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Get Il Dsd X 164.6 2016

Isability Identification Card at no fee on the basis that I am an individual who is disabled as defined in Section 4A of the Illinois Identification Card Act. This report shall remain valid for three months. I affirm that the information in this affidavit is true and correct. Applicant's Signature/Date _____________________________________________________________________________________ Driver’s License Number and/or Identification Card Number ______________________________________________.

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