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Get AK DMV 412 2015

ADDRESS STATE ZIP ALASKA DRIVER LICENSE NUMBER CONTACT PHONE NUMBER EMAIL ADDRESS SCHOOL DISTRICT OR CONTRACTOR FOR WHOM DRIVING EMPLOYER PHONE NUMBER Have you ever been convicted for an offense listed on the backside of this application? Yes No If you answered “Yes”, please list the conviction type, state where the conviction occurred, and the conviction date. Conviction Type State Where Conviction Occurred Conviction Date I certify that the above is true and accurate to the best.

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