PA DOT Form DL-11CD. Self-Certification Form

The Form DL-11CD, also known as the Self-Certification Form, is used by individuals in Pennsylvania to provide certification of their physical and mental fitness to operate a motor vehicle. This form serves as a declaration that the individual meets the necessary requirements and does not have any medical conditions or impairments that would hinder their ability to drive safely.

The Self-Certification Form consists of sections where the applicant provides personal information such as their name, address, date of birth, and driver's license number. Additionally, there are specific questions related to the individual's medical history, including any conditions that may affect their driving abilities.

It is important for the applicant to carefully review and accurately answer all the questions on this form. Providing false information or failing to disclose relevant medical conditions can have serious legal and safety implications.

Application Example: An individual who has recently been diagnosed with a medical condition that may impact their ability to drive safely must complete and submit the Form DL-11CD to the Pennsylvania Department of Transportation (PennDOT). By completing this form honestly and thoroughly, the individual ensures that their driving privileges align with their physical capabilities.

Related Forms: Form DL-11CD DS is an alternative version of the Self-Certification Form that allows applicants to submit their certification online, simplifying the submission process for those who prefer electronic methods.

Differences from Similar Forms: While there may be similar self-certification forms in other states, it is essential to consider that the specific requirements and regulations outlined in the Form DL-11CD are tailored to Pennsylvania's Department of Transportation. It is crucial to use the correct form that corresponds to the state you reside in to ensure compliance with local laws and regulations.