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Get Vicroads Consent Release Information 2001-2024

Ormation to a Third Person Your Personal Details Surname Given Name(s) Company Name and ACN (if applicable) Home (or company) Address Postcode Garaged Address (if different from above) Postcode Home Phone Work Phone D Date of Birth D M M Y Registration Number Y Y Y Driver’s Licence No VIN No Hereby Consent to Release (records kept by VicRoads) Registration Licence Note: Licence details include any convictions or other information recorded against my name relevant eit.

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