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APPLICATION FOR CONCEALED WEAPON OR FIREARM …

FDACS-16036 Rev. 07/17 Page 1 of 2 florida Department of Agriculture and Consumer ServicesDivision of LicensingAPPLICATION FOR CONCEALED WEAPON OR FIREARM LICENSEC hapter 790, florida StatutesPost Office Box 6687sTallahassee, FL 32314-6687s(850) I APPLICANT INFORMATION Read APPLICATION instructions before you begin. Place letter/number inside each box as shown SECURITY NUMBER ALIEN REGISTRATION NUMBERLAST NAME FIRST NAME MIRESIDENCE ADDRESS PHONE NUMBERRESIDENCE ADDRESS CONTINUED (SUITE, BLDG., APT., ETC.)CITY STATE ZIP CODE-MAILING ADDRESS IF DIFFERENT FROM ABOVEMAILING ADDRESS CONTINUED (SUITE, BLDG., APT., ETC.)CITY STATE ZIP CODE-SEX RACE EYE COLOR HAIR COLOR DATE OF BIRTH (mmddyyyy) WEIGHT HEIGHTLBSFTINPLACE OF BIRTH - (INCLUDE STATE OR PROVINCE --- AND COUNTRY)EMAIL ADDRESSAre you an active-duty United States military servicemember, as defined in Section , florida Statutes, or an honorably discharged United States veteran, as defined in Section , florida Statutes, and are requesting expedited processing of your APPLICATION ?

Florida Department of Agriculture and Consumer Services. Division of Licensing. APPLICATION FOR CONCEALED WEAPON OR FIREARM LICENSE. Chapter 790, Florida Statutes Post Office Box 6687. sTallahassee, FL 32314-6687s(850) 245-5691 www.mylicensesite.com. S

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