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Form MVL-24 Maine

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Form MVL-24 Maine

Certification of Acquired Brain Injury

This document is an application form for a non-driving card issued by the Maine Secretary of State's Bureau of Motor Vehicles for individuals with acquired brain injuries. The form requires the person's name, date of birth, mailing address, telephone number, and the signature of a licensed neurologist or physician attesting to the diagnosis. The applicant is instructed to mail the completed application along with a $5.00 check or money order to the provided address. The card does not provide driving privileges and cannot be used as identification.

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