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)_____ CHECK THIS BOX AND PROVIDE AN EMAIL ADDRESS ABOVE TO REQUEST ELECTRONIC NOTICE IN ADVANCE OF PERMIT EXPIRATION. ( RESIDENT PERMITS ONLY) 4. PHYSICAL FEATURESHEIGHT _____ WEIGHT _____ SEX _____ RACE _____ HAIR COLOR _____ EYE COLOR _____SCARS, MARKS, TATTOOS, PECULIAR CHARACTERISTICS: _____ SECURITY NUMBER (OPTIONAL)SEE NOTICE 1 ON PAGE 3 6.
notice 1 disclosure of social s ecurity number this information is provided pursuant to the government data collection and dissemination practices act (§ 2.2-3800 et seq).
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