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Ky Form Tc 94 191 2020
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STREET ADDRESS
CITY
STATE
ZIP
MAILING ADDRESS (if different from street address)
CITY
STATE
ZIP
DATE OF BIRTH (mm/dd/yyyy)
DRIVER LICENSE #/SSN # (last 4 digits of SSN)
EXPIRATION (mm/dd/yyyy)
SECTION 2: PAYMENT INFORMATION
Select the item you wish to purchase.
Driver License Renewal ($20.00)
ID card/Duplicate License ($12.00)
Combination D-M ($30.00)
Would you like to donate $1 to the Trust for Life Organ Donation Program?
Yes
No
Form of payment:
cash
check*
money...
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