CPL Quick Reference Support Guide 2023

064

CPL Renewal Self Directed Live Fire Certificate of Completion Applicaant Print Name

Reciept attached ( Optional ) Range Officer_________________________________ Optional

This form is designed for the renewal applicant that has elected to complete the range portion without an Instructor . It is not a requirement of the state law. S ee attached recommended course of fire and target.

Applicaant Signature ______________________________

Date _ ________________________________________ Range Location __ _______________________________

This is to confirm that _____________________________________ has completed one hour of range time as per renewal requirements effective on November 2015.