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Get IL VSD-851 2012

01 S. Second St., Rm. 520 Springfield, IL 62756 Fax (217) 785-1038 www.cyberdriveillinois.com Please print or type License Plate Number Vehicle Identification Number Vehicle Make Vehicle Year Last Name First Name Middle Initial Last Name First Name Middle Initial Address City Phone Number(s) Driver’s License Number(s) State ZIP Code Reason for License Plate Revocation (check one): o Vehicle sold with license plates attached o License plates lost/missing/destroyed o Registered .

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