| Last Name: Pitts |
First Name: Jemery |
Date: 06/11/2024 |
DOB: 05/01/1997 |
| Age: 26 |
Address: Jefferson |
Phone Number: 43113 |
Nationality: American |
Documents:
I understand that I am obligated to be complete and truthful in providing information on this application. I understand that i should follow all the rules of Licensed Timber Operators Registration and the regulation inside the San Andreas Fire Code, and all data above that requested to the San Andreas Law Enforcement Agencies will be stored permanently in the SAN FIRE Administrative Services Office and will show all of my databases and records during your stay in San Andreas. I, hereby declare that I have read and understood the restrictions, and understand the consequences that follow by violating the license rules and restrictions. I also hereby consent and approve the form stated above.
Please submit this application along with a check or money order in the amount payable to the SAN FIRE. Submit a separate application and payment for each requested report. Mail the application with your payment.
Los Santos, 06/11/2024
Jemery Pitts
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