Form S.T.S.033 Application for Firearms Purchaser Identification Card and/Or Handgun Purchase Permit - Township of Freehold, New Jersey

Form S.T.S.033 is a New Jersey State Police form also known as the "Application For Firearms Purchaser Identification Card And/or Handgun Purchase Permit". The latest edition of the form was released in September 1, 2009 and is available for digital filing.

Download a fillable PDF version of the Form S.T.S.033 down below or find it on New Jersey State Police Forms website.

ADVERTISEMENT
FIREARMS APPLICATIONS
YOU MUST BE A TAX PAYING RESIDENT OF
FREEHOLD TOWNSHIP
Effectively immediately firearm applications will only be accepted typed. No handwritten
applications will be accepted. Below you will find the necessary forms to complete. Print 2 copies
2 ORIGINAL copies are needed to process your
of each document as
application. Do not sign documents. Signatures must be witnessed by
Records Personnel!!!
EMPLOYER & REFERENCES: You MUST have full name, street address, zip codes and phone
numbers. (These numbers will not be looked up for you).
This Policy is set by the NJSP and NJAC 13:54-1.4 and not Freehold Township
and/or
N
E
W
A
P
P
L
I
C
A
T
I
O
N
S
:
N
E
W
A
P
P
L
I
C
A
T
I
O
N
S
:
(NEVER HAD A FIREARMS ID CARD
want PERMITS for
handguns)
FORM STS-33 (Application for ID Card and/or Purchase Permit)
Check appropriate boxes at top of form for ID Card / 1 Permit Per Month Only
Fill in boxes #1 thru #30
FORM # SP-66 (Mental Health Record)
*YOU MUST BE FINGERPRINTED BY IDENTOGO by MorphoTrust USA
P
U
R
C
H
A
S
E
P
E
R
M
I
T
S
O
N
L
Y
:
(
E
a
c
h
t
i
m
e
y
o
u
a
p
p
l
y
f
o
r
a
p
e
r
m
i
t
f
o
r
h
a
n
d
g
u
n
,
P
U
R
C
H
A
S
E
P
E
R
M
I
T
S
O
N
L
Y
:
(
E
a
c
h
t
i
m
e
y
o
u
a
p
p
l
y
f
o
r
a
p
e
r
m
i
t
f
o
r
h
a
n
d
g
u
n
,
t
h
i
s
p
r
o
c
e
d
u
r
e
m
u
s
t
b
e
d
o
n
e
)
t
h
i
s
p
r
o
c
e
d
u
r
e
m
u
s
t
b
e
d
o
n
e
)
(YOU ALREADY HAVE A FIREARMS ID CARD)
FORM # STS-33 (Application for ID Card / Purchase Permit)
Fill in Boxes #1 thru #30
FORM# SP-66 (Mental Health Record)
)
See Applicant Instructions to complete FORM #SB1-212A (Request for Criminal History
C
H
A
N
G
E
O
F
A
D
D
R
E
S
S
/
L
O
S
T
/
M
U
T
I
L
A
T
E
D
/
C
H
A
N
G
E
O
F
N
A
M
E
C
H
A
N
G
E
O
F
A
D
D
R
E
S
S
/
L
O
S
T
/
M
U
T
I
L
A
T
E
D
/
C
H
A
N
G
E
O
F
N
A
M
E
FORM # STS-33
Check box/boxes for reason a new card is being requested
Fill in Boxes #1 thru to #30
FORM # SP-66 (Mental Health Record)
)
See Applicant Instructions to complete FORM #SB1-212A (Request for Criminal History
* You will be notified by mail when your items are ready. Upon picking up your items, you will
need $5.00 for an ID card, $2.00 for each permit. This fee may be CASH or CHECK.
FIREARMS APPLICATIONS
YOU MUST BE A TAX PAYING RESIDENT OF
FREEHOLD TOWNSHIP
Effectively immediately firearm applications will only be accepted typed. No handwritten
applications will be accepted. Below you will find the necessary forms to complete. Print 2 copies
2 ORIGINAL copies are needed to process your
of each document as
application. Do not sign documents. Signatures must be witnessed by
Records Personnel!!!
EMPLOYER & REFERENCES: You MUST have full name, street address, zip codes and phone
numbers. (These numbers will not be looked up for you).
This Policy is set by the NJSP and NJAC 13:54-1.4 and not Freehold Township
and/or
N
E
W
A
P
P
L
I
C
A
T
I
O
N
S
:
N
E
W
A
P
P
L
I
C
A
T
I
O
N
S
:
(NEVER HAD A FIREARMS ID CARD
want PERMITS for
handguns)
FORM STS-33 (Application for ID Card and/or Purchase Permit)
Check appropriate boxes at top of form for ID Card / 1 Permit Per Month Only
Fill in boxes #1 thru #30
FORM # SP-66 (Mental Health Record)
*YOU MUST BE FINGERPRINTED BY IDENTOGO by MorphoTrust USA
P
U
R
C
H
A
S
E
P
E
R
M
I
T
S
O
N
L
Y
:
(
E
a
c
h
t
i
m
e
y
o
u
a
p
p
l
y
f
o
r
a
p
e
r
m
i
t
f
o
r
h
a
n
d
g
u
n
,
P
U
R
C
H
A
S
E
P
E
R
M
I
T
S
O
N
L
Y
:
(
E
a
c
h
t
i
m
e
y
o
u
a
p
p
l
y
f
o
r
a
p
e
r
m
i
t
f
o
r
h
a
n
d
g
u
n
,
t
h
i
s
p
r
o
c
e
d
u
r
e
m
u
s
t
b
e
d
o
n
e
)
t
h
i
s
p
r
o
c
e
d
u
r
e
m
u
s
t
b
e
d
o
n
e
)
(YOU ALREADY HAVE A FIREARMS ID CARD)
FORM # STS-33 (Application for ID Card / Purchase Permit)
Fill in Boxes #1 thru #30
FORM# SP-66 (Mental Health Record)
)
See Applicant Instructions to complete FORM #SB1-212A (Request for Criminal History
C
H
A
N
G
E
O
F
A
D
D
R
E
S
S
/
L
O
S
T
/
M
U
T
I
L
A
T
E
D
/
C
H
A
N
G
E
O
F
N
A
M
E
C
H
A
N
G
E
O
F
A
D
D
R
E
S
S
/
L
O
S
T
/
M
U
T
I
L
A
T
E
D
/
C
H
A
N
G
E
O
F
N
A
M
E
FORM # STS-33
Check box/boxes for reason a new card is being requested
Fill in Boxes #1 thru to #30
FORM # SP-66 (Mental Health Record)
)
See Applicant Instructions to complete FORM #SB1-212A (Request for Criminal History
* You will be notified by mail when your items are ready. Upon picking up your items, you will
need $5.00 for an ID card, $2.00 for each permit. This fee may be CASH or CHECK.
STATE OF NEW JERSEY
Application for Firearms Purchaser Identification Card and/or Handgun Purchase Permit
This form is prescribed by the Superintendent for use by applicants for Firearms Purchaser I.D. Cards & Handgun Purchase Permits. Any alteration to this form is expressly forbidden.
Check Appropriate Block(s)
Initial Firearms Purchaser Identification Card
Change of name on Identification Card
Lost or Stolen Identification Card
List former name and attach copy of marriage license or court order
Mutilated Identification Card
Change of Address on Identification Card
Change of Sex on Identification Card
Application to Purchase a Handgun
Quantity of Permits:
(1) NAME
Last ( If female, include maiden)
First
Middle
(2) SOCIAL SECURITY NUMBER
-
-
(3) RESIDENCE ADDRESS
Number & Street
City
State
Zip
(4) HOME TELEPHONE
(
)
-
(5) DATE OF BIRTH
(6) AGE
(7) PLACE OF BIRTH
City, State, Country
(8) DRIVER'S LICENSE NUMBER & STATE
/
/
(9) SEX
RACE
HEIGHT
WEIGHT
HAIR
EYES
(10) DIST. PHYSICAL CHARACTERISTICS
(11) U.S. CITIZEN
(Marks, Scars, Tattoos)
Yes
No
(12) NAME OF EMPLOYER
EMPLOYER'S ADDRESS & TELEPHONE
(13) OCCUPATION
(14) ADDRESS APPEARING ON FORMER FIREARMS IDENTIFICATION CARD (If Applicable)
(15) N.J. FIREARMS ID CARD/SBI NUMBER
(16) Have you ever been convicted of any domestic violence offense in any jurisdiction which involved the elements of (1) striking, kicking, shoving, or (2)
Yes
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
(17) Are you subject to any court order issued pursuant to Domestic Violence? If yes, explain.
Yes
No
(18) Have you ever been adjudged a juvenile delinquent? If yes, list date(s), place(s), and offense(s).
Yes
No
(19) Have you ever been convicted of a disorderly persons offense in New Jersey or any criminal offense in another jurisdiction where you could have been
Yes
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
(20) Have you ever been convicted of a crime in New Jersey or a criminal offense in another jurisdiction where you could have been sentenced to more than
Yes
six months in jail that has not been expunged or sealed? If yes, list date(s), place(s) and crime(s).
No
(21) Do you suffer from a
(22) If answer to question 21 is yes, does this make it unsafe for you to handle firearms? If not, explain.
Yes
Yes
physical defect or disease?
No
No
(23) Are you an alcoholic?
(24) Have you ever been confined or committed to a mental institution or hospital for treatment or observation of a
Yes
Yes
mental or psychiatric condition on a temporary, interim, or permanent basis? If yes, give the name and location of the
No
No
institution or hospital and the date(s) of such confinement or commitment.
(25) Are you dependent
(26) Have you ever been attended, treated or observed by any doctor or psychiatrist or at any hospital or mental
Yes
Yes
upon the use of a narcotic(s)
institution on an inpatient or outpatient basis for any mental or psychiatric condition? If yes, give the name and location
No
No
or other controlled
of the doctor, psychiatrist, hospital or institution and the date(s) of such occurrence.
dangerous substance(s)?
(27) Have you ever had a firearms purchaser identification card, permit to purchase a handgun, permit to carry a handgun or any other firearms license or
Yes
application refused or revoked in New Jersey or any other state? If yes, explain.
No
(28) Are you presently, or have you ever been a member of any organization which advocates or approves the commission of acts of force and violence, either
Yes
to overthrow the Government of the United States or of this State, or which seeks to deny others their rights under the Constitution of either the United States or
No
the State of New Jersey? If yes, list name and address of organization(s).
(29) Names, Addresses and Telephone Numbers of two reputable persons who are presently acquainted with the applicant, other than relatives:
A.
B.
APPLICANT: DO NOT WRITE BELOW THIS SPACE
I hereby certify that the answers given on this application are complete, true and correct
A non-refundable fee of $5.00 for a F irearms Purchaser Identification Card (Initial
in every particular. I realize that if any of the foregoing answers made by me are false, I
Firearms Purchaser ID card only) and/or $2.00 for each Permit to Purchase a Handgun,
am subject to punishment.
payable to the Superintendent of State Police or the Chief of Police in the municipality in
which you reside, must accompany this application.
(30)
IDENTIFICATION CARD/PERMIT NUMBER(S)
APPROVED
Signature of Applicant
Date of Application
(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.
Reason for Disapproval
APPLICANT: DO NOT WRITE BELOW THIS SPACE
DISAPPROVED
A. CRIMINAL RECORD
B. PUBLIC HEALTH SAFETY AND WELFARE
This
Day of
, 20
C. MEDICAL, MENTAL OR ALCOHOLIC BACKGROUND
D. NARCOTICS/ DANGEROUS DRUG OFFENSE
GRANTED ON
APPEAL
E. FALSIFICATION OF APPLICATION
Signature
Title
F. DOMESTIC VIOLENCE
G. OTHER (SPECIFY)
Department of Police
Municipal Code #
S.T.S. 033 (Rev. 09/09)
CLEAR FORM
CLEAR FORM
N.J.S.A. 30:4-24.3 provides that all records
CONSENT FOR
of any individual's commitment to a non-
MENTAL HEALTH RECORDS SEARCH
correctional in sti tu tion for mental health
reasons shall be con fi den tial and shall not
This consent MUST be completed by the firearm ap pli cant.
be disclosed ex cept in lim it ed circumstanc-
Failure to consent requires denial or dis ap prov al of the application.
es or with the consent of the in di vid u al.
PART ONE (To be completed by the applicant)
Name: (Last, Maiden, First, MI)
Date of Birth: (Month, Day, Year)
Social Security Number:
Address: (Number & Street)
(Municipality)
(County)
(State)
List Prior Addresses for past 10 years:
NOT APPLICABLE
ADDRESS 1: Dates Resided
From: ________________________ To: ________________________
(Number & Street)
(Municipality)
(County)
(State)
ADDRESS 2: Dates Resided
From: ________________________ To: ________________________
(Number & Street)
(Municipality)
(County)
(State)
I, __________________________________________________ am aware of my rights under N.J.S.A. 30:4-24.3, and the
Health Insurance Portability and Insurance Accountability Act (HIPAA), 45 C.F.R. 164.50, and consent to the disclosure of
my mental health records to the Chief of Police and the Su per in ten dent of State Police, or their designees, for the purpose of
verifying my fi rearms permit application and my fi t ness to own a fi re arm under N.J.S.A. 2C:58-3. I understand that copies
of this authorization shall be considered suffi cient authorization for the release of records.
Investigating Police Department
Witness (Print Name)
X
Signature of Witness
X
Signature of Applicant
Date
The disclosure of my Social Security Number is voluntary. Without this number, the processing of my application may be delayed. This number is considered confi dential.
PART TWO (To be completed by County Adjuster's Office, Mental Health Institution and/or Doctor)
Record of Admission
Date of
Signature of Authorized
Commitment or Treatment
Check
Official or Doctor
(Dr.: Provide Medical License #)
Yes
No
Expunged
__________________________________________________
______________ ________________________
County Adjuster's Office
Yes
No
Expunged
__________________________________________________
______________ ________________________
Institution or Doctor
PART THREE (To be completed by authorized official or doctor only if applicant has record of admission,
commitment, or treatment at a hospital, mental institution or sanitarium for a mental disorder)
NAME OF HOSPITAL, MENTAL INSTITUTION
ADMISSION
DISCHARGE
SIGNATURE OF AUTHORIZED
OR SANITARIUM
OFFICIAL OR DOCTOR
(mo/day/yr)
(mo/day/yr)
__________________________________________
____________ to ____________
____________________________________
__________________________________________
____________ to ____________
____________________________________
Additional forms may be obtained through the New Jersey State Police, Firearms Investigation Unit,
P .O. Box 7068, West Trenton, NJ 08628-0068, or via the internet at www.njsp.org/info/forms.html.
S.P . 66 (Rev. 10/14)
16FT00015

Download Form S.T.S.033 Application for Firearms Purchaser Identification Card and/Or Handgun Purchase Permit - Township of Freehold, New Jersey

1062 times
Rate
4.3(4.3 / 5) 64 votes
ADVERTISEMENT
Page of 6