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ALL INFORMATION IS REQUIRED PURCHASE KANSAS TAGS OR LICENSE
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| FIRST NAME | |
| MIDDLE INIT | |
| LAST NAME | |
| STREET | |
| CITY | |
| STATE | |
| COUNTRY | |
| ZIPCODE | |
| HEIGHT | ft inches |
| WEIGHT | lbs |
| EYE COLOR | |
| HAIR COLOR | |
| PHONE NUMBER | |
| BIRTH DATE | |
| SOCIAL SEC # | |
| DRIVER LIC # | |
| HUNTER SAFETY # | |
| US CITIZEN? | YES / NO |