Revised 3/2021
Date of Request:
Program Name:
Contact Person:
Site Address (If different from mailing address)
Address of office where the software will be installed and used.
Mailing Address
Phone Number:
Company/Agency:
e-mail:
License No.:
Change of Site Address
TO BE COMPLETED BY PENNDOT
Date Received: Amount: $
Check #:
Date Sent:
Date Logged:
by:
by:
by:
Use this form to request an updated version of the Pennsylvania Department of Transportation's Engineering Software.
Please provide all requested information below so that the Department can update its software license database. Please
include payment of the appropriate update fee including 6% PA Sales Tax (if applicable). The sales tax does not
apply to out-of-state organizations as long as both the Mailing Address and the Site License Address are outside of
Pennsylvania. Update fees can be found clicking the program name on the Ordering/Updating page of our support website
(https://penndot.engrprograms.com/home/Ordering/Ordering.htm). Payment can be made by check payable to
"Pennsylvania Department of Transportation" or credit card. For credit card payments, e-mail the form to
PenndotBisEngineer@pa.gov
and an invoice will be e-mailed to the Contact Person with a link to the Pay PennDOT website.
PENNSYLVANIA DEPARTMENT OF TRANSPORTATION
ENGINEERING SOFTWARE UPDATE REQUEST
Change of Mailing Address
Change of Contact Person
Special Instructions:
Updating from Version:
Version Requested:
Overnight Mail Address
Pennsylvania Department of Transportation
OA-Bureau of Solutions Management
Highway Applications Division
Commonwealth Keystone Building, 5th Floor
400 North Street
Harrisburg, PA 17120-0041
US Postal Service Address
Pennsylvania Department of Transportation
OA-Bureau of Solutions Management
Highway Applications Division
P.O. Box 8213
Harrisburg, PA 17105-8213
Tel: (717) 783-8829
Fax: (717) 705-5529
When paying by check, send request form and payment to:
Update Fee:
6% PA Sales Tax:
Tax-Exempt Organization. PA Exemption Certificate (Form REV-1220) required.
Total Payment Enclosed: $
Non-PA Organization. Both Mailing and Site Adresses must be outside PA.
Credit Card Payment
