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Get MI RI-012 2009

Ly print answers to all fields. 1. Full Legal Name (First, Middle, Last, Suffix) 2. Date of Birth 3. Previous Names or Alias (If applicable) 4. Daytime Telephone Number 5. Social Security Number (Voluntary) 6. Driver License Number or State Identification Number 7. a. Residential Address b. Residential City c. Residential Zip 8. a. Mailing Address (If different) b. Mailing City c. Mailing Zip 9. a. Race b. Gender c. Height d. Weight e. Hair Color f. Eye Color 10. Name of Police.

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