MOTOR VEHICLE/VESSEL RECORDS REQUEST
| Requester's Information
|
abc
| Name of Requester
| Oscar Grace
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| Date
|
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| Reference # (Case/File Name)
|
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| Street Address
|
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| Exemption # (See Exemptions Listed on the Back of This Form)
|
|
| City State Zip
|
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| "I understand that I may not redisclose this information except as provided in section 119.0712(2), Florida Statutes."
|
| Signature of Requester or Contact Person
|
|
| Telephone Number
|
|
| Current Registration Request
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| Request type
| * Motor Vehicle * Vessel * Mobile Home
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| VIN/HIN Number
|
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| License Plate or FL #
| * ABC-123, * ABC-723, * ABC-733
|
| ...
|
