Fillable Change Of Name Request - 10.25.18 - Fillable The Commonwealth of Massachusetts

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Change Of Name Request - 10.25.18 - Fillable The Commonwealth of Massachusetts

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Name Change Notification – 10.2018
The Commonwealth of Massachusetts
Department of Criminal Justice Information Services
Firearms Records Bureau
200 Arlington Street, Suite 2200
Chelsea, MA 02150
NAME CHANGE REQUEST FOR
FIREARMS IDENTIFICATION CARD AND LICENSE TO CARRY FIREARMS
Instructions:
1. Complete the information below. Please PRINT CLEARLY.
2. Make a legible photocopy of the front side of your firearms identification card or license to carry.
3. Send this form to the Firearms Records Bureau either by email or mail:
FRB@mass.gov
OR
Firearms Records Bureau
200 Arlington Street, Suite 2200
Chelsea, MA 02150
ATN: Change of Address Notification
4. You will not receive a new license with the updated name.
_________________________________________
Date
Previous name:
______________________________________________
Last Name, First Name
_________________________________________
FID card or LTC #
______________________________________________
Date of Birth
New name:
______________________________________________
Last Name, First Name
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Change Of Name Request - 10.25.18 - Fillable The Commonwealth of Massachusetts

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Completed 26 February 2020

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