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Get MA T21844 2015-2024

Will be verified with the Social Security Administration. I have reviewed this completed Application Form and swear (affirm), under the penalties of perjury, that the information I have provided is true and complete. False statements are punishable by fine, imprisonment, or both (M.G.L. c 90 §24). Signature: Date: The Registrar reserves the right to cancel, revoke, or recall, any permit, license, or ID card if it is determined that the applicant was not qualified for such permit, license, or .

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