Free TC-465 - Utah

Utah State Tax Commission

TC-465
Rev. 1/00

Waiver

I hereby ask that the criminal information requested be released to the Utah State Tax Commission, Motor Vehicle Enforcement Division and release the Utah State Bureau of Criminal Identification from any liability resulting from such request.

Signed

Date

Subscribed and sworn to before me this

day of

, 20

.

Signature of notary public

Notary public for the state of

Commission expires ORIGINAL - BCI YELLOW - MVED
TC-465.CDR Rev. 1/00