Naugatuck Police Department Online License to Carry Gun Permit Director

Welcome! This is an official application for a temporary pistol permit. You must completely and accurately fill-out this application to be considered for a license. Any falsification of the information within this application will result in the refusal of this application for a license to carry.

There are non-refundable online service and processing fees. These fees will be charged even if your application is denied.

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

Driver's License / Non-Operator ID: ^{(or other State Issued ID)}

^{ID Number:}

^{Issuing State:}

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:

Physical Description:

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:

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: ^{(please list all previous addresses)}

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

Employment Status:

What is your current employment status?

Employed Unemployed Retired

Work Information And Address: ^{(enter your place of employment)}

Employer Name:

Address Line 1:

Address Line 2:

City:

State : ^(region)

Zip Code: ^{(postal code)}

Country:

Phone number:

Occupation Field:

Please indicate your current occupation field. Enter unemployed if you currently do not have a job.

Occupation Field:

Attach Documentation: please upload the required documentation

If you need 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 front & back (e.g. CT Driver's License / State ID)
Permanent Resident Card (green card), if applicable
Naturalized citizens must provide your Naturalization Certificate
DD-214, if applicable
Two (2) required certificates of completion from an approved Basic Pistol Safety Course

Uploaded Files:

I will mail, email, fax, or hand deliver these documents. I am aware that not uploading the required documents at this time may delay the processing of my application.

Add files...

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

Training Documentation:

National Rifle Association Department of Energy and Environmental Protection (DEEP) Other (Please specify on the next page where indicated).

Select Your Application Type:

Temporary Pistol Permit

Total Fee:

$0

I understand that any false statement herein, which I do not believe to be true and which is intended to mislead a public servant in the performance of his or her official function, is punishable by law (See C.G.S. § 53a-157b). I further understand that any statement in this application that is determined to be false or inaccurate shall constitute grounds for the denial of such application. If approved before the facts are known, such approval shall be void if based on a false or inaccurate statement. My signature below attests to the accuracy, completeness and to the truth of all information supplied on this application:

I declare, under the penalties of false statement, that the answers to the above are true and correct.

I also acklowledge that I have read and understand the FBI Privacy Act Statement, Agency Privacy Requirements for Noncriminal Justice Applicants, and Noncriminal Justice Applicant’s Privacy Rights.

Please enter your e-Signature

Your Initials:

For security purposes, we logged your IP Address: 3.149.24.143, 172.71.191.55:56026, 40.1.3.141

Required signature

NOTE: You must have the following items with you at the time of your appointment in order to complete the application process:

PRINTED "Applicant Tracking Number"
Completed, notarized pistol permit application pages 1-4 attached (blue).
A copy of your NRA Certificate signed by the instructor.
A copy of your Driver's License, front and back.
If you were not born in the U.S., naturalization (citizenship) papers in addition to your Driver's License.

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

I declare, under the penalties of false statement, that the answers to the above are true and correct.

Coupon Code:

Your Initials:

Back To Previous Step

Naugatuck Police Department

Temporary Pistol Permit Please Enter All Information

Please read the following before proceeding:

Applicant Information:

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

Driver's License / Non-Operator ID: ^{(or other State Issued ID)}

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: ^{(please list all previous addresses)}

Employment Status:

Work Information And Address: ^{(enter your place of employment)}

Occupation Field:

Attach Documentation: please upload the required documentation

Uploaded Files:

Training Documentation:

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:

Temporary Pistol Permit Please Enter All Information

Add An Address

Add a reference

Update a reference

Please read the following before proceeding:

Applicant Information:

Previous Aliases: (please list all previous aliases)

Driver's License / Non-Operator ID: (or other State Issued ID)

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: (please list all previous addresses)

Employment Status:

Work Information And Address: (enter your place of employment)

Occupation Field:

Attach Documentation: please upload the required documentation

Uploaded Files:

Training Documentation:

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)}

Driver's License / Non-Operator ID: ^{(or other State Issued ID)}

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: ^{(please list all previous addresses)}

Work Information And Address: ^{(enter your place of employment)}

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}