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Get Ny Ppb-3 2007

ATION YEAR LAST NAME EXPIRATION DATE MONTH FIRST NAME RESIDENCE ADDRESS HGT(INS) WGT (LBS) MI MONTH HAIR RACE EMPLOYED BY SOCIAL SECURITY NUMBER PRESENT OCCUPATION NATURE OF BUSINESS YEAR CITIZEN OF U.S.A. YES NO BUSINESS ADDRESS I HEREBY APPLY FOR A PISTOL/REVOLVER LICENSE TO: (Check one only) CARRY CONCEALED * POSSESS/CARRY DURING EMPLOYMENT (* Premise address or place of employment must be provided) STREET ADDRESS OR OTHER LOCATION DAY YEAR DATE OF BIRTH ZIP CODE CITY,VI.

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