LTC-70.pdf - Texas Department of Public Safety Regulatory...

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APPLICANT INFORMATION - NOTE: Name must match the name on DL/ID LTC License Number Texas Department of Public Safety Regulatory Services Division To upload your supporting documents please visit RSD secured website: HANDGUN LICENSING Change of Address/Name Change/Replacement/Modification/Lawful Presence Driver License ID Card DL / ID State (2-LETTER CODE) License / ID Number ADDRESS CHANGE (check one) Change Mailing Only Change Physical Only Change Both Residence Address (Cannot be a PO Box) City State (2-LETTER CODE) ZIP Code County Mailing Address (If different from Residence Address) City State (2-LETTER CODE) ZIP Code County I understand all fees submitted to Handgun Licensing are non-refundable and non-transferable . I verify the information provided is true and correct, and I understand this is an official government record and any false statement made on this document or any other supplement provided to DPS may result in criminal prosecution . Applicant Signature Date (MM/DD/YYYY) (You may copy and paste a scanned .jpg or pdf of your signature) NAME CHANGE (Include legal documents as supporting documentation for name change: marriage license, divorce decree, etc.)
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