Dps 129 C PDF Details

The DPS-129-C form is an essential document issued by the State of Connecticut's Department of Emergency Services and Public Protection. Located at 1111 Country Club Road in Middletown, this form lays the groundwork for individuals seeking to maintain compliance with state requirements regarding permits. To ensure completeness, the form mandates the inclusion of several critical items: proof of legal and lawful presence in the United States, demonstrated by presenting a U.S. Passport, Birth Certificate, or documentation from the U.S. Citizenship and Immigration Services; a non-refundable fee of $70.00, payable to the Treasurer of the State of Connecticut; and a valid photo identification if a birth certificate is used to verify legal status. For those opting to renew by mail, notarization becomes a necessary step. Personal details such as name, address, place of birth, country of citizenship, and an array of identifying information including alien registration number, social security number (optional), and physical characteristics are also required. Moreover, the form places a high emphasis on the accuracy and truthfulness of the information provided by featuring a declaration that must be signed and attested to in the presence of an official. The unique aspect of this form is its role in facilitating communication between the Department of Mental Health and Addiction Services and the Department of Emergency Services and Public Protection concerning the permit holder’s mental health status, specifically in relation to any psychiatric disabilities that may impact their permit eligibility. This inter-departmental coordination aims to uphold the stipulations outlined in C.G.S. Section 29-28, ensuring the safety and well-being of the community while respecting individual rights.

QuestionAnswer
Form NameDps 129 C
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesct pistol permit renewal, connecticut pistol renewal, connecticut pistol permit renewal, dps 129 c form

Form Preview Example

STATE OF CONNECTICUT

Department of Emergency Services and Public Protection

1111 Country Club Road

Middletown, CT 06457-2389

DPS-129-C (08/31/11)

Name:

Address:

City, State Zip:

FORM MUST BE ACCOMPANIED BY:

1.Proof of legal and lawful presence in the United States: Copy of U.S. Passport, Birth Certificate, or U.S. Citizenship and Immigration Services issued permanent residence identification/documentation.

2.$70.00 Fee (Check or money order payable to

“Treasurer, State of Connecticut”). DO NOT

SEND CASH.

3.Copy of valid photo identification if providing a birth certificate as proof of legal and lawful presence in the United States.

4.Notarization ONLY if renewing by mail.

Place of Birth:

Country of Citizenship:

Telephone:

FOLD HERE

Please check the information below:

Alien Registration Number: [if applicable]

Date of Expiration: [if AR # has exp date]

PERMIT ID NUMBER:

DATE OF BIRTH:

SOCIAL SECURITY NUMBER: (Optional)

EYE COLOR:

HEIGHT:

FT

IN

WEIGHT: LBS SEX:RACE:

Current Permit Valid:

 

From

Through

A=ASIAN

B=BLACK

I=INDIAN

W=WHITE

U=UNKNOWN

ATTACH IN THIS

SQUARE, USING

TRANSPARENT TAPE, A PASSPORT PHOTO

(2” X 2”) OF YOU

THAT WAS TAKEN WITHIN THE PAST 6

MONTHS

Please sign within the box in presence of official

By affixing my signature to this form, I certify that the information I have provided in this form is true and correct to the best of my knowledge and belief, and that the attached photograph was taken of me within the last 6 months. I am aware that in order to effectuate C.G.S 29-28, the Department of Emergency Services and Public Protection (DESPP) will be notified by the Department of Mental Health and Addiction Services if I have been confined in a hospital for psychiatric disabilities within the proceeding twelve (12) months by order of a probate court. This information will be used by the DESPP in order to fulfill its obligations under C.G.S. Section 29-28.

Subscribed to and sworn to before me this

 

day of

 

, 20

 

.

Notary Public:

 

 

 

 

Term Expires:

 

 

 

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Feel free to prepare the Current Permit Valid From, Through, AASIAN BBLACK IINDIAN WWHITE, Please sign within the box in, By affixing my signature to this, Subscribed to and sworn to before, day of, Notary Public, and Term Expires space with the appropriate information.

Entering details in ct permit renewal stage 2

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