EFTA01428155.pdf

EPSTEIN, JEFFREY E. 11111E ST. JAMES STTHOMAS, VI 00802 IssUed 10/211 Cl 112012019 '1'!!Irl00OIOOCi7431 DDB 1/20.11953 Hair GRV Jyes B1U Blood Type 0+ Restrictions I I 11EltE8YI1AKE/UI TO CI2ss A = P;iva\" Class B = School Bus I Class C = Taxi 0' C""" ff.u; i Class 0 =Motorcycle O.11y I Class E = Heavy Equipment Class S U )en &Jot.""ffie I N .'F!Cti_"5 UPON MY DEATH Of: A; /ViiJ DMdod OI! , parb. r.: lIM 1."""'-"0 body paris: c: U.IiI.IIc:r.I'- EFTA01428155