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SAN ANDREAS DEPARTMENT OF MOTORVEHICLE Commercial License Registration |
| Last Name: Samuel | First Name: Ben | Date: 28/12/2024 | DOB: 12/11/1996 |
| Age: 27 | Address: Los Santos | Phone Number: 961786 | Nationality: Amerika Serikat |
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, 28/12/2024
Ben Samuel
