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Get PA DL-17 2021-2024

30 DAYS PRIOR TO THE ELIGIBILITY DATE THAT IS LISTED IN YOUR RESTORATIONS REQUIREMENT LETTER NOTE: THIS FORM IS ONLY VALID FOR 60 DAYS FROM THE DATE THE FORM WAS SIGNED. IF THE FORM EXPIRES PRIOR TO AN INDIVIDUAL S DRIVING PRIVILEGE BEING RESTORED, A NEW DL-17 IS REQUIRED. ALL INFORMATION MUST BE COMPLETED DRIVER S LICENSE NUMBER LAST NAME JR/ETC MIDDLE NAME FIRST NAME DATE OF BIRTH (must be listed) Month Day Year TELEPHONE NUMBER (8:00 a.m. to 4:30 p.m.) E-MAIL ADDRESS (if applicab.

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