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= wy * Record Request FD-125 Rev. 4-1-93) O Birth O Credit AY cximinal O Death O INS) © Mamiaget 1 Motor Vehicle “© Other Buded File Number Q\ENWWN-. 10806 2. Date b O pe Oo7 b6 -2 | b7C -2 , . b6 -3 b7c -3 : b3 -1 Address Residence os . Business Former b6 -2 b7c -2 * Date and place of marriage Gfapplicable) Arrest Number a Social Security Number Specific information desi: NCL Results of check Birthplace Fingerprint classification Divers License Number QO D/L Photo QQ Other Criminal specialty b6 -3 b7c -3 b3 -1 03956-6978.