.
2. In Section A, provide your full driver information. Enter your name, address, driver license number, city, state, and zip code. Ensure accuracy in these details to avoid any processing issues.
3. Proceed to Section B to list all vehicles you own or are permitted to operate. For each vehicle, include the plate number, title number, VIN number, and year/make. If a violation occurred prior to October 1, 2003, you can check the appropriate box and omit vehicle details.
4. In Section C, indicate your ownership status by checking the appropriate box. If you have vehicles inoperable, or if your income qualifies for a hardship exemption, ensure to follow the accompanying instructions for that section. Print and sign your name and date it at the end of this section.
5. Finally, after you have filled out Section C, follow the vendor's instructions to complete Section D. This section requires verification by the vendor who will confirm the details and sign off on the installation of the ignition interlock device. Make sure the vendor completes their part before submission.
6. Once all sections are filled out and verified, you may save your changes, download, print, or share the completed form as needed before emailing the final document to RA-PDIGNINTSELFCERTS@pa.gov.

Complete your DL-21SC (5-17) form online today to ensure a smooth restoration process.