Transcription of FILE NUMBER: APPLICATIONFORCONCEALED …
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FILE NUMBER: APPLICATIONFORCONCEALED …
SP-248 (10-1-2017) FILE NUMBER: _____ APPLICATION FOR CONCEALED HANDGUN PERMIT COMMONWEALTH OF VIRGINIA VIRGINIA CODE SECTIONS AND 06 RESIDENT PERMIT NONRESIDENT PERMIT RENEWAL SEE NOTICE 2 PAGE 3 LEGAL NAME (ATTACH A SEPARATE LISTING OF ANY ADDITIONAL NAMES YOU MAY HAVE USED OR BEEN KNOWN BY) FIRST _____ MIDDLE _____ LAST_____ OF BIRTH (YOU MUST BE AT LEAST 21 YEARS OF AGE) MONTH _____ DAY _____ YEAR _____ ADDRESS (ATTACH A SEPARATE LISTING OF ALL ADDRESSES WITHIN THE LAST 5 YEAR PERIOD) STREET OR RURAL ROUTE _____ CITY _____ COUNTY _____ STATE _____ ZIP _____ MAILING ADDRESS (IF DIFFERENT) _____EMAIL (OPTIONAL)
yes no did you receive an honorable discharge yes no not applicable. 2. form . part a commitments to the commissioner of health and developmental services
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