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SAN ANDREAS DEPARTMENT OF MOTORVEHICLE Commercial License Registration |
| Last Name: Kazuya | First Name: Shinichiro | Date: 26/12/2024 | DOB: 23/11/2000 |
| Age: 24 | Address: Richman | Phone Number: 912108 | Nationality: Japan |
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, 26/12/2024
Shinichiro Kazuya
