1 placard 2 placards (Limit 1 replacement placard if lost ...
(Street or P.O. box) (City) (State) (Zip) Driver License or State Identification Card Number: _____ Phone: _____ (Home) NOTICE: I understand that by signing and submitting this form, my ability to operate a motor vehicle may be reviewed by the Department as provided in 47 O.S. ยง 6-119, pursuant to the standards prescribed by the Driver License ... ................
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