REV 06/2018
CCW PERMIT
TERMS OF USE
WRITE/TYPE YOUR INITIALS ON EACH LINE
As a CCW Permit Holder I agree to abide by the following conditions:
I will not use my CCW permit for purposes of employment.
I will not consume alcoholic beverages or be under the influence of any illegal
substance while in possession of a firearm.
I will only carry those firearms specifically listed on my CCW permit.
I agree to notify the CCW office within three business days of arrest or any negative
law enforcement contact.
I agree to notify the CCW office within ten business days of any change of address.
I understand any violation of the above terms may result in denial or revocation of my
CCW permit.
PRINT OR TYPE NAME
DO NOT WRITE/TYPE BELOW THIS LINE
SIGN AND DATE IN FRONT OF CCW AGENT
I have read and understand the conditions above.
APPLICANT SIGNATURE
DATE