Oce use only
ID number __________________
SID number ________________
FBI number ________________
CPL number ________________
X
Concealed Pistol License Application
PRINT or TYPE all information
Application type
Original application Renewal of license Late renewal of license Replacement license
Name (Last, First, Middle) CPL number, if applicable Expiration date
Other names by which you have been known (for example: maiden name) Driver license number State
Physical address – required City State ZIP code
Mailing address (if dierent) City State ZIP code
Date of birth Birthplace (City, State/Province, Country) 10-digit phone (optional) Gender
Male Female Non-binary
Height Weight Eyes (color) Hair color Ethnicity
Hispanic or Latino Not Hispanic or Latino
Race (Check all that apply)
Black or African American American Indian or Alaska Native White Asian Native Hawaiian or Other Pacic Islander
Email address for concealed pistol license renewal (optional)
List type and location of all marks, scars, and tattoos
Residency
1. Are you a U.S. citizen? ................................................................... Yes No
If no, enter country of citizenship
2. Are you a permanent resident alien? ........................................................ Yes No
If yes, enter your permanent resident card number
3. Are you a legal alien temporarily residing in Washington? ........................................ Yes No
If yes, enter your alien registration/I-94 number and;
Enter your alien rearms license number: Expiration date:
Answer the following
1. Have you ever been convicted in adult court or adjudicated in a juvenile court of a felony, or of the following crimes when
committed by one family or household member against another, on or after July 1, 1993: assault in the fourth degree,
coercion, stalking, reckless endangerment, criminal trespass in the rst degree, or violation of the provision
of a protection order or no-contact order restraining the person or excluding the person from a residence? .. Yes No
2. Are you now on bond or personal recognizance pending trial, appeal or sentence for any serious
oense as dened in RCW 9.41.010 or for a felony for any crime where the judge can imprison
you for more than one year? ............................................................... Yes No
3. Have you been convicted of 3 or more violations of Washington’s rearms laws within any 5-year period? .. Yes No
4. Are you an unlawful user of, or addicted to, marijuana, or any depressant, stimulant, or narcotic drug, or
any other controlled substance? ............................................................ Yes No
5. Have you ever been adjudicated mentally defective (which includes having been adjudicated
incompetent to manage your own aairs) or have you ever been committed to a mental institution? ....... Yes No
6. Have you been discharged from the Armed Forces under dishonorable conditions? .................... Yes No
7. Are you subject to a court order restraining you from harassing, stalking, or threatening your child
or an intimate partner or child of such partner? ................................................. Yes No
8. Have you been convicted in any court of a misdemeanor crime of domestic violence? .................. Yes No
9. Have you ever renounced your United States citizenship? ........................................ Yes No
10. Are you an alien illegally in the United States? ................................................. Yes No
Signing this application authorizes the Department of Social and Health Services, as well as mental-health institutions and
other health-care facilities, to release information relevant to your eligibility for a concealed pistol license to an inquiring court or
law-enforcement agency.
I certify under penalty of perjury under the law of Washington that the foregoing is true and correct.
Date and place (city or county) signed Applicant signature
FIR-652-007 (R/6/21)WA Page 1 of 2
feet inches pounds
Print completed form and sign here.
Local law enforcement use only
Database Date Checked by _____________________________________________
NICS ___________ _________________________________________________________________
WACIC/NCIC ___________ _________________________________________________________________
Warrant le ___________ _________________________________________________________________
DOL rearms le ___________ _________________________________________________________________
DSHS ___________ _________________________________________________________________
Local check ___________ _________________________________________________________________
Fingerprints (original ___________ _________________________________________________________________
application only)
Approved Denied By ____________________________________________________ Date ____________________________
What do I need to apply for a concealed pistol license?
• Bring a photo ID such as a valid state driver license or ID card.
• Bring your permanent resident card if you are a permanent resident alien.
• If you have an alien rearms license, bring your original passport and United States issued alien number or admission number.
• Bring your original certicate of rehabilitation or rearms restoration orders, if applicable.
How much does it cost for a concealed pistol license?
• Original license – $36
• Renewal license – $32
• Late renewal license – $42
• Replacement license – $10
Plus background check fees. All fees are non-refundable.
Do I need to get a ngerprint or background check?
• Yes. The law enforcement agency will take your ngerprints and conduct a background check before they issue an
original CPL.
• The background check process will usually be completed within 30 days from the date you apply.
• If you do not have a valid Washington driver license or Washington state identication card or have not been a resident of
Washington state for the prior 90 consecutive days, then the process may take up to 60 days.
Are there any other requirements?
Yes. Your application can be denied if:
• You have a concealed pistol license in a revoked status
• You are under 21 years of age
• You are subject to a court order or injunction concerning the possession of rearms
• You are free on bond or personal recognizance pending trial, appeal, or sentencing for a felony oense
• You have an outstanding warrant for your arrest from any court of competent jurisdiction for a felony or misdemeanor
• You have been ordered to forfeit a rearm within one year before ling a concealed pistol license application
Who do I contact if I have any questions?
• Contact your local law enforcement agency or county sheri’s oce.
CAUTION: Although state and local laws do not dier, federal law and state law on the possession of rearms dier.
If you are prohibited by federal law from possessing a rearm, you may be prosecuted in federal court. A state
license is not a defense to federal prosecution.
FIR-652-007 (R/6/21)WA Page 2 of 2