Arkansas State Police

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CONCEALED HANDGUN CARRY LICENSE APPLICATION

DEPARTMENT OF ARKANSAS STATE POLICE

Items marked with ^* are required.

Attestation

I attest that I have read and understand the following:

***NOTICE: THE APPLICATION FEE IS NON-REFUNDABLE***
Your application may be denied based on the information you provide. Please read the law and the Administrative Rules carefully. If you have questions about your eligibility, please consult your instructor.

Full Name Warning - This form must be completed with a personal computer desktop or laptop. Using a mobile phone or tablet may not work properly.

*Last Name

*First Name

Middle

Suffix

NOTICE: The processing of your license will be delayed and you will be unable to check the status of your application online IF you do not enter your name in the correct boxes.

Alias

Last

First

Middle

Birth

^*Date

Ex. 10/31/1973

^*Country of birth

^*City of birth

^*Proof of citizenship

Current Permanent Resident Card
Naturalization Papers
Passport
Born Abroad Certificate
Pending

^*State of birth

Birth State is required.

Drivers License

^*Social Security No.

^*Drivers License No.

Ex. 123456789

^*Drivers License State

Physical Characteristics

^*Hair color

^*Eye color

^*Height (Feet)

^*Height (Inches)

^*Race

^*Gender

Address Information

Physical Address

^*County (not State)

^*City

^*Address

^*State

^*ZIP

Mailing Address

Same as physical address.

Address

City

State

ZIP

^*Do you live within the city limits? Yes No

Contact Information

Evening phone number

^*Daytime phone number

Cell phone number

Fax

^*E-mail address

Military Information

^**Are you in the United States military or a United States military veteran? Yes No

(please provide copy of DD214/similar document for verification of military service)

Arkansas Department of Public Safety | One State Police Plaza Dr | Little Rock, AR 72209