YEAR of BIRTH for the person with the appointment *
Your answer
Date of the appointment *
MM
/
DD
/
YYYY
Time of the appointment *
Time
:
AM
PM
Location where the appointment was made (if the office you have an appointment at is NOT on this list, you may have scheduled in a COUNTY motor vehicle office. Please contact that office to cancel your appointment). *
What service did you request?
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Email address to contact if there are questions
Your answer
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