Voluntary Surrender Of Oklahoma Self-Defense Act License Form printable pdf download

Voluntary Surrender Of Oklahoma Self-Defense Act License Form

LEAVE BLANK. FOR OSBI USE ONLY.

VOLUNTARY SURRENDER OF

OKLAHOMA SELF-DEFENSE ACT

LICENSE FORM

Pursuant to the provisions of Title 21 O.S. §1290.17(A) of the Oklahoma Self Defense Act,

I am voluntarily surrendering my Oklahoma Self-Defense Act License.

I am aware of and acknowledge the following:

1. Surrender of my handgun license renders the license invalid.

2. Surrender of my current license does not prevent me from submitting a new

application for a license in the future.

3. Voluntary surrender of my license will not be deemed a suspension or revocation

by the Bureau.

4. Voluntary surrender of my license will not be reviewable by a hearing examiner or

subject to judicial review under the Administrative Procedures Act.

5. By surrendering the license, I forfeit all fees paid to date.

____________________________________________________________________________________

(SIGNATURE)

____________________________________________________________________________________

(PRINTED NAME)

________________________________________

_______________________________________

(LICENSE #)

(DATE)

Please return this signed form with the Self-Defense Act License to:

OSBI SDA LICENSING UNIT

6600 NORTH HARVEY

OKLAHOMA CITY, OK 73116

Should you have any questions, please call the SDA Licensing Unit at (405) 879-2690.

Voluntary Surrender Of Oklahoma Self-Defense Act License Form