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Get AZ DoT 96-0104 2014

Application Type:  New Plate  New Placard For renewals, use form # 40-0112, available online. Phone ( Applicant Mailing Address DISABILITY – HEARING IMPAIRED PLATE/PLACARD APPLICATION Clear Date of Birth Driver License Number ) City State Zip Plate Applicants: Vehicle information below is for plate applicants only (vehicle must be owned or leased by the person with a disability or hearing impaired) Vehicle Identification Number Year Make Current Plate Number Physical Disab.

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