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2. I'm requesting information for:

   1. Myself
   2. Someone else
4. First Name
5. Last Name
7. Address
9. City
10. State
11. Zip Code
13. Home Phone
14. Cell Phone
16. Email
18. Date of Birth
    Date of Birth
20. Resident of Gratiot County?

    1. Yes
    2. No
22. Requested Information
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23. Submit

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