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Are unmarried and provide proof that your spouse had this plate and is now deceased. A new plate will be issued with the same emblem, with a new plate number. Affidavit State law makes falsifying information on this application a third-degree felony. I meet the eligibility requirements as listed on this form, and am providing proof to that effect. Signature of Applicant Form VTR-421 Rev 01/16 Date Online form at www.TxDMV.gov Page 1 of 2 Application for Military Meritorious Service Licens.

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