REV 12/2018
SAN BERNARDINO COUNTY SHERIFF’S DEPARTMENT
VERIFICATION OF CONCEALED WEAPON(S) FOR LICENSE
has completed the San Bernardino County Sheriff’s
LEGAL NAME
Department weapon(s) verification.
Date:
Applicant Signature
From:
Home Address:
To:
City:
Zip:
Mailing Address:
City:
Zip:
Employer Name:
Occupation:
Employer Address:
City:
Zip:
Phone Numbers
Home:
Work:
Cell:
SSN:
Email Address:
Height:
Weight:
Eye Color:
Hair Color:
DOB:
OFFICE USE ONLY
Add
Del
MANUFACTURER
SERIAL NUMBER
CALIBER
MODEL
1.
2.
3.