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SAN ANDREAS DEPARTMENT OF MOTORVEHICLE Commercial License Registration |
| Last Name: Halimawan | First Name: Youma | Date: 13/12/2024 | DOB: 20/10/1999 |
| Age: 24 | Address: Los Santos | Phone Number: 114163 | Nationality: Jepang |
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, 13/12/2024
Youma Halimawan
