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TIONS) Race Sex Height Hair Color Eye Color Date Of Birth OR LARCENY OF MOTOR FUEL Weight G.S. 20-16(a)(9),-(a)(10),-(a)(10a),-(e1),-(e2); 20-16.1; Drivers License No. And State Social Security No. Offense For Which Defendant Was Convicted Date Of Conviction NOTE: Use this form when defendant's license is suspended/revoked under G.S. 20-17(a)(16) for a second or subsequent offense of larceny of motor fuel. NOTE: Use this form when defendant's license is suspended/revoked under any o.

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