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Kwy, Mail Stop 97 Tallahassee, FL 32399 Original Duplicate Lost-in-transit Section 1: REGISTRANT INFORMATION Registrant s Name as It Appears on Driver License Registrant s Phone Number (First, Full Middle/Maiden, & Last Name) (Voluntary) FL DL/ID or FEID/Suffix Number Registrant s Mailing Address I Registrant s Residential Street Address Registrant s Email (Voluntary) Sex Date of Birth City State Zip Code City State Zip Code Section 2: APPLICANT WITH ME.

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