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Clerk's Office: Driver's Application Background Check

2. Driver's Application

4. Last Name*

5. First Name*

6. Middle Initial*

8. Ethnicity*

9. Sex*
   -- Select One --MaleFemale

11. Month of Birth*

12. Day of Birth*

13. Year of Birth*

15. Other Names:

17. Copy of Valid Driver's License*

    Please upload a copy of the driver's valid Michigan driver's license.

Leave This Blank:


19. Submit

* indicates a required field