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Interlock device? YES NO If yes, give date when violation occurred and check one of the following: 1. I was found not guilty. 2. I paid the ticket, plead guilty or was found guilty. 3. The case hasn't been decided yet. C REQUEST FOR EXEMPTION FROM PHOTO - ABSENTEE EXEMPTION During the next 60 days I will be absent from PA for the following reason: Military School Work Travel Within 45 days of my return I will apply for a driver's license containing my photo. X.

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