Data For Texas Occupational Driver'S License Page 2
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1
2DATA FOR TEXAS
OCCUPATIONAL DRIVER’S LICENSE
PRINT OR TYPE:
Full Name: _______________________________________________
First
Middle
Last
Address:
_______________________________________________
Street Address
_______________________________________________
City
State
Zip Code
Date of Birth
Sex
Color
Color
Weight
Height
Driver’s
Month
Day
Year
Eyes
Hair
Pounds
Ft. Inch
License No.
|
|
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This is to certify that I am the person named and described herein.
____________________________
Usual Signature of Applicant
Mail to:
Driver Improvement and Control
Occupational License Section
Texas Department of Public Safety
P.O. Box 15999
Austin, TX 78761
INFORMATION BELOW THIS LINE IS FOR DEPARTMENT USE ONLY
DATE OF ISSUE: __________________
EXPIRE: ________________
(DIC-37)
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