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2. A $5 fee must be paid upon submission of the application. Letter will be mailed to your home address within 10 days unless otherwise requested.
4. Last Name*
5. First Name*
7. Home Address*
8. City*
9. State*
10. Zip Code*
12. Phone Number*
13. Email Address*
15. Age*
16. Race*
17. Height*
18. Weight*
20. Date Of Birth
21. Social Security #*
22. Place of Birth*
24. Sex*

    1. Male
    2. Female
25. Drivers License #*
27. Name & Address of Agency Requiring Letter*
29. Please note that this letter does not prove residency and will state that the applicant has never been arrested by the Fort Lee Police Dept.
33. 
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field