Change Of Address Notification For License To Carry Firearms And Firearms Identification Card
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1New Bedford Police Department
Criminal Investigation Division
Firearms Bureau
871 Rockdale Avenue, New Bedford, MA 02740
Phone: 508-991-6300 x-150 Fax: 508-979-1566
Scott W. Lang
Mayor
David A.Provencher
Chief of Police
CHANGE OF ADDRESS NOTIFICATION FOR
LICENSE TO CARRY FIREARMS AND FIREARMS IDENTIFICATION CARD
Instructions:
1)
Please PRINT CLEARLY the information requested below;
2)
Please make a legible photocopy of both sides (1 copy for each side) of your firearms
identification card or license to carry firearms and attach these copies to this sheet as page #2
and #3;
3)
Make 3 photocopies of this completed form and attach page #2 and #3;
4)
Mail by certified mail this original with the attached page #2 and #3 to the following address:
Firearms Record Bureau
ATTN: “CHANGE OF ADDRESS NOTIFICATION”
200 Arlington Street, Suite 2200
Chelsea, MA 02150
5)
Mail 1 copy to the police department that issued your firearms identification card or license to
carry firearms.
6)
Mail 1 copy to the police department in the city/town that you have moved to;
7)
Retain 1 copy in your files for important future reference.
Today’s Date: _____________
First Name: _________________
M.I.: ______ Last Name: __________________________
Date of Birth: _______________
LTC#: __________________ FID#: _________________
Expires: ________________ Expires: _______________
New Street Address: ________________________________________________ Apt#: _______
New City/Town: _________________________________ State: ________ Zip: ____________
Mailing Address (If Different): ____________________________________________________
Home Phone#: (
) _____________________ Work Phone#: (
) ____________________
City/Town that issued your current FID/LTC: _________________________________________
Massachusetts General Law Chapter 140 Section 129B(11): A [FID] cardholder shall notify, in writing, the licensing authority that issued such card, the
chief of police into whose jurisdiction such cardholder moves and the executive director of the criminal history systems board of any change of address. Such
notification shall be made by certified mail within 30 days of its occurrence. Failure to so notify shall be cause for revocation or suspension of such card.
Massachusetts General Law Chapter 140 Section 131(l): Any [LTC] licensee shall notify, in writing, the licensing authority who issued said license, the
chief of police into whose jurisdiction the licensee moves and the executive director of the criminal history system board of any change of address. Such
notification shall be made by certified mail within 30 days of its occurrence. Failure to so notify shall be cause for revocation or suspension of said license.
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