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Get CA LIC 9163 2008

:______________________________________ EYE Color:____________________ HAIR Color:______________ Home Address: (All applicants must complete) ALIEN REGISTRATION, OUT OF STATE DRIVER’S LICENSE OR I.D. POB:_________________________________________________ STREET OR PO BOX SOC:_________________________________________________ CITY, STATE AND ZIP CODE (See Privacy Statement on Page 4) 6. Facility Number:__________________________________________ Level of Service ✓ ■ DOJ ✓ ■ F.

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