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

What Is Form S.P.232A?

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 August 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.232A 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.232A "Renewal Application for a Retired Law Enforcement Officer Permit to Carry a Handgun" - New Jersey

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STATE OF NEW JERSEY
Renewal Application for a Retired Law Enforcement Officer Permit to Carry a Handgun
Part 1
PRINT OR TYPE ALL INFORMATION
(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) COUNTY OF RESIDENCE
(8) MUN. CODE NO.
(9) DRIVER'S LICENSE NUMBER & STATE
(10) SEX
HEIGHT
WEIGHT
HAIR
EYES
RACE
(11) DATE OF MOST RECENT FIREARMS QUALIFICATION (12) DATE CURRENT RPO PERMIT EXPIRES
(13) SBI NUMBER
Have you ever been convicted of any domestic violence offense in any jurisdiction which involved the elements of (1) striking, kicking,
(14)
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.
(15)
Yes
No
Have you ever been adjudged a juvenile delinquent? If yes, list date(s), place(s), and offense(s).
(16)
Yes
No
Have you ever been convicted of a disorderly persons offense in New Jersey or any criminal offense in another jurisdiction where you
(17)
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
(18)
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 19 is yes, does this make it unsafe for you to handle firearms? If not, explain.
(19)
(20)
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?
(22)
(21)
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
(23)
Have you ever been attended, treated or observed by any doctor or psychiatrist or at any hospital or
(24)
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
(25)
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
(26)
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).
(27) SIGNATURE OF APPLICANT
The disclosure of my Social Se cu ri ty num ber is voluntary. Without this number,
(28) DATE OF APPLICATION
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.
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 2
STATE POLICE USE ONLY - DO NOT WRITE BELOW THIS LINE - STATE POLICE USE ONLY
APPROVED
DISAPPROVED Specify __________________________________________________________________________________________________________
GRANTED ON APPEAL Specify ___________________________________________________________________________________________________
Permit No. ___________________________
Date Permit Issued: ___________________________ Date Permit Expires: ____________________________
Date Documents Forwarded:
To Applicant ______________ To Police Department ______________
Signature of Superintendent of State Police
(Affix Seal Here)
S.P . 232A (Rev. 08/09)
CLEAR FORM
STATE OF NEW JERSEY
Renewal Application for a Retired Law Enforcement Officer Permit to Carry a Handgun
Part 1
PRINT OR TYPE ALL INFORMATION
(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) COUNTY OF RESIDENCE
(8) MUN. CODE NO.
(9) DRIVER'S LICENSE NUMBER & STATE
(10) SEX
HEIGHT
WEIGHT
HAIR
EYES
RACE
(11) DATE OF MOST RECENT FIREARMS QUALIFICATION (12) DATE CURRENT RPO PERMIT EXPIRES
(13) SBI NUMBER
Have you ever been convicted of any domestic violence offense in any jurisdiction which involved the elements of (1) striking, kicking,
(14)
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.
(15)
Yes
No
Have you ever been adjudged a juvenile delinquent? If yes, list date(s), place(s), and offense(s).
(16)
Yes
No
Have you ever been convicted of a disorderly persons offense in New Jersey or any criminal offense in another jurisdiction where you
(17)
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
(18)
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 19 is yes, does this make it unsafe for you to handle firearms? If not, explain.
(19)
(20)
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?
(22)
(21)
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
(23)
Have you ever been attended, treated or observed by any doctor or psychiatrist or at any hospital or
(24)
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
(25)
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
(26)
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).
(27) SIGNATURE OF APPLICANT
The disclosure of my Social Se cu ri ty num ber is voluntary. Without this number,
(28) DATE OF APPLICATION
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.
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 2
STATE POLICE USE ONLY - DO NOT WRITE BELOW THIS LINE - STATE POLICE USE ONLY
APPROVED
DISAPPROVED Specify __________________________________________________________________________________________________________
GRANTED ON APPEAL Specify ___________________________________________________________________________________________________
Permit No. ___________________________
Date Permit Issued: ___________________________ Date Permit Expires: ____________________________
Date Documents Forwarded:
To Applicant ______________ To Police Department ______________
Signature of Superintendent of State Police
(Affix Seal Here)
S.P . 232A (Rev. 08/09)
CLEAR FORM