Follow the steps to complete the DL-17 (12-19) form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter your driver’s license number in the designated field. This number is essential for identifying your driving record.
3. Provide your last name, first name, and middle name (if applicable) in the respective fields.
4. Fill in your date of birth by selecting the month, day, and year from the dropdown menus.
5. Input a valid telephone number where you can be reached between 8:00 a.m. and 4:30 p.m.
6. If you have an email address, provide it in the designated field. This is optional but can enhance communication.
7. If you need to change your address, check 'Address Change' and enter your new street address, city, state, and ZIP code. A Post Office Box may be included but cannot be used as the only address.
8. Indicate whether you would like the county voter registration office notified of your address change by selecting yes or no.
9. Write your printed name in the space that states 'I hereby state that I do not own any motor vehicle(s) currently registered in the Commonwealth of Pennsylvania.'
10. Sign the form in ink and enter the date next to your signature to certify the information provided.
11. Review all the information entered to ensure accuracy, as any misstatements may result in legal penalties.
12. Once you are satisfied with your completed form, you can save changes, download, print, or share the form as needed.

Complete your DL-17 (12-19) form online today to ensure a smooth restoration of your driving privileges.