Part One is to be completed by the applicant; Part Two by County Adjuster's Office, Mental Health Institution and/or Doctor.
Part Three: to be completed by authorized official or doctor only if applicant has record of admission, commitment, or treatment for a mental disorder.
Social Security number: disclosure is voluntary; the number will be used to expedite the application, and without it the processing of the application may be delayed.
Prior addresses: list prior addresses for past 10 years.
Other names: if you have been known by any additional names, aliases or maiden names, indicate them; if no, write Not Applicable.
| Question | Answer |
|---|---|
| Form Name | S.P. 66 |
| Form Length | 2 pages |
| Fillable? | Yes |
| Fillable fields | 75 |
| Avg. time to fill out | 13 min |
| Edition | 05/24 |
| Additional forms | New Jersey State Police, Firearms Investigation Unit, P.O. Box 7068, West Trenton, NJ 08628-0068 |
| Other names | S.P. 66, SP 66, SP66, SP-066, S.P. 066, Form SP-066, SP 066, Consent for Mental Health Records Search |
| Official source | S.P. 66 (Rev 05/24), New Jersey State Police |
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