Get TX DPS CHL-90 2010

I also understand that this is an official Government record and that any missing information and/or false statement made on this document or any supplement provided to the Department will cause a delay in the processing of my application and may result in criminal prosecution. Applicant Signature Date / / Mail this completed form along with any and all required supplemental documents and/or fee to Concealed Handgun Licensing MSC 0245 PO Box 4087 Austin TX 78773-0001 CHL-90 Rev. 02/2013 FORM. Texas Department of Public Safety Regulatory Services Division CONCEALED HANDGUN LICENSING MUST USE MOST CURREN T FORM P RI N T CLEARLY IN BLACK INK EXAMPLE MAKE SURE ENTIRE CIRCLE IS FI LLED www. dps. texas. gov Yes No SUPPLEMENTAL INFORMATION APPLICANT INFORMATION Are you applying for both a Concealed Handgun License and Certification as a Qualified Handgun Instructor I currently hold a valid CHL License AS APPEARS ON CHL-78 Driver License ID Card CHL License No THE ABOVE SPACE IS RESERVED FOF OFFICE USE ONLY First Name Applicant Last Name Issuing State 2-DIGIT CODE Suffix M. I. IF ANY - Social Security No* DL/ID Number An instructor applicant must meet at least one of the qualifications listed below. Per Government Code 411. 190 Certification Date MM/DD/YYYY I am currently certified by Texas Commission on Law Enforcement Officer Standards and Education TCLEOSE to instruct others in the use of handguns. Please attach a legible copy of documents and/or certificates as proof that you are a TCLEOSE firearm instructor. I am certified under Chapter 1702 Occupations Code to instruct others in the use of handguns. Please attach a legible copy of your Level III pocket card. A Level III Classroom Instructor only does not qualify. I regularly instruct others in the use of handguns and have graduated from a handgun instructor school that uses a nationally accepted course designed to train persons as handgun instructors. training course s you have completed* instructor s training course s you have completed* I certify that I am a Peace Officer certified by the Texas Commission on Law Enforcement Officer Standards and Education TCLEOSE and wish to receive TCLEOSE credit when I successfully complete CHL Instructor training. Expiration Date / TCLEOSE PID Number I verify that the information provided is true and correct and I understand that any required fee is non-refundable. Texas Department of Public Safety Regulatory Services Division CONCEALED HANDGUN LICENSING MUST USE MOST CURREN T FORM P RI N T CLEARLY IN BLACK INK EXAMPLE MAKE SURE ENTIRE CIRCLE IS FI LLED www. dps. texas. gov Yes No SUPPLEMENTAL INFORMATION APPLICANT INFORMATION Are you applying for both a Concealed Handgun License and Certification as a Qualified Handgun Instructor I currently hold a valid CHL License AS APPEARS ON CHL-78 Driver License ID Card CHL License No THE ABOVE SPACE IS RESERVED FOF OFFICE USE ONLY First Name Applicant Last Name Issuing State 2-DIGIT CODE Suffix M. dps. texas. gov Yes No SUPPLEMENTAL INFORMATION APPLICANT INFORMATION Are you applying for both a Concealed Handgun License and Certification as a Qualified Handgun Instructor I currently hold a valid CHL License AS APPEARS ON CHL-78 Driver License ID Card CHL License No THE ABOVE SPACE IS RESERVED FOF OFFICE USE ONLY First Name Applicant Last Name Issuing State 2-DIGIT CODE Suffix M. I. IF ANY - Social Security No* DL/ID Number An instructor applicant must meet at least one of the qualifications listed below. .