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Get FL HSMV-84019 2011-2024

Type or legibly print all information, except signatures. In order to process this application, all questions, including the sworn statement, must be properly completed. Please complete the appropriate form for either Unsatisfied Judgment or Bankruptcy. All documents supporting the claim must be submitted with the application in order to properly access the claim for approval or disapproval. The completed application and supporting documents are to be forwarded to: Claims Administrator Division.

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