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Get FL HSMV 72077 2016-2021

E: Street Address: Sex: Date of Birth: Driver License Number: Violation/Offense: Violation/Offense Date: Conviction Date: Incarceration Date: Release Date: (Must be on or after conviction date) (Must be on or after conviction date or incarceration date and/or credit for time served) Agency: Address of Agency: Name and Title of Person Signing Release: Signature of Person Signing Release: Telephone Number of Person Signing: Release: Name of Person in Charge of Correctional Facility: Teleph.

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