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Get J23 Form 2015-2024

LICENSE NO. or FED. EMPLOYER ID NO. TELEPHONE NO. (Required) DMV USE ONLY AMOUNT RECEIVED IDENTIFICATION REQUIRED SEE REVERSE SIDE NAME NUMBER AND STREET CITY OR TOWN TOTAL STATE ZIP CODE *IDENTIFICATION REQUIREMENTS - Identification is required by law which must contain a photo. The requester must provide a copy of his/her current photo identification, driver's license, or passport or the request may not be processed. SPECIAL INSTRUCTIONS FOR THOSE WHO WISH TO OBTAIN RECORD INFORMA.

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