NEW JERSEY STATE POLICE
Range Authorization Form
On Monday, April 27, 2020, Philip D. Murphy, Governor of the State of New Jersey, issued
Executive Order 129 addressing individual Carry Permits pursuant to N.J.S.A. 2C:58-4.
In limited circumstances, this Executive Order allows a shooting range that is otherwise closed,
pursuant to Executive Order 107 (2020), to offer individuals and their single instructors the
ability to complete training and practice for the purpose of testing to satisfy N.J.A.C. 13:54-2.4
or N.J.A.C. 13:54-2.9. When a Police Chief, State Police Station Commander and/or the
Superior Court find that the applicant would qualify for such permit except that the applicant
cannot show the requisite familiarity with the safe handling and use of handguns under N.J.S.A.
2C:58-4, N.J.A.C. 13:54-2.4, and/or N.J.A.C. 13:54-2.9 due to the restrictions imposed in
response to the Public Health Emergency declared in Executive Order No. 103 (2020), this
Range Authorization Form should be issued.
This form, upon the signature of either the Chief of Police or NJSP Station Commander, as
applicable, or a Judge of the Superior Court, authorizes the identified individual and their single
instructor access to a shooting range for the sole purpose of completing the described training,
practice, or testing. The shooting range may offer such individual and their single instructor
access to that range for the sole purpose of completing the described training, practice or testing.
Name: ___________________________________________ DOB: _____________________
SBI #: ______________________________ Case #: _____________________________
Investigating Police Department: ___________________________________________________
______________________________________________
Chief of Police, NJSP Station Commander (Print Name)
______________________________________________
Chief of Police, NJSP Station Commander (Signature)
Judge of the Superior Court: _____________________________________________
** This Form is authorized by Executive Order 129 and may be used immediately upon issuance of the Order. It
shall remain in use until the Executive Order is revoked or modified by the Governor. **
S.P. 742 (04/20)
