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I further understand that willful and false certification shall subject me to fines/imprisonment as outlined in R.S. 47 463. MEDICAL EXAMINER S CERTIFICATION OF MOBILITY IMPAIRMENT I certify that Name Birth Date Address Race/Sex City/State/Zip code meets the requirements as outlined in shown on reverse side and qualifies for a mobility impaired license plate/hang-tag. A medical examiner s certification is required for renewal of hang-tag. UNABLE TO APPEAR IN PERSON AT OFFICE OF MOTOR VEHICLES...
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What is i certify that name?
I certify that name is a statement made by an individual or entity confirming the accuracy of the information provided.
Who is required to file i certify that name?
Individuals or entities who are required by law or regulation to certify the accuracy of certain information.
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To fill out I certify that name, one must provide their name, signature, and date confirming the accuracy of the information provided.
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The purpose of I certify that name is to ensure that the information provided is accurate and truthful.
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The information reported on I certify that name may vary depending on the specific requirements, but typically includes details on financial transactions, compliance with regulations, or other relevant information.
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