CONCEALED WEAPON PERMIT APPLICATION
To be completed by each person making application:
RESIDENT OF MONTANA AT LEAST 6 MONTHS () Yes () No
CITIZEN OF THE UNITED STATES () Yes () No
18 YEARS OF AGE OR OLDER () Yes () No
PLEASE TYPE OR PRINT
Full name: .............
Last | First | Middle |
Alias/Maiden/Nickname: ..............
Address: Home: ................ | Zip ............... |
Employer: ........................... | Zip ............... |
Phone: | .............../ | .............../ | ............... |
Home | Employer | Message |
Place of birth: ................. | Date of birth: ........... |
Driver's license #: ........... | Issuing state: ........... |
Social Security # (optional): ...............
Sex ........... Ht. ........... Wt. ........... Eyes ........... Hair ...........
LIST EACH FORMER EMPLOYER OR BUSINESS ENGAGED IN FOR THE LAST 5 YEARS:
Employer or business name | Address | Dates of employment | |
1. | ............................................... | ................................ | ............................................... |
2. | ............................................... | ................................ | ............................................... |
3. | ............................................... | ................................ | ............................................... |
4. | ............................................... | ................................ | ............................................... |
5. | ............................................... | ................................ | ............................................... |
6. | ............................................... | ................................ | ............................................... |
LIST EACH PLACE IN WHICH YOU HAVE LIVED FOR THE LAST 5 YEARS:
City | State | Dates of residence | |
1. | ................................ | ................................ | ................................ |
2. | ................................ | ................................ | ................................ |
3. | ................................ | ................................ | ................................ |
4. | ................................ | ................................ | ................................ |
5. | ................................ | ................................ | ................................ |
6. | ................................ | ................................ | ................................ |
MILITARY SERVICE, BRANCH ............. | FROM ............. | TO ............. |
TYPE OF DISCHARGE ............. | RANK UPON DISCHARGE ............. |
HAVE YOU EVER BEEN ARRESTED FOR OR CONVICTED OF A CRIME OR FOUND GUILTY IN A COURT-MARTIAL PROCEEDING?
() YES() NO
IF YES, COMPLETE THE FOLLOWING (Exceptions: minor traffic violations) (Attach additional sheet if necessary):
City | State | Charge | Date | |
1. | .................................... | .................................... | ................................... | .................................... |
2. | .................................... | .................................... | ................................... | .................................... |
3. | .................................... | .................................... | ................................... | .................................... |
4. | .................................... | .................................... | ................................... | .................................... |
5. | .................................... | .................................... | ................................... | .................................... |
LIST THREE PERSONS WHOM YOU HAVE KNOWN FOR AT LEAST 5 YEARS THAT WILL BE CREDIBLE WITNESSES TO YOUR GOOD MORAL CHARACTER AND PEACEABLE DISPOSITION (DO NOT include relatives or present/past employers):
Name | Address | Phone | |
1. | .................................... | .................................... | .................................... |
2. | .................................... | .................................... | .................................... |
3. | .................................... | .................................... | .................................... |
PLEASE EXPLAIN YOUR REASONS FOR REQUESTING THIS PERMIT (Attach additional sheet if necessary):
...............................................
...............................................
...............................................
I, the undersigned applicant, swear that the foregoing information is true and correct to the best of my knowledge and belief and is given with the full knowledge that any misstatement may be sufficient cause for denial or revocation of a permit to carry a concealed weapon. I authorize any person having information concerning me that relates to the information requested by this application and the requirements for a concealed weapon permit, either public record or otherwise, to furnish it to the sheriff to whom this application is made.
................................................
Signature
................................................
Date of application
This application must be signed in the presence of the sheriff or a designee.
§ 45-8-322, MCA