Get Penndot - Self-certification Of Vehicle(s) Owned/operated - Lifesafer

Filling out the PennDOT - Self-Certification of Vehicle(s) Owned/Operated - LifeSafer form is essential for individuals eligible for vehicle restoration through the ignition interlock program. This guide provides step-by-step instructions to help you navigate the process with confidence, ensuring that all necessary information is accurately submitted.

Follow the steps to complete the self-certification form effectively.

1. Locate the ‘Get Form’ button to obtain the self-certification form and open it in your editing software.
2. In Section A, carefully enter your full name, driver license number, and current address. Ensure you include your city, state, and zip code. You may use a P.O. Box in addition to your physical address, but it cannot be the sole address.
3. Move to Section B, where you must list all vehicles you own or have permission to operate. Enter the plate number, title number, VIN, and the year and make of each vehicle. If applicable, indicate if a violation occurred prior to 10/1/03 by checking the appropriate box.
4. In Section C, indicate your status by checking the correct box: whether you own or do not own a vehicle, or if you seek a hardship exemption. Print your name, sign, and date the section as required. If applying for a hardship exemption, ensure to attach a copy of your most recent income tax return.
5. Proceed to Section D, where the ignition interlock vendor will complete the verification process. They will fill in their name, signature, and the date after installing the ignition interlock system.
6. Finally, review the entire form for accuracy, save your changes, and then follow the instructions provided for submitting the completed document to the Bureau of Driver Licensing at the designated address.

Complete your self-certification form online to ensure a smooth restoration process.