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CONCEALED HANDGUN CARRY LICENSE APPLICATION ... - …

Revised October 2016 1 CONCEALED HANDGUN CARRY LICENSE APPLICATION form department OF arkansas STATE POLICE (Please print clearly and provide all requested information) Check one: New APPLICATION Renewal APPLICATION Transfer APPLICATION Full Name: _____ Last First Middle Jr., Sr., or III (if applicable) Give all other names you have ever used: _____ Date of Birth: _____ Place of Birth: _____ Race: _____ Sex: _____ (Month/Day/Year) (City) (State) Social Security #: _____Driver s LICENSE #: _____ _____ State Hair color: _____ Eye color: _____ Height: _____ feet _____ inches Physical Address:_____ _____ City State ZIP Mailing Address: _____ _____ City State ZIP List the county of your physical residence:_____ Do you live within the city limits _____?

Revised October 2016 1 CONCEALED HANDGUN CARRY LICENSE APPLICATION FORM DEPARTMENT OF ARKANSAS STATE POLICE (Please print …

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