Department of the Secretary of State
Bureau of Motor Vehicles
Certification of Membership
Wabanaki Confederacy
I certify that ____________________________________________________
Name Printed or Typed Date of Birth
whose address is __________________________________________ is a member
Address
of the following tribes: Penobscot, Passamaquoddy, Maliseet, Micmac Tribe
________________________________________________
Signature of Tribal Official Office held by Official
_______________________________________________
Printed or Typed Name of Tribal Official Date
MV-18
