Fill and Sign the Application for License to Carry a Concealed Handgun Ohio Form

Application to Carry a Concealed Pistol, Revolver or other Firearm To:__________________________ (Title of Law Enforcement Official or Other Authority)County of _________________State of _________________I, the undersigned, in accordance with the provisions of ____________________ (citation of state statute), make application for a _______________ (License or Permit) to carry concealed the following weapon: 1.Description of weapon: [ ] Pistol, [ ]Revolver[ ]Other Weapon: (describe) __________________________________________ ________________________________________________________________ 2. Name of Manufacturer: __________________________________________________3. Serial No.: _________________________________________________4. Caliber: ____________________________________________________ In support of this application, the following information is hereby submitted:A. Applicant's Name: ________________________________________________B. Occupation: _____________________________________________________ C.Residence Address: ________________________________________________ ____________________________ (street number, city, county, state and zip code) D. Business Address: _________________________________________________ _____________________________ (street number, city, county, state and zip code)E. Age: ________F. Date of birth (month/day/year): ______________________________ H. Identification: _____________________________________ (driver's license, include state of issue and number) I. Height of Applicant: _____________________J. Weight of Applicant: ____________________K. Color of Eyes: ______________________L. Color of Hair: ______________________ M. Reason for desiring a license to carry concealed the above-described weapon: _______________________________________________________________Witness my signature this the ______________________ (date)._____________________________________(Printed Name of Applicant)_____________________________________ (Signature of Applicant) Information to be Inserted by Board or Officer Issuing License To the Applicant:Your application for a license to carry concealed the above-described weapon is:[ ]Approved[ ]Denied for the following reasons: _________________________________________ ____________________________________________________________________ A license issued under this application expires ________________ (number of months or years) after the date of issuance. Number of License Issued: ____________________________Date issued: _______________________________________Dated: ________________________________________________________ (Printed Name of Officer Issuing License) _______________________________________ (Signature of Officer Issuing License)