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MOTOR VEHICLE RECORD REQUEST PERMISSION FORM I the undersigned give authorization for P. W. Wood and Son Inc. and Cornell Cooperative Extension to obtain a current copy of my Motor Vehicle Driving Record MVR. NAME AS IT APPEARS ON LICENSE ADDRESS DATE OF BIRTH STATE OF LICENSE DRIVER S LICENSE NUMBER SIGNATURE DATE SIGNATURE OFFICE USE ONLY FORM TO BE RETURNED TO UNDERSIGNED CCE AUTHORIZATION SIGNATURE PRINT NAME EMAIL ADDRESS for results. This authorization is good until revoked by me in...
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