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~ COMMERCIAL EMPLOYER PULL NOTICE oepeenent of Mex Vehk~es <br /> A,u,,:se,..,V.~ ENROLLMENT OF OUT OF STATE UCENSED DRIVERS Empeyer Pu. Notice--H2~ <br /> P.o. Box N4231 <br /> THIS FORM IS FOR ENROLLING DRIVERS ONLY 8ecmmeeo, CA g4244-23~0 <br /> Pieace type or print in ink <br /> <br /> ( ) F~. <br /> <br /> [] <br /> <br /> PRINT AS SHOWN ON OUT-OF-&TA TE LICENSE 'REMARK$' FOR YOUR U~E (LiIT TO 215PACES) <br /> '~') ~ L~ST NAME. HRST. ~DOLE (DO NOT USE <br /> {HOME STATE AOORESS) I Cn'Y I STATE <br /> <br />2) COMPI.EYE LAST'NAME, FIRST. MM3OLE (DO NOT USE NMITIRL.S) <br /> <br /> {HOME STATE ADORESS) <br /> <br />~1) COMPt~I.ASTNAME. FIFIST. MIIX)LE (DOMOTU:$E/NIT~)I I I t I I I I I I I I I <br /> <br /> (HOME STATE ADORESS) ~CITY {STATE <br /> DRIVER LICENSE NO, REMARKS <br /> <br />4) COMP~=TE~AS~;~4ME, RRST.~mDD,.E (DO NOT USE INITMLS) <br /> <br /> (HO~E STATE ADDRESS) CRY STATE <br /> <br /> ORIVER UCENSE NQ ~ REM~ <br />5)COMPLETE LASf NAME. FIRST, MID(X.E (DONOT USEINrJ~) I I I I I I I I I I I , I <br /> <br /> (HOME STATE ADDRESS) <br /> <br /> D~vER uc..sE ,.o. <br /> <br />B) COMPLETE LAST NAME, FIRST, MID(N,E (DO NOT UJE <br /> <br /> (HOME STATE ADDRESS) <br /> <br /> DRIVER LICENSE NO. I REM~ <br /> , I I I I I I I I I,,, I I I <br /> <br /> TOTAL DRIVERS ADDED <br /> <br /> X ~.00 = TOTAL DUE CeeNeeelby: <br /> <br /> Wemmm meSemm m el~ek w menmy er~lm~ ~ ee DMV. <br /> <br /> <br />