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SOLICITAO DE 2 VIA DE PLACA

Eu,_______________________________________________________________________,
portador do RG_______________________________, CPF___________________________,
residente na ________________________________________________________________
_____________________________________, n___________, complemento___________,
bairro ______________________________________, CEP__________________________,
proprietrio

do

veculo

placa_________________________________,

Renavam__________________________________________________________________.

Venho solicitar 2 via da placa supracitada pelo motivo de:


Roubo

Furto

Perda

Dano

____________________________, _______ de _________________________ de 20_____.

_____________________________________
(Assinatura)

Unidade
(carimbo e assinatura)

Vistoria
(carimbo e assinatura)

Lacrao
(carimbo e assinatura)

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