SP 642: New Jersey Application for Permit to Carry a Handgun

Enter the Municipal Code. Each person applying for a Permit to Carry a Handgun must supply a letter of need, specific in content, as to why they have a need to carry a firearm in the State of New Jersey. If this application is employment-related, then your employer must supply this letter. List the reason for this application.

Enter (1) Last Name (If female, include maiden), First and Middle, and (2) Resident Address (Number - Street - City - State - Zip).

Enter (3) Date of Birth, Month Day Year, (4) Age, (Place of Birth - City - State or Country) and (5) U.S. Citizen, Yes No.

Enter (6) Social Security Number.

Enter (7) Sex, Height, Weight, Eyes, Race, Hair and Complexion, and (8) Distinguishing Physical Characteristics.

Enter (9) Name of Employer and (10) Employer's Address (Number - Street - City - State - Zip).

Enter (11) Occupation, (12) Home Telephone and (13) Business Telephone.

Enter (14) Driver's License Number & State and (15) If you possess a N.J. Firearms Purchaser ID Card, list the number.

(16) Have you ever been adjudged a juvenile delinquent? If Yes, List Date(s) Place(s) Offense(s)

(17) Have you ever been convicted of a disorderly persons offense, that has not been expunged or sealed? (18) Have you ever been convicted of a criminal offense, that has not been expunged or sealed? If Yes, List Date(s) Place(s) Offense(s)

(19) Have you ever had a firearms purchaser identification card, permit to purchase a handgun, or permit to carry a handgun refused or revoked? If Yes, By Whom? When? Where Why?

(20) Have you ever had an Employee of Firearms Dealer License refused or revoked? (21) Are you an Alcoholic? (22) Have you ever been confined or committed to a mental institution or hospital for treatment or observation of a mental or psychiatric condition on a temporary, interim or permanent basis? If Yes, give the name and location of the institution or hospital and the date(s) of such confinement or commitment (23) Are you dependent upon the use of any narcotic or other controlled dangerous substance?

(24) Are you now being treated for a drug abuse problem?

(25) Have you ever been attended, treated or observed by any doctor or psychiatrist or at any hospital or mental institution on an inpatient or outpatient basis for any mental or psychiatric conditions? If Yes, give the name & location of the doctor, psychiatrist, hospital or institution and the date(s) of such occurrence.

(26) Do you suffer from a physical defect or sickness? (27) If answer to question 26 is yes, does this make it unsafe for you to handle firearms? If not, explain. (28) Are you subject to any court order issued pursuant to Domestic Violence? If yes, explain.

(29) Have you ever been convicted of any domestic violence in any jurisdiction which involved the elements of (1) striking, kicking, shoving, or (2) purposely or attempting to or knowingly or recklessly causing bodily injury, or (3) negligently causing bodily injury to another with a weapon? If Yes, explain.

(30) Are you presently, or have you ever been a member of any organization which advocates or approves the commission of acts of violence, either to overthrow the government of the United States or of this State, or to deny others of their rights under the Constitution of either the United States or the State of New Jersey? If yes, list name and address of organization(s) here:

Endorsement Number One - Reference must have known applicant for a minimum of three years preceding the date of the application.

I am personally acquainted with the applicant named on page one of this application. I have known Him/Her for the past years to be a person of good moral character and behavior and who is capable of exercising self control. I have reviewed this application and I believe that the answers given by the applicant to the questions set forth in this application are complete, true and correct in every particular.

A money order in the amount of $50.00 payable to State of New Jersey - Treasurer must accompany this application. (checked November 2, 2026)

The applicant named on page one, being duly sworn, upon oath deposes and states that he/she is the applicant named on page one of this application; that the answers to the questions given on this application are complete, true and correct in every particular.

The disclosure of my social security number is voluntary. Without this number, the processing of my application may be delayed. This number is considered confidential.

Falsification of this form is a crime of the third degree as provided in NJS 2C:39-10c.

Notary Public.