Pulaski County Clerk of Circuit Court Online Concealed Handgun Permit Application

Welcome! This is an official application for a concealed handgun permit. You must completely and accurately fill-out this application to be considered for a permit. The making of a materially false statement in an application under this article shall constitute perjury, punishable as provided in § 18.2-434.

A non-refundable processing fee is required. In addition, an online service fee is required to process payment. These fees will be charged even if your application is denied or the process is not completed by the applicant.

QUESTIONS - PLEASE READ each question carefully and answer as fully as possible. Incorrect information will affect the processing of your application

RENEWALS - If you are unable to provide your File# please enter NA into the field and be sure to upload a copy of your current CHP

Applicant Information:

Last Name: ^{(official ID)}

First Name:

Middle Name:

Maiden Name:

Suffix: ^{(jr, sr, etc.)}

SSN:

SSN: ^(confirm)

Previous Aliases: ^{(please list all previous aliases)}

Previous Last Name	Previous First Name	Previous Middle Name	City Where Changed	State	Court File #

Information Related To Your Birth:

Date of Birth:

Current Age:

Birth City:

Birth State:

Birth Country:

Demographic Information:

Race:

Gender:

Male

Female

Height:

^feet ^inches

Weight:

Hair Color:

Eye Color:

Scars, Marks, Tattoos, Peculiar Characteristics:

Telephone Number: ^{(###-###-####)}

^Primary:

^Work:

^{Mobile Phone:}

^Fax:

Updates via text message?

Yes No

Email:

^Address:

^Confirm:

Please Create A Password: ^{(you can use this to track progress, and we may need to contact you during the process)}

Password:

Password: ^(confirm)

Password Information: In order to comply with CJIS standards we have employed the use of a password complexity monitor. As you enter your password, we will display an indicator of complexity. You will only be able to submit passwords that are sufficiently complex as to be considered 'safe' by CJIS standards. The visual indicator will turn Blue or Green to indicate that your password is safe.

Important: CJIS requires we maintain a strict password policy and system of checks. As such, we check the following items as you enter your new password:

The password must be a minimum length of eight (8) characters on all systems
The password must not be a dictionary word
The password must not be the same as your email address
The password must not be a proper name

Current Residence Address: ^{(this may be different than your mailing address)}

Address Line 1:

Address Line 2:

City:

County:

State:

Zip Code: ^{(postal code)}

Country:

^{Mailing Address Different:}

Yes No

Present Mailing Address: ^{(if different from residence address)}

Address Line 1:

Address Line 2:

City:

State : ^(region)

Zip Code: ^{(postal code)}

Country:

Spouse Residence Address:

Address Line 1:

Address Line 2:

City:

State : ^(region)

Zip Code: ^{(postal code)}

Country:

Previous Addresses - For the last 5 years: ^{(please list all previous addresses)}

Address Line 1	Address Line 2	City	State	Zip	Country	From	To

Attach Documentation: please upload the required documentation

To upload documentation, please use the 'Add Files' button below to begin the process. The maximum size of individual files is 5 MB. The address on government issued IDs must match the address on this application.

VALID GOVERNMENT ISSUED PHOTO ID (e.g. VA DRIVERS LICENSE / STATE ID, PASSPORT, ID ISSUED BY THE U.S. DEPARTMENT OF DEFENSE)
ATTACH A PHOTOCOPY OF THE DOCUMENTATION THAT DEMONSTRATES YOUR COMPETENCE WITH A HANDGUN

Uploaded Files:

Add files...

Please select a document type then, click on the “Attach” button to complete the upload process.

Select Your Application Type:

New Concealed Handgun Permit

New Concealed Handgun Permit - Retired per § 18.2-308.03

Total Fee:

$0

I, THE UNDERSIGNED, AFFIRM THAT THE INFORMATION CONTAINED IN THIS APPLICATION AND IN ANY ATTACHMENTS TO THIS DOCUMENT IS BOTH CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE. THE WILLFUL MAKING OF A FALSE STATEMENT IN THIS APPLICATION CONSTITUTES PERJURY AND IS PUNISHABLE IN ACCORDANCE WITH §18.2-434 OF THE CODE OF VIRGINIA. I ALSO AFFIRM AND UNDERSTAND THAT THE ISSUANCE OF A CONCEALED HANDGUN PERMIT DOES NOT NECESSARILY ENTITLE ME, THE UNDERSIGNED, TO POSSESS, TRANSPORT OR SELL A FIREARM UNDER STATE OR FEDERAL LAW.

I HEREBY AUTHORIZE THE PULASKI COUNTY SHERIFF TO RECEIVE MY CRIMINAL AND/OR DRIVING HISTORY AND I HEREBY RELEASE THE SHERIFF, HIS OFFICERS, AGENTS, AND EMPLOYEES FROM ANY AND ALL LIABILITY RESULTING THEREFROM.

Please enter your e-Signature

Your Initials:

For security purposes, we logged your IP Address: 18.119.105.155, 172.68.168.169:40988, 40.1.3.141

Required signature

Please select an appointment below. This is for presenting your ID and signing the application in our presence for that processing of the application. You may come to the office at any time between 8:30am and 4:30pm, Monday to Friday.

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

← prior month
← prior week

first available →
next week →
next month→

None Selected

Coupon Code:

Your Initials:

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Pulaski County Clerk of Circuit Court

Concealed Handgun Permit Application Please Enter All Information

Please read the following before proceeding:

Applicant Information:

Previous Aliases: ^{(please list all previous aliases)}

Information Related To Your Birth:

Select Appropriate Immigrant Classification: ^{(only choose one)}

Which of the following exceptions set forth in 18Z USC 922(y) do you meet?:

Demographic Information:

Telephone Number: ^{(###-###-####)}

Email:

Please Create A Password: ^{(you can use this to track progress, and we may need to contact you during the process)}

Current Residence Address: ^{(this may be different than your mailing address)}

Present Mailing Address: ^{(if different from residence address)}

Spouse Residence Address:

Previous Addresses - For the last 5 years: ^{(please list all previous addresses)}

Attach Documentation: please upload the required documentation

Uploaded Files:

Select Your Application Type:

Total Fee:

$0

Please enter your e-Signature

Application Qualification Questions:

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

Concealed Handgun Permit Application Please Enter All Information

Add An Address

Add An Alias

Add a reference

Update a reference

Please read the following before proceeding:

Applicant Information:

Previous Aliases: (please list all previous aliases)

Information Related To Your Birth:

Select Appropriate Immigrant Classification: (only choose one)

Which of the following exceptions set forth in 18Z USC 922(y) do you meet?:

Demographic Information:

Telephone Number: (###-###-####)

Email:

Please Create A Password: (you can use this to track progress, and we may need to contact you during the process)

Current Residence Address: (this may be different than your mailing address)

Present Mailing Address: (if different from residence address)

Spouse Residence Address:

Previous Addresses - For the last 5 years: (please list all previous addresses)

Attach Documentation: please upload the required documentation

Uploaded Files:

Select Your Application Type:

Total Fee:

$0

Please enter your e-Signature

Application Qualification Questions:

You Must Select An Appointment: your appointment will be confirmed prior to checkout

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

Your Appointment Choice Is:

No Appointments Available

Your signature is required.

Error processing application

Error processing application

You must be a US Citizen

Required field missing

Required field missing

Permit Expired

Permit Expired

Permit Expired

No Appointments Available

Permit Expires Soon

Permit Expired

Donations cant be taken with cash

You Must Select An Appointment: your appointment will be confirmed prior to checkout

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

Your Appointment Choice Is:

No Appointments Available

You Must Select An Appointment: your appointment will be confirmed prior to checkout

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

Your Appointment Choice Is:

No Appointments Available

Previous Aliases: ^{(please list all previous aliases)}

Select Appropriate Immigrant Classification: ^{(only choose one)}

Telephone Number: ^{(###-###-####)}

Please Create A Password: ^{(you can use this to track progress, and we may need to contact you during the process)}

Current Residence Address: ^{(this may be different than your mailing address)}

Present Mailing Address: ^{(if different from residence address)}

Previous Addresses - For the last 5 years: ^{(please list all previous addresses)}

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}