REAL ID INDICATOR REQUEST FORM
DL-63RID (9-19)
REAL ID INDICATOR REQUEST FORM
You must make application in person at a PennDOT REAL ID Driver License Center in order to receive your product the same day. If you do not make application at a REAL ID Driver License Center your product will be mailed to you within 15 business days.
DRIVER INFORMATION DRIVER'S LICENSE NUMBER
LAST NAME(S)
JR/ETC
FIRST NAME
MIDDLE NAME
TELEPHONE NUMBER
EMAIL ADDRESS
ADD REAL ID INDICATOR - There will be a one-time non-refundable $30 REAL ID fee to opt into REAL ID. The non-refundable $30 fee will be added to the applicable driver license or identification card fee(s):
Non-Commercial Driver License (non-CDL) holders are required to submit a renewal application, along with the applicable renewal fee(s).
Photo identification (ID) card holders are required to submit a renewal application, along with the applicable renewal fee(s).
Commercial Driver License (CDL) holders may either apply to renew the CDL or apply for a duplicate CDL, along with the applicable renewal/duplicate fee(s).
Non-U.S. Citizens with a non-Commercial Driver License (non-CDL) that is not yet eligible for renewal are required to apply for a duplicate license, and pay the applicable duplicate fee. If the license is within 6-months of expiration, a renewal application is required, along with the applicable renewal fee(s).
Non-U.S. Citizens with a Commercial Driver License (CDL) that is not yet eligible for renewal are required to apply for a duplicate license, and pay the applicable duplicate fee. If the license is within 6-months of expiration, a renewal application is required, along with the applicable CDL renewal fees(s).
REMOVE REAL ID INDICATOR - This will remove the REAL ID indicator from your record and opt you out of REAL ID. (Must appear in person at a PennDOT Driver License Center.)
I understand that if I should choose to opt back into the REAL ID program later, I will be required to submit my identity and
residency documentation in person at a PennDOT Driver License Center. Additionally, I understand that I will be required to pay
the applicable non-refundable REAL ID $30 opt-in fee.
Applicant's Initials
Date
TRANSFER/SWAP REAL ID INDICATOR - Must appear in person at any PennDOT Driver License Center.
I would like to transfer my REAL ID INDICATOR from my driver's license to my identification card. (NOTE: A DL-54B form, along with the applicable fee(s), must accompany this request to transfer.)
I would like to transfer my REAL ID INDICATOR from my identification card to my driver's license. (NOTE: A DL-80, or DL80CD for CDL holders, along with the applicable fee(s) must accompany this request to transfer.)
REALID Product Lost/Stolen
Applicant's Initials
Date
AUTHORIZATION AND CERTIFICATION
I certify under penalty of law that all information given on this application is true and correct. If using a Messenger Service, I hereby authorize
the Department to furnish them with my driving record for the purpose of processing this form. I hereby acknowledge this day that I have
received notice of the provisions of Section 3709 of the Vehicle Code. (See reverse for provisions.)
XSIGN
HERE
(Applicant's Signature in Ink)
(Date)
WARNING: Misstatement of fact is a misdemeanor of the third degree punishable of up to $2,500 and/or imprisonment up to 1 year (18 Pa C.S. Section 4904(b)).
OFFICIAL USE ONLY
Applicant's original product was received. ____________________ __________________
Examiner #
Date
______________________
DL Location
PROOF OF IDENTITY You will need to provide ONE document proving your identity and your lawful status in the United States when applying for a REAL ID. The most common documents you can use to prove your identity are:
If you are a U.S. citizen acceptable documents include:
? Certified copy of a birth certificate filed with the State Office of Vital Records/Statistics with a raised/embossed seal ? A valid, unexpired, U.S. Passport or Passport Card ? Certificate of U.S. Citizenship (USCIS Form N-560 or Form N-561) ? Consular Report of Birth Abroad (CRBA) issued by the U.S. Department of State, Form FS-240, DS-Form1350 or FS-Form 545 ? Certificate of Naturalization issued by DHS; Form N-550 or N-570
If you are a lawful permanent resident, acceptable documents include:
? Unexpired Employment Authorization Card, (EAD) issued by DHS; Forms I-766 or Form 1-688B ? Valid, Unexpired Permanent Resident Card I-551 (Green Card) Issued by DHS or INS ? Unexpired foreign passport with a valid unexpired US visa affixed, accompanied by the approved I-94 indicating temporary evidence of
Permanent Residence
PROOF OF SOCIAL SECURITY You must present your social security card when applying for a REAL ID. Your card must be original.
? Social Security Card, with your current legal name.
PROOF OF YOUR PENNSYLVANIA RESIDENCY Everyone, regardless of age, will need to provide TWO documents to prove Pennsylvania residency when applying for a REAL ID. Select which residency documents you will bring to the Driver License Center.
? Current, unexpired PA driver's license or photo ID card ? Current PA vehicle registration card ? Valid auto insurance card ? A computer-generated utility bill showing your name and address (cell phone, cable, electric, gas) ? Post-marked mail/package labels through USPS, UPS, FedEx etc. ? A W-2 form/pay stub ? Lease agreements or mortgage documents
For additional information on REAL ID, please visit the Department of Homeland Security's website at .
CHANGE/CORRECTION Please complete the appropriate driver license application for change/correction and submit with this form. ONLY
NAME CHANGE - If you desire to use your birth name, you must present your state issued certified copy of a birth certificate filed with the State Office of Vital Statistics with a raised/embossed seal. If your name changed by permission of court, you must present a Certified Copy of the Court Order(s). If you desire to use your spouse's surname, you must present your certified marriage certificates. If you desire to use another name, you must present a court order showing your full legal name. To report errors on your driver's license relating to name, date of birth or social security number, please contact PennDOT's Customer Care Center at 717-412-5300. If you are required to present supporting documentation to correct your record, all documents must be originals and presented in person at a PennDOT Driver License Center.
? For NAME corrections, you must present your state issued certified copy of a birth certificate filed with the State Office of Vital Statistics with a raised/embossed seal, a Certified Copy of the Court Order(s) and/or your certified marriage certificate(s).
? For DATE OF BIRTH corrections, you must present state issued birth certificate certified copy of a birth certificate filed with the State Office of Vital Statistics with raised/embossed seal.
? For SOCIAL SECURITY NUMBER corrections, you must present your Social Security Card. *Note: All name changes must be made in person at a PennDOT Driver License Center. All documents must be original.
PROOF OF YOUR PENNSYLVANIA RESIDENCY Section 3709 provides for a fine of up to $300 for dropping, throwing or depositing, upon any highway, or upon any other public or private property without the consent of the owner thereof or into or on the waters of this Commonwealth, from a vehicle, any waste paper, sweepings, ashes, household waste, glass, metal, refuse or rubbish or any dangerous or detrimental substance, or permitting any of the preceding without immediately removing such items or causing their removal. For any violation of Section 3709, I may be subject to a fine of up to $300 upon conviction, including any violation resulting from the conduct of any other persons present within any vehicle of which I am the driver.
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