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Va Registration Form 2020-2023
Or black ink Starred items are required* If you do not complete all of the items that are marked with your application may be denied See instructions on reverse side. YES NO I am a citizen of the United States of America* Full social security number N - Date of birth No SSN was ever issued* M / D Y Gender Jr. Sr. II III IV Circle if applicable Last name None Middle name First name Residence address May not be a P. O. Box Apt ZIP City/Town E-mail Phone Have you ever been convicted of a felony or...
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