PennDOT DL-21SC Form: Vehicle Self-Certification Guide – If you are restoring your driving privileges in Pennsylvania after a DUI-related suspension or revocation and must comply with the state’s ignition interlock requirements, you will almost certainly need Form DL-21SC. Officially titled “Self-Certification of Vehicle(s) to Be Operated or Inoperable,” this PennDOT form is a critical step in the process of obtaining an Ignition Interlock Restricted License.
This guide explains exactly what Form DL-21SC is, who must file it, how to complete it correctly, where to download the official version, and how the form is submitted. All information is based on current PennDOT instructions and official resources.
What Is PennDOT Form DL-21SC?
Form DL-21SC is the official Pennsylvania Department of Transportation document used to self-certify the vehicles you own, operate, or that are inoperable when you are required to install an ignition interlock device. The form also covers situations in which you own no vehicles at all.
The current version is DL-21SC (4-18). It contains four main sections:
- Section A – Driver Information
- Section B – Vehicle Information
- Section C – Statement of Vehicle(s) to Be Operated / Non-Ownership / Inoperable
- Section D – Statement of Vendor (completed by an approved ignition interlock provider)
Accurate completion is essential. Misstatement of fact on the form is a misdemeanor of the third degree under 18 Pa. C.S. § 4904(b) and can result in a fine of up to $2,500 and/or imprisonment of up to one year.
Who Needs to Complete Form DL-21SC?
You must complete Form DL-21SC if:
- Your driving privilege was suspended or revoked for a DUI offense (or chemical test refusal) that requires an ignition interlock restriction.
- You have received a Restoration Requirements Letter from PennDOT showing an eligibility date for restoration.
- You need to certify the vehicles you will operate during the interlock period, declare that you own no vehicles, or state that certain vehicles titled in your name are inoperable.
Even if you do not own any vehicles, you are still required to obtain an Ignition Interlock Restricted License and hold it for the mandated period. In that case, an approved vendor uses the DL-21SC to certify non-ownership after checking PennDOT’s vehicle records.
For official details on ignition interlock requirements, visit the PennDOT Ignition Interlock FAQs.
When Should You Complete the Form?
Do not begin the process until you have received your Restoration Requirements Letter and an eligibility date appears on it. The letter is typically mailed approximately 30 days before you become eligible to restore your privileges.
Important: Do not contact an ignition interlock vendor to install a device or certify the form until an eligibility date is listed. Completing the form too early can delay processing.
How to Download the Official Form DL-21SC?
Always use the official PennDOT version of the form. Download the current PDF directly from the Commonwealth of Pennsylvania website:
Download Official PennDOT Form DL-21SC (PDF)
You may also obtain a copy from an approved ignition interlock vendor or by calling the PennDOT Driver and Vehicle Services Customer Call Center at 717-412-5300.
Step-by-Step Instructions for Completing Form DL-21SC
Print the form and complete it in blue or black ink. Typewritten information is also acceptable. Follow these steps carefully:
Section A – Driver Information
- Enter your full legal name.
- Provide your complete residential address. A P.O. Box may be listed in addition to the street address but cannot be used as the only address.
- Enter your Pennsylvania driver license number (found on your Restoration Requirements Letter).
- Include city, state, and ZIP code.
Section B – Vehicle Information
- List every vehicle you own or have permission to operate that will be driven during the interlock period, or any vehicle titled/registered in your name that is inoperable.
- For each vehicle provide: Plate number, Title number, VIN, and Year/Make.
- This information appears on the vehicle registration card.
- If you need more space, attach a separate sheet.
- If your violation occurred prior to October 1, 2003, check the corresponding box; you do not need to list vehicle details in that case.
You will be required to show the vendor a valid registration card and proof of insurance for the vehicles listed.
Section C – Statement of Vehicle(s) to Be Operated / Non-Ownership / Inoperable
Check only one box and complete the corresponding statement:
- You will operate the vehicle(s) listed in Section B.
- You do not own any vehicle(s).
- The vehicle(s) titled/registered in your name is/are inoperable (attach a notarized statement explaining why the vehicles are inoperable if this option is selected).
Print your name, sign in ink, and date the form. By signing, you authorize PennDOT to furnish your vehicle record to the ignition interlock vendor.
Section D – Statement of Vendor
Leave this section blank. An approved ignition interlock vendor completes Section D after verifying your information against PennDOT records and (if applicable) installing the interlock device(s). The vendor then emails the completed form to PennDOT at [email protected].
Finding an Approved Ignition Interlock Vendor
Only PennDOT-approved vendors may install ignition interlock devices or certify Form DL-21SC. For a current list of approved providers, visit the Pennsylvania DUI Association Ignition Interlock page or call the Association at 1-800-627-2384.
Vendors set their own fees for installation, monitoring, and non-ownership certification. PennDOT does not regulate these prices.
What Happens After the Form Is Submitted?
Once the vendor emails the completed and verified DL-21SC to PennDOT:
- PennDOT processes the certification.
- You must also submit any other required forms listed on your Restoration Requirements Letter (commonly DL-3731 – Application for Ignition Interlock License).
- After all requirements are met, PennDOT issues the Ignition Interlock Restricted License.
You must maintain the interlock restriction for the full required period (usually one year) and comply with all vendor monitoring rules. At the end of the period, a Declaration of Compliance from the vendor is generally required before an unrestricted license can be issued.
Related Forms You May Also Need
- DL-3731 – Application for Ignition Interlock License / Return of Regular Driver License
- DL-17 – Statement of Non-Ownership of Vehicle(s) (sometimes used in conjunction with non-ownership certification)
- DL-21SCR – Self-Certification of Vehicles Requesting Removal of Ignition Interlock From Vehicles Not Operated
- DL-3805 – Ignition Interlock Employment Exemption Affidavit
All forms are available on the official PennDOT website under Driver and Vehicle Services forms and publications.
Common Questions About Form DL-21SC
Is there a fee to file Form DL-21SC with PennDOT?
No. PennDOT does not charge a fee to process the form. However, the ignition interlock vendor may charge a service fee for verification and submission.
Can I submit the form myself?
No. Section D must be completed by an authorized vendor. The vendor emails the finished form directly to PennDOT.
What if I buy or register a vehicle after certifying non-ownership?
You must immediately install an approved ignition interlock device on the new vehicle and notify the vendor. Failure to do so can result in license recall.
Where can I get help?
Contact the PennDOT Driver and Vehicle Services Customer Call Center at 717-412-5300 (Monday–Friday, 8 a.m.–5 p.m. ET). TTY users should dial 711.
Important Reminders
- Use only the official current version of Form DL-21SC.
- Never contact a vendor before you have an eligibility date on your Restoration Requirements Letter.
- Provide complete and accurate vehicle information; the vendor will verify everything against PennDOT records.
- Keep copies of all forms and correspondence for your records.
Completing Form DL-21SC correctly is one of the key steps toward restoring your driving privileges under Pennsylvania’s ignition interlock program. Download the official form, follow the instructions carefully, work with an approved vendor, and submit all required documentation on time.