Transcription of FILE NUMBER: APPLICATIONFORCONCEALED ... - vsp.state.va.us
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FILE NUMBER: APPLICATIONFORCONCEALED ... - vsp.state.va.us
SP-248 (7-1-2016) 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 1. FULL LEGAL NAME (ATTAC H A S E P AR ATE LIS TING OF ANY ADDITIONAL NAMES YOU MAY HAVE US ED OR BEEN KNOWN BY) FIRST _____ MIDDLE _____ LAST_____ 2. DATE OF BIRTH (YO U MUS T B E AT LE AS T 21 YE AR S OF AG E) MONTH _____ DAY _____ YEAR _____ 3. RESIDENTIAL ADDRESS (ATTAC H A S E P AR ATE LIS TING O F ALL ADDR E S SES WITHIN THE LAS T 5 YE AR P E R IO D) STREET OR RURAL ROUTE _____ CITY _____ COUNTY _____ STATE _____ ZIP _____ MAILING ADDRESS (IF DIF F E R E NT) _____EMAIL (OPTIONAL)_____ 4. PHYSICAL FEATURES HEIGHT _____ WEIGHT _____ SEX _____ RACE _____ HAIR COLOR _____ EYE COLOR _____ SCARS, MARKS, TATTOOS, PECULIAR CHARACTERISTICS: _____ 5.
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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