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Get PA DL-3731 2021-2024

DL-3731 4-16 APPLICATION FOR IGNITION INTERLOCK LICENSE/RETURN OF REGULAR DRIVER LICENSE PLEASE READ IMPORTANT INFORMATION ON THE REVERSE SIDE. DRIVER S LICENSE NUMBER LAST NAME JR/ETC FIRST NAME MIDDLE NAME DATE OF BIRTH Month Day Year TELEPHONE NUMBER 8 00 A. M. -4 30 P. M. EYE COLOR Please check one BLUE BROWN GREEN HAZEL E-MAIL ADDRESS if applicable INK BLACK GRAY P DICHROMATIC OTHER OUT-OF-STATE ADDRESS CHANGE* We may not issue driver license products to an out-of-state address except in the case of an employee of federal or state government armed forces personnel or their families whose workplace is located outside of Pennsylvania* If this exception applies to you please check the appropriate box and include documentation of your status with this application* Attach a letter from your employer on their letterhead to document your status or attach a copy of your current Photo ID issued by your employer. If you are the immediate family of a person meeting one of the allowable exceptions attach the documentation of the person employed* Additionally you must indicate your relationship to that person* I certify that my workplace is located out of state and I am employed by or am the immediate family of a person employed by US Armed Forces Federal Government Pennsylvania State Government Spouse Dependent Child ADDRESS CHANGE - A Post Office Box number may be used in addition to the actual residence address but cannot be used as the only address. NEW STREET ADDRESS ZIP CODE STATE CITY If you are a registered voter in PA would you like us to notify your county voter registration office of this change If you are not a registered voter you may contact your county voter registration office. YES NO ADD Parental consent required if under 18 REMOVE B APPLICATION OPTIONS - MUST CHECK ONE OPTION 1 I am applying for an ignition interlock license. OR As a result of the disqualification of my commercial driving privilege in accordance with Section 1617 of the PA Vehicle Code My ignition interlock period has been served and I am applying for the return of my previous classification* NOTE If applying for the return of your previous CDL classification after serving your disqualifications period you must complete form DL-100CD. During your ignition interlock period were you given a ticket or cited for driving without an ignition interlock system and/or tampering with an ignition interlock device YES If yes give date when violation occurred and check one of the following 1. I was found not guilty. 2. I paid the ticket plead guilty or was found guilty. 3. The case hasn t been decided yet. C REQUEST FOR EXEMPTION FROM PHOTO - ABSENTEE EXEMPTION During the next 60 days I will be absent from PA for the following reason Military School Work Travel Within 45 days of my return I will apply for a driver s license containing my photo. X SIGN HERE APPLICANT S SIGNATURE D AUTHORIZATION AND CERTIFICATION Sign and Enter Fee Veterans Designation I certify under penalty of law that I am a qualified applicant and hereby request it be added to my product.

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