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INSTRUCTIONS ON REVERSE SIDE OF FORM

Name of Transferor Number 1 (Please Print) PA DL/Photo ID# Date of Birth or Bus. ID# Address (Street, City, State, Zip Code) Signature of Transferor Number 1 Date Name of Transferor Number 2 (Please Print) PA DL/Photo Date of Birth or Bus. ID# Address (Street, City, State, Zip Code) Signature of Transferor Number 2 Date B C MV-13ST (1-19) www ...

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