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IDENTIFICATION REQUIRED SEE REVERSE SIDE

IDENTIFICATION REQUIRED SEE REVERSE SIDE

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SPECIAL INSTRUCTIONS FOR THOSE WHO WISH TO OBTAIN RECORD INFORMATION ON OTHERS Specify the applicable code below in the space on the front of this form in the REQUEST SECTION. I hereby request the Department of Motor Vehicles to disclose personal information from its records.

  Reserve, Identification, Required, Side, Identification required see reverse side

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