Fillable CHANGE OF INFORMATION / REPLACEMENT LICENSE REQUEST FORM (Oklahoma)

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CHANGE OF INFORMATION / REPLACEMENT LICENSE REQUEST FORM (Oklahoma)

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The CHANGE OF INFORMATION / REPLACEMENT LICENSE REQUEST FORM (Oklahoma) form is 1 page long and contains:

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  • 10 check-boxes
  • 25 other fields

Country of origin: US
File type: PDF

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SELF-DEFENSE ACT LICENSE
CHANGE OF INFORMATION / REPLACEMENT LICENSE REQUEST FORM
Check appropriate box(es) and send original, signed, notarized form along with any required documents and/or
payment to:
Oklahoma State Bureau of Investigation
Self-Defense Act Licensing Unit
6600 North Harvey Place
Oklahoma City, OK 73116
CHANGE OF ADDRESS (Fill in name, social security #, email address, current address and new address)
CHANGE OF NAME (Fill in old name, new name, email address, social security # and current address)
REPLACEMENT LICENSE (For replacement license only, fill in name, email address, social security #,
and current address)
If license was lost or stolen initial here: ____________ Please destroy old license when new one arrives.
Name on File:
Social Security #:
Email Address: Check if email is New / Changed
(Required for Expiration Notifications)
Current Address on
File:
Current Address
City
Zip Code
New Name:
New Physical
Address:
Physical Address
City
Zip Code
County
New Mailing
Address:
Mailing Address
City
Zip Code
Signature of License Holder:
Date:
Subscribed and sworn to before me this
day of
Notary Public
If requesting a replacement license or new license with updated information, please include payment of $15.00
ACCEPTABLE FORMS OF PAYMENT (PERSONAL CHECKS NOT ACCEPTED):
CASH (In-person only) CASHIER’S CHECK / MONEY ORDER VISA MASTERCARD DISCOVER AMERICAN EXPRESS
CREDIT CARD # ________ - ________ - ________ - ________ EXPIRATION DATE: _______ SECURITY CODE: _______
SECURITY CODE FOR VISA, MC, DISCOVER IS 3 DIGITS ON BACK OF CARD. AMEX SECURITY IS 4 DIGITS ON FRONT
NAME AS IT APPEARS ON CREDIT CARD:
(PLEASE PRINT)
CARD HOLDER’S SIGNATURE (REQUIRED):
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CHANGE OF INFORMATION REPLACEMENT LICENSE REQUEST FORM (Oklahoma)

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Completed 11 May 2021

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