This document is a request form for a driver's license or identification card number. The availability of records is subject to the Uniform Motor Vehicle Records Disclosure Act. The form must be completed in full and signed, with notarization required for processing. Information requested includes name as it appears on ID, date of birth, social security number, address, city, state, zip code, telephone number, and FAX number. The requestor certifies that the information will be used as authorized by law and acknowledges penalties for false statements.
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