Form Dps 445 - Application For Weapons Carry License

Form Dps 445 - Application For Weapons Carry License - Georgia

_____________________ County, Georgia

County Number ________________

APPLICATION FOR WEAPONS CARRY LICENSE

Applicant’s Name:____________________________________________________________________________

First

Middle

Last

(or as registered with INS)

Maiden Name, Aliases & Names Previously Used: __________________________________________________

Date of Birth: ___/___/___ (Age if < 21:____ + attach proof of completed basic training or honorable discharge)

INS Alien/Admission No. _________________________

Sex: _______Race: _________ Height _________ Weight: _______ Hair Color:_________ Eye Color: ________

Place of Birth: _______________________________________________________________________________

City

State, Province or District

Country

Residence/Street Address: _____________________________________________________________________

City, State, Zip:

____________________________________________ County: ______________________

Mailing Address if different:____________________________________________________________________

Phone Numbers:

Home (_______) _____________________Other (_____) __________________________

GA Military Base of non-resident who is active military __________________(attach copy of active duty orders)

1. Are you currently a United States Citizen? …………………………………………….……… Yes

Have you ever renounced your U.S. citizenship? …………………………………………….. Yes

If so, attach a copy of the reversal of renunciation.

► If you are not a U.S. Citizen:

You must show proof of name/address/date of birth/place of birth/INS or ICE number/photo ID.



Identify all countries of citizenship:



Attach: (a) Documentation of your lawful presence in the United States, for example:

-As to Immigrant Aliens: Resident Alien card, Permanent Resident Card or Immigrant

Visa with Adit Stamp; OR

-As to Non-Immigrant Aliens: a Student Visa, Tourist Visa, Employment Authorization

Card, or valid Passport with Arrival/Departure Record;

and

(b) Proof of residency in the State of Georgia.

2. Are you a non-immigrant (temporarily admitted) alien? [See above] …………………………. Yes

If yes, attach proof that you fall within an exemption establishing your eligibility.

DPS 445 (5/16)

Form Dps 445 - Application For Weapons Carry License - Georgia