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Collects applicant identity details including name, date of birth, eye color, height, sex/gender designation, social security or driver’s license number, and current street address. Includes sections for out-of-state license status, prior learner permit/driver’s license/ID issuance records, voter registration update option, and organ and tissue donation selection. 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Box 68272 • Harrisburg, PA 17106-8272  \n\n|  | ALL SECTIONS MUST BE COMPLETED |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |\n| A | LAST NAME |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | JR./ETC |  |  |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  | FIRST NAME MIDDLE NAME |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  | DATE OF BIRTH |  |  |  |  | HEIGHT |  |  |  |  |  | SOCIAL SECURITY NUMBER OR DRIVER'S LICENSE NUMBER |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Telephone Number (8:00 [a. m. to](a. m. to) 4:30 p. m . ) |  |  |  |  |\n|  | MONTH |  | DAY |  | YEAR | FEET |  | INCHES |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  | EYE COLOR (please check one): |  |  |  |  |  |  |  |  | BLUE |  |  | BROWN |  | GREEN | | HAZEL | | PINK | | BLACK |  GRAY  |  |  | DICHROMATIC |  |  |  | OTHER |  |  |  |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  | SEX/GENDER DESIGNATION |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  | I,   wish the gender designation on my Driver’s License/ ID Card to read PRINT NAME |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  | |  |  |  |  |  |  |  | Male (M) |  | |  |  |  |  |  | Female (F) |  | |  |  |  |  | Non-Binary/Other (X) |  |  |  |  |  |  |  |  |\n|  | I hereby certify under penalty of law that this request for the selected gender designation to appear on my Driver’s License/ ID Card accurately reflects my gender identity and is not for any fraudulent or other unlawful purpose. |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  | CURRENT STREET ADDRESS-A Post Office Box number may be used in addition to the actual residence address, but cannot be used as the only address. |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  | CITY |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | STATEPA |  |  |  |  | ZIP CODE |  |\n|  | This application will also serve as a request to update your voter registration unless you check this box: \u003Cbr>If you are not registered to vote, you will receive an application to register. You must be a U. S. citizen to register to vote in Pennsylvania. |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  | PA strongly supports organ and tissue donation because of its life-saving and life-enhancing opportunities  ADD (Parental consent required if under 18)  REMOVE |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n| B | Do you hold a current/valid out-of-state driver's license?  YES  NO If yes, you must surrender your out-of-state valid license. |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  | Please provide the names and STATE LP/DL/ID NUMBER NAME (if different than above) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |\n|  | record numbers (if known) of all |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | ","cbCaittoxDb6smTD","https://ap.wps.com/l/cbCaittoxDb6smTD","pdf",931115,"English","# Application For Initial Identification\n## Applicant Personal Information\n## Address, Voter Registration, and Organ Donation\n## Out-of-State Driver’s License and Prior Records\n## Fee Information","[{\"question\":\"What information must be completed in this application for initial identification?\",\"answer\":\"The form requires applicant identity details (name, date of birth, eye color, height, sex/gender designation) and personal identifiers, plus the current street address and related selections like voter registration and organ donation.\"},{\"question\":\"How does the application handle out-of-state driver’s license holders?\",\"answer\":\"Applicants must indicate whether they hold a current/valid out-of-state driver’s license; if yes, they must surrender that valid license. The form also requests state and record numbers for prior learner permits, driver’s licenses, or ID cards if known.\"},{\"question\":\"What does the fee section cover?\",\"answer\":\"The fee section provides the cost based on the selected scenario, including applying for an initial identification card if the applicant has never held a Pennsylvania driver’s license/permit/ID, or applying for a non-driver ID for specific reasons.\"}]","DL-54A - Application For Initial Identification | PDF",1790257358]