Get FL HSMV 74039 2015-2021
Ase Number hereby authorize the Bureau of Motorist Compliance to release my $________ security deposit to _______________________________. This deposit was made in accordance with Section 324.051 and Section 324.061, Florida Statutes, with respect to claims for injuries to person or property resulting from an automobile crash on ______________ in or near________________________________________________. I further authorize and request that this payment be forwarded to at________________________.
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