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SAN ANDREAS DEPARTMENT OF MOTORVEHICLE Commercial License Registration |
| Last Name: Beneke | First Name: Cooper | Date: 05/11/2024 | DOB: 01/01/2000 |
| Age: 23 Years | Address: San Andreas | Phone Number: 751456 | Nationality: America |
Documents:
ID Card
Driving License
I understand that I am obligated to be complete and truthful in providing information on this application. I have read, understand and agree with the contents of this form, including the certifications on the back of this form. I certify under penalty of perjury under the laws of the State of California that all the information on this form is true and correct.
Los Santos, 05/11/2024
Cooper Beneke
