1 RICHMOND POLICE DEPARTMENT PERMIT ... - City of Richmond

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SECTION 10: PISTOL & AMMUNITION – SALES – LICENSED DEALER 1. Is the applicant a licensed firearm dealer pursuant to 18 USC §921 et seq.? ___YES ___NO a. If yes, list Federal firearms License Number; _______________________________ b. Name of individual(s) whose name(s) appear on Federal Firearms License: 2. Is the applicant a firearms dealer registered with the Virginia State Police Dept? ___ YES ___ NO a. If yes, list VSP Identification Number: ___________________________________________ b. Attach a copy of completed Firearms Dealer Registration form displaying VSP Identification Number (with all attachments) 10
I CERTIFY THAT I HAVE EXAMINED THIS APPLICATION AND THE DOCUMENTS SUBMITTED IN SUPPORT THEREOF, AND TO THE BEST OF MY KNOWLEDGE AND BELIEF, THEY ARE TRUE, CORRECT AND COMPLETE. I HAVE NEITHER WITHHELD NOR MISREPRESENTED ANY FACTS CONTAINED HEREIN. BY MY SIGNATURE BELOW, I AUTHORIZE THE RICHMOND POLICE DEPARTMENT TO CONDUCT AN INVESTIGATION INTO MY BACKGROUND TO DETERMINE MY QUALIFICATIONS FOR THE PERMIT AND/OR LICENSE THAT I AM SEEKING. I ALSO UNDERSTAND THAT ANY FALSIFICATION OR MISSTATEMENT OF MATERIAL FACTS MAY BE GROUNDS FOR DENIAL OF THIS APPLICATION. ____________________________________________________ Applicant’s signature _______________________ Date COMMONWEALTH OF VIRGINIA CITY/COUNTY OF __________________________________________, to wit: The foregoing document was acknowledged before me this _______day of ____________________, ___________________ by ___________________________________________________________ My Commission Expires: __________________________________ __________________________________________________________ Notary Public ***************ALL APPLICATIONS MUST BE NOTARIZED******************** 11
Page 1 and 2: RICHMOND POLICE DEPARTMENT PERMIT A
Page 3 and 4: SECTION 2: DRIVING HISTORY PROVIDE
Page 5 and 6: SECTION 4: ADDITIONAL INFORMATIOIN
Page 7 and 8: SECTION 7: FAMILY AND HOUSHOLD Name
Page 9: SECTION 8: APPLICANTS FOR TAXI CAB

1 RICHMOND POLICE DEPARTMENT PERMIT ... - City of Richmond

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