Please read all instructions prior to completing the application and fingerprint cards. You
Must submit the following:
New Permit Application, complete both pages of the form. All questions must be answered. Print
and sign both pages. Both pages must be mailed along with the required documents and fee.
Applications may not be submitted electronically or by email at this time.
o The FIREARMS QUALIFICATION AND STATUTORY REVIEW AFFIDAVIT section on the
second page of the application must be completed by all applicants. Indicate where you
received your firearms training from in accordance with Arizona Revised Statute 13-3112.
o You must sign and date attesting that you have reviewed and are knowledgeable of the
Arizona Revised Statutes Title 13, Chapter 4 and Chapter 31.
A copy of a document demonstrating competence with a firearm in accordance with Arizona
Revised Statute 13-3112(E)(6 a-d) and/or 13-3112(N)(1-8).
o This document must be consistent with where you indicated your firearms training was taken
from under the FIREARMS QUALIFICATION AND STATUTORY REVIEW AFFIDAVIT.
o Only 1 type of acceptable firearms training is needed to apply for an Arizona permit.
Two completed fingerprint cards. See instructions for completing the required information on the
fingerprint cards. Fingerprint images shall be taken by a qualified fingerprint technician, they
must be classifiable, not smudged or outside of the allowable box area. They must be submitted
on FBI form FD-258, which is the Blue Applicant Fingerprint card. Do NOT bend the fingerprint
cards. Fingerprinting services are available at multiple locations, search the internet, or check
with your local police department or sheriffs office.
$60.00 cashier’s check, money order, or certified check payable to
AZ DPS
If applicable, record your address and signature on the cashiers check or money order.
o Personal checks, business checks, credit card payments, and cash are NOT accepted.
If applicable, in reference to the 2
nd
question on the application, if yes, submit a copy
of one of the following: Certificate of Naturalization; record of birth abroad to American citizen;
record of birth abroad to armed service personnel; or a current United States passport.
If applicable, in reference to the 3
rd
question on the application, if yes, submit a copy of your
Permanent Resident Alien card (front and back). The “A” number must be clearly visible, and
the issue and expiration dates must be imprinted on the front of the card. The card must be
current. Conditional Residents do not qualify for an Arizona permit. You must also submit
documentation to prove residency in the state of Arizona. Documentation may include an
Arizona Driver’s License or ID card, or two documents issued from two separate businesses,
organizations or government agencies (utility bills, credit card/bank statements, insurance
policy, lease, etc.) with your name and physical address listed (not a P.O. Box), matching the
address provided on your application.
o You must either be a US citizen or an Arizona resident; with a valid Permanent Resident
Alien card, to obtain an Arizona Concealed Weapons permit in accordance with Arizona
Revised Statute 13-3112(E)(1).
2
Do not send original documents as proof of firearms training, unless you are using your expired Arizona
Concealed Weapons permit which has passed its renewal timeframe. In this instance, you must submit
the original expired Arizona Concealed Weapons permit card.
N
OTE: Do not send any original documents. Original documents will not be returned.
Mail application packet to: AZ DPS CWPU
P.O. Box 6488
Phoenix, AZ 85005
Packet must include:
Completed Application, both pages
Two completed fingerprint cards
Certificate or document demonstrating firearms competence
Payment $60.00 (money order or cashiers check)
**Additional documents are required if you are a US Citizen born outside of
the USA or you are a documented permanent resident residing in Arizona
Ap
plication packets that are incomplete, or inaccurate, will be returned to
the applicant.
T
he New Permit Application is on the next page.
DPS 802-07202-F Rev. 7-2019
ARIZONA DEPARTMENT OF PUBLIC SAFETY
PERMIT APPLICATION
O
ENSURE ALL BLOCKS ARE FILLED
PLEASE TYPE OR PRINT LEGIBLY USING BLACK INK ONLY.
LEGAL NAME (Last)
(First)
(Middle)
COUNTY
RESIDENCE ADDRESS (Street number and name including Apartment / Lot) CITY STATE ZIP CODE
MAILING ADDRESS (if different from above) CITY STATE ZIP CODE
BIRTH DATE (mm/dd/yyyy)
CONTACT PHONE NO. (Include Area Code)
EYE COLOR
Black Green
Blue Gray
Brown Hazel
HAIR COLOR
Bald Gray
Black Red or Auburn
Blonde Sandy
Brown White
ORIGIN / RACE
American Indian or Alaskan Native (I)
Asian / Pacific Islander (A)
Black (B)
Hispanic / White (W)
(Optional)
GENDER
Male
Female
HEIGHT
WEIGHT
PLACE
OF
BIRTH
(State)
(Country)
All applicants: Please answer “YES” or “NO” to each question below. ALL questions MUST be answered.
YES NO
Are you a United States citizen born in the United States or one of its territories?
Are you a United States citizen born outside of the United States or one of its territories? If YES, submit a copy of one of
the following: certificate of naturalization; record of birth abroad to American citizen; record of birth to armed service
personnel; or a current United States passport.
Are you an alien admitted to the United States as a lawful permanent resident? *
*If you responded Yes to the permanent resident question, submit a copy (front & back) of your Permanent Resident Alien card. The
“A” number must be clearly visible, and issue and expiration date must be imprinted on front of card. Submit documentation to prove
residency in the state of Arizona. Documentation may include an Arizona Driver’s license or ID card, or two documents issued from
two separate businesses, organizations or government agencies (utility bills, credit card/bank statements, insurance policy, lease, etc.)
with your name and physical address listed (not a P.O. Box), matching the address provided on your application.
Are you currently under indictment for a felony arrest?
Have you ever been convicted of a felony offense? If YES, the conviction must be expunged, set aside, vacated or
pardoned;
or you must have your firearm rights restored to be considered for a permit. Please provide court
documentation. You must not be a prohibited possessor under state or federal law.
Have you been adjudicated delinquent for a felony? If YES, you must have your firearm rights restored. Please
provide court documentation.
Are you an unlawful user of, or addicted to, any controlled substances?
Are you currently under indictment for a misdemeanor crime of domestic violence?
Have you ever been convicted of a misdemeanor crime of domestic violence? If YES, the conviction must be set-aside,
vacated, expunged or pardoned in order to be considered for a permit. Please provide court documentation.
Have you been discharged from the United States Armed Forces under dishonorable conditions? If YES, you are
disqualified from obtaining a permit.
Have you been adjudicated as mentally incompetent or committed to a mental institution? If YES, you are disqualified
from obtaining a permit
Applications are processed in accordance with Arizona Revised Statute §13-3112 and Arizona Administrative Code Title
13, Chapter 9 which are available on our website at www.azdps.gov.
I attest under penalty of perjury that all statements made on this application are true.
X
APPLICANT SIGNATURE
DATE mm/dd/yyyy
DPS 802-07202-B Rev. 7/2019
INSTRUCTIONS
1. Complete and sign page one of application.
2. Your social security number is requested in accordance with AAC R13-9-202(1)(d). Disclosure is
voluntary and the information will be used as an identification tool. Failure to provide the information
may impact our ability to immediately verify an applicant’s identity resulting in processing delays.
3. Review and become knowledgeable of Arizona Revised Statutes Title 13, Chapter 4 and Chapter 31
on the Arizona State Legislature web site: http://www.azleg.gov/ArizonaRevisedStatutes.asp.
4. All applicants must complete & sign the Firearms Qualifications & Statutory Review Affidavit
(below)
5. You must attach a firearms-safety certificate of completion or document demonstrating firearm
competence. This may include an NRA certificate of completion, a certificate of completion of any
course instructed by a current NRA certified instructor, a certificate or card from a hunter education
or safety course, another state’s permit (if approved by DPS), a governmental police agency firearms
qualification certificate along with a copy of a valid LE identification credential, an Arizona armed
security guard certification of training by a DPS approved instructor, a US Department of Defense
DD-214 or active duty military credentials demonstrating firearms competence.
6. Submission of fingerprints is required of all initial CCW applicants. DPS does not provide fingerprint
services. However, fingerprint services may be available at your local law enforcement agency or
through a private fingerprint service.
7. Fingerprints submitted will be used to check criminal history records of the FBI. Procedures for
obtaining a copy of FBI criminal history records are set forth at Title 28, Code of Federal Regulations
(CFR), section 16.30 through 16.33 or go to the FBI website at
http://www.fbi.gov/about-us/cjis/background-checks. Procedures for obtaining a change, correction,
or updating of an FBI criminal history record are set forth at title 28, code of regulations (CFR),
section 16.34
8. Fingerprint data is transmitted electronically to the FBI for processing. If the FBI is unable to process
the images, the Concealed Weapon Permit Unit will mail a reject notice, blank fingerprint card and
pre-addressed return envelope to the applicant requesting submission of a second fingerprint card
9. To avoid fingerprint processing delays, submit two fingerprint cards with the initial application.
10. Submit the completed application, two completed fingerprint cards and applicable fee to DPS in the
envelope provided.
11. Acceptable forms of payment include a money order, cashier’s or certified check for $60.00
made payable to AZ DPS. Fees are non-refundable. Personal checks are not accepted.
FIREARMS QUALIFICATION AND STATUTORY REVIEW AFFIDAVIT
(ALL applicants MUST complete this section)
I attest that I have satisfactorily demonstrated competence with a firearm through completing a firearms safety
course provided by:
(Print name of organization, governmental police agency, or branch of military)
I further attest that I have reviewed and am knowledgeable of Arizona Revised Statutes Title 13, Chapter 4 and Chapter 31.
X
Applicant’s Signature
Date mm/dd/yyyy
Fingerprint Card Instructions:
All fingerprints must be submitted on an FBI form FD-258, which is blue and is
identified as an Applicant fingerprint card. Those using the ink and roll method must
use black thermal-impregnated fingerprint ink. Prints must be classifiable, within the
designated space and in the correct sequence.
The following boxes must be filled in with black ink and neatly printed (all capital letters):
Signature of person fingerprinted: Self explanatory.
Residence of person fingerprinted: Address, self explanatory.
Date: MMDDYY or MMDDYYYY; January 4, 2002 would be 010402 or 01042002
Signature of person taking fingerprints: Self explanatory.
NAM: Last, First Middle, in caps.
AKA: Previous names, maiden names, etc., in caps.
CTZ: US (or leave blank if a non-citizen)
SOC: Do not use dashes between numbers: 123-45-6789 would be 123456789.
DOB: All numbers, MMDDYY or MMDDYYYY: January 4, 1950 would be 010450 or 01041950.
SEX: Single letter, M for male, F for female.
RACE: Single letter, Hispanic/White: W, Black: B, Asian/Pacific Islander: A, American Indian/Alaskan
Native: I.
Note: Persons are classified by race according to Federal Bureau of Investigations National
Crime Information Center standards. Therefore, Hispanic decent is classified as White.
HGT: Three numbers, no other marks or letters (6 feet 2 inches: 602; 5 feet 10 inches: 510).
WGT: Three numbers, no other marks or letters (210 pounds: 210; 98 pounds: 098).
HAIR: Three letters, Blonde: BLN; Brown: BRO; Red: RED; Grey: GRY; Black: BLK; White; Bald: XXX.
EYES: Three letters, Blue: BLU; Brown: BRO; Hazel: HZL; Green: GRN; Grey: GRY; Black: BLK
POB: State only (or country only, if born outside of the United States or its territories). Chicago,
Illinois would be ILLINOIS. Munich, Germany would be GERMANY.
PRIVACY ACT STATEMENT
Authority: The FBI’s acquisition, preservation, and exchange of fingerprints and
associated information is generally authorized under 28 U.S.C. 534. Depending on the
nature of your application, supplemental authorities include Federal statutes, State
statutes pursuant to Pub. L. 92-544, Presidential Executive Orders, and federal
regulations. Providing your fingerprints and associated information is voluntary;
however, failure to do so may affect completion or approval of your application.
Principal Purpose: Certain determinations, such as employment, licensing, and
security clearances, may be predicated on fingerprint-based background checks. Your
fingerprints and associated information/biometrics may be provided to the employing,
investigating, or otherwise responsible agency, and/or the FBI for the purpose of
comparing your fingerprints to other fingerprints in the FBI’s Next Generation
Identification (NGI) system or its successor systems (including civil, criminal, and latent
fingerprint repositories) or other available records of the employing, investigating, or
otherwise responsible agency. The FBI may retain your fingerprints and associated
information/biometrics in NGI after the completion of this application and, while retained,
your fingerprints may continue to be compared against other fingerprints submitted to or
retained by NGI.
Routine Uses: During the processing of this application and for as long thereafter as
your fingerprints and associated information/biometrics are retained in NGI, your
information may be disclosed pursuant to your consent, and may be disclosed without
your consent as permitted by the Privacy Act of 1974 and all applicable Routine Uses as
may be published at any time in the Federal Register, including the Routine Uses for the
NGI system and the FBI’s Blanket Routine Uses. Routine uses include, but are not
limited to, disclosures to: employing, governmental or authorized non-governmental
agencies responsible for employment, contracting, licensing, security clearances, and
other suitability determinations; local, state, tribal, or federal law enforcement agencies;
criminal justice agencies; and agencies responsible for national security or public safety.
Applicant Notification and Record Challenge
Your fingerprints will be used to check the criminal history records of the FBI. You have
the opportunity to complete or challenge the accuracy of the information contained in the
FBI identification record. The procedure for obtaining a change, correction, or updating
an FBI identification record are set forth in Title 28, CFR, 16.34. You can find additional
information on the FBI website at https://www.fbi.gov/about-us/cjis/background-checks