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SAN ANDREAS DEPARTMENT OF MOTORVEHICLE Commercial License Registration |
| Last Name: Brotista | First Name: Johans | Date: 16/1/2025 | DOB: 1/1/1999 |
| Age: 47 | Address: Los Santos | Phone Number: 968105 | Nationality: Melayu |
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, 16/1/2025
Johans Brotista
