Form S.P.232 "Initial Application for a Retired Law Enforcement Officer Permit to Carry a Handgun" - New Jersey

What Is Form S.P.232?

This is a legal form that was released by the New Jersey State Police - a government authority operating within New Jersey. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2009;
  • The latest edition provided by the New Jersey State Police;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form S.P.232 by clicking the link below or browse more documents and templates provided by the New Jersey State Police.

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Download Form S.P.232 "Initial Application for a Retired Law Enforcement Officer Permit to Carry a Handgun" - New Jersey

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CLEAR FORM
STATE OF NEW JERSEY
Initial Application For a Retired Law Enforcement Officer
Permit to Carry a Handgun
Part 1
PRINT OR TYPE ALL INFORMATION
Applicant: Complete ONLY PART 1 of this application and mail entire two page application to NJSP Firearms Investigation Unit - RPO, P .O. Box 7068,
West Trenton, NJ 08628-0068. If you reside in New Jersey, enter your municipal code in block 9. If your retirement is a result of service with more than
one agency, list the most recent agency information in block 11 and attach a listing of all agencies with which you earned retirement credit. Include full
contact information for each agency. Failure to properly complete this application may result in a delay in issuing a permit to carry.
(1) NAME
Last
First
Middle
(2) SOCIAL SECURITY NUMBER
(4) HOME PHONE NUMBER
(3) RESIDENCE ADDRESS
Street
City
State
Zip Code
(5) DATE OF BIRTH
(6) AGE
(7) PLACE OF BIRTH
City
State
(8) COUNTY OF RESIDENCE
(9) MUN. CODE NO.
(10) SEX
HEIGHT
WEIGHT
HAIR
EYES
RACE
(11) FORMER LAW ENFORCEMENT EMPLOYER
(12) ADDRESS OF FORMER EMPLOYER
(13) FORMER EMPLOYER'S PHONE NO.
(14) DRIVER'S LICENSE NUMBER & STATE
(15) SBI NUMBER
Have you ever been convicted of any domestic violence offense in any jurisdiction which involved the elements of (1) striking, kicking,
(16)
Yes
shoving, or (2) purposely or attempting to or knowingly or recklessly causing bodily injury, or (3) negligently causing bodily injury to another
with a deadly weapon? If yes, explain.
No
Are you subject to any court order issued pursuant to Domestic Violence? If yes, explain.
(17)
Yes
No
Have you ever been adjudged a juvenile delinquent? If yes, list date(s), place(s), and offense(s).
(18)
Yes
No
Have you ever been convicted of a disorderly persons offense in New Jersey or any criminal offense in another jurisdiction where you
(19)
Yes
could have been sentenced up to six months in jail that has not been expunged or sealed? If yes, list date(s), place(s) and offense(s).
No
Have you ever been convicted of a crime in New Jersey or a criminal offense in another jurisdiction where you could have been
(20)
Yes
sentenced to more than six months in jail that has not been expunged or sealed? If yes, list date(s), place(s) and crime(s).
No
Do you suffer from a
If answer to question 21 is yes, does this make it unsafe for you to handle firearms? If not, explain.
(21)
(22)
Yes
Yes
physical defect or disease?
No
No
Have you ever been confined or committed to a mental institution or hospital for treatment or
Are you an alcoholic?
(23)
(24)
Yes
Yes
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.
No
No
Are you dependent
Have you ever been attended, treated or observed by any doctor or psychiatrist or at any hospital or
(25)
(26)
Yes
Yes
upon the use of a narcotic(s)
mental institution on an inpatient or outpatient basis for any mental or psychiatric condition? If yes, give the
No
No
or other controlled
name and location of the doctor, psychiatrist, hospital or institution and the date(s) of such occurrence.
dangerous substance(s)?
Have you ever had a firearms purchaser identification card, permit to purchase a handgun, permit to carry a handgun or any other firearms
(27)
Yes
license or application refused or revoked in New Jersey or any other state? If yes, explain.
No
Are you presently, or have you ever been a member of any organization which advocates or approves the commission of acts of force
(28)
Yes
and violence, either to overthrow the Government of the United States or of this State, or which seeks to deny others their rights under the
No
Constitution of either the United States or the State of New Jersey? If yes, list name and address of organization(s).
(29) SIGNATURE OF APPLICANT
The disclosure of my Social Se cu ri ty num ber is voluntary.
(30) DATE OF APPLICATION
Without this number, the pro cess ing of my application may be
de layed. This number is used for document track ing pur pos es
only and is con sid ered con fi den tial.
Falsification of this form is a crime of the third degree as provided in NJS 2C:39-10c.
S.P . 232 (Rev. 06/09)
NOTICE: This Application is a two-sided, one page document.
Page 1
If Internet form, print Page 1, return to printer and print Page 2 on reverse side.
CLEAR FORM
STATE OF NEW JERSEY
Initial Application For a Retired Law Enforcement Officer
Permit to Carry a Handgun
Part 1
PRINT OR TYPE ALL INFORMATION
Applicant: Complete ONLY PART 1 of this application and mail entire two page application to NJSP Firearms Investigation Unit - RPO, P .O. Box 7068,
West Trenton, NJ 08628-0068. If you reside in New Jersey, enter your municipal code in block 9. If your retirement is a result of service with more than
one agency, list the most recent agency information in block 11 and attach a listing of all agencies with which you earned retirement credit. Include full
contact information for each agency. Failure to properly complete this application may result in a delay in issuing a permit to carry.
(1) NAME
Last
First
Middle
(2) SOCIAL SECURITY NUMBER
(4) HOME PHONE NUMBER
(3) RESIDENCE ADDRESS
Street
City
State
Zip Code
(5) DATE OF BIRTH
(6) AGE
(7) PLACE OF BIRTH
City
State
(8) COUNTY OF RESIDENCE
(9) MUN. CODE NO.
(10) SEX
HEIGHT
WEIGHT
HAIR
EYES
RACE
(11) FORMER LAW ENFORCEMENT EMPLOYER
(12) ADDRESS OF FORMER EMPLOYER
(13) FORMER EMPLOYER'S PHONE NO.
(14) DRIVER'S LICENSE NUMBER & STATE
(15) SBI NUMBER
Have you ever been convicted of any domestic violence offense in any jurisdiction which involved the elements of (1) striking, kicking,
(16)
Yes
shoving, or (2) purposely or attempting to or knowingly or recklessly causing bodily injury, or (3) negligently causing bodily injury to another
with a deadly weapon? If yes, explain.
No
Are you subject to any court order issued pursuant to Domestic Violence? If yes, explain.
(17)
Yes
No
Have you ever been adjudged a juvenile delinquent? If yes, list date(s), place(s), and offense(s).
(18)
Yes
No
Have you ever been convicted of a disorderly persons offense in New Jersey or any criminal offense in another jurisdiction where you
(19)
Yes
could have been sentenced up to six months in jail that has not been expunged or sealed? If yes, list date(s), place(s) and offense(s).
No
Have you ever been convicted of a crime in New Jersey or a criminal offense in another jurisdiction where you could have been
(20)
Yes
sentenced to more than six months in jail that has not been expunged or sealed? If yes, list date(s), place(s) and crime(s).
No
Do you suffer from a
If answer to question 21 is yes, does this make it unsafe for you to handle firearms? If not, explain.
(21)
(22)
Yes
Yes
physical defect or disease?
No
No
Have you ever been confined or committed to a mental institution or hospital for treatment or
Are you an alcoholic?
(23)
(24)
Yes
Yes
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.
No
No
Are you dependent
Have you ever been attended, treated or observed by any doctor or psychiatrist or at any hospital or
(25)
(26)
Yes
Yes
upon the use of a narcotic(s)
mental institution on an inpatient or outpatient basis for any mental or psychiatric condition? If yes, give the
No
No
or other controlled
name and location of the doctor, psychiatrist, hospital or institution and the date(s) of such occurrence.
dangerous substance(s)?
Have you ever had a firearms purchaser identification card, permit to purchase a handgun, permit to carry a handgun or any other firearms
(27)
Yes
license or application refused or revoked in New Jersey or any other state? If yes, explain.
No
Are you presently, or have you ever been a member of any organization which advocates or approves the commission of acts of force
(28)
Yes
and violence, either to overthrow the Government of the United States or of this State, or which seeks to deny others their rights under the
No
Constitution of either the United States or the State of New Jersey? If yes, list name and address of organization(s).
(29) SIGNATURE OF APPLICANT
The disclosure of my Social Se cu ri ty num ber is voluntary.
(30) DATE OF APPLICATION
Without this number, the pro cess ing of my application may be
de layed. This number is used for document track ing pur pos es
only and is con sid ered con fi den tial.
Falsification of this form is a crime of the third degree as provided in NJS 2C:39-10c.
S.P . 232 (Rev. 06/09)
NOTICE: This Application is a two-sided, one page document.
Page 1
If Internet form, print Page 1, return to printer and print Page 2 on reverse side.
STATE OF NEW JERSEY
Initial Application For a Retired Law Enforcement Officer
Permit to Carry a Handgun
Part 2
APPLICANT: DO NOT WRITE BELOW THIS LINE
THIS PART IS TO BE COMPLETED BY THE FORMER EMPLOYER .
The Superintendent of State Police, Chief of Police or the Chief Law Enforcement Officer will certify the above portion of the retired police officer's ap pli ca tion
for a permit to carry a handgun in accordance to N.J.S. 2C:39-6L(2).
Name of Police/Law Enforcement Agency: _____________________________________________________________________________________
Applicant's Date of Hire: _________________
Applicant's Date of Retirement: _________________
Did the Applicant Retire in Good Standing:
Yes
No
Did the Applicant Retire on a Disability Retirement?
Yes
No
If yes, did the applicant’s disability retirement include a certification that the applicant
was mentally incapacitated for the performance of his or her usual law enforcement duties and any other available duty in the department which you were
willing to assign him or her?
Yes
No
I, _______________________________________, indicated by my signature below, certify to the reasonable knowledge as the chief law enforcement
officer of the agency which employed the retired law enforcement officer listed on this application, the applicant is not subject to any mentally incapacitating
disabilities, or any of the disabilities or restrictions set forth in subsection c. of N.J.S. 2C:58-3.
_____________________________________________________________________
____________________________
Signature of Superintendent of State Police/Chief of Police or Chief Law Enforcement Officer
P .D. Municipal Code
LIST ALL HANDGUNS KNOWN TO BE REGISTERED TO APPLICANT (
If more space is needed, attach bond paper.)
MAKE
MODEL
SERIAL #
CALIBER
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Processing Police Agency: Upon completion of this portion of the application, mail to NJSP Firearms Investigation Unit- RPO, P .O. Box 7068, West Trenton, NJ 08628-0068.
Part 3
STATE POLICE USE ONLY - DO NOT WRITE BELOW THIS LINE
Approved
Disapproved Specify ____________________________________________________________________________________
Granted on Appeal Specify ____________________________________________________________________________________________
Permit No._____________________________________ Date Permit Issued:___________________
Date Permit Expires:___________________
Date Documents Forwarded:
To Applicant ______________ To Police Dept. ______________
Signature of Superintendent of State Police
(Affix Seal Here)
S.P . 232 (Rev. 06/09)
NOTICE: This Application is a two-sided, one page document.
Page 2
If Internet form, print Page 1, return to printer and print Page 2 on reverse side.
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