Transcription of EASY CARD SERVICES - Miami-Dade County
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EASY CARD SERVICES - Miami-Dade County
The personal information requested in this document is for statistical and record keeping purposes only. La informaci n personal que se solicita en este documento tiene fines estad sticos y de archivo solamente. Tout enf masyon ke nou mande nan dokiman sa-a se pou estatistik pa nou epi pou travay biwo pa nou-an s lman. Social Security Number:Date of Birth:Fecha de Nacimiento / Dat Ou F t N mero de Seguro Social / Nimewo Sosval Name:Sexo / Ki sa w ye Nombre / Non Gender: MaleMasculino / Gason FemaleFemenino / Fi Mailing Address:Direcci n Postal / Adr s Postal City:Ciudad / Vil State:Estado / Eta Zip Code:C digo Postal / Zip K d Phone Number:Tel fono / Nimewo Telef nRace/Ethnicity (Check only one) Raza/Etnia (Escoja solo una) Ki ras ou (Mete sa w vle ye-a)American Indian / Alaskan NativeNativo Americano Nativo de Alaska Ameriken Endyen, ou moun AlaskaAsian / Pacific IslanderAsi tico de las islas del Pac fico Azyatik oubyen z n pasifik HispanicHispano Pany lAfrican-AmericanNegro, no de origen hispano Nwa, ki pa pany lWhite, not HispanicBlanco, no de origen hispano Blan, ki pa pany lUnder penalty of perjury, I declare that I have read the Golden Passport application and t
Golden Passport EASY Card ki pèdi pa koute anyen pou ranplase yo yon premye fwa, $10 pou dezyèm ranplasman an, ak $25 pou chak ranplasman aprè. Miami-Dade Transit Golden Passport Office located on the first floor of the Government Center Metrorail station, at 111 NW 1st Street Miami, FL 33128 Golden Passport Hotline: 786-469-5028.
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