Mercer Island Police Department Online Concealed Pistol License Application

Welcome! This is an official application for a Washington Concealed Pistol License. This application must be filled-out completely and accurately. Any falsification of the information within this application is a crime and will result in the denial of the applicant’s Concealed Pistol License request.

A non-refundable processing fee is required. In addition, an online service fee is required to process payment. These fees will be charged even if your application is denied. This service is provided by a third party vendor and the Police Department only collects the fees in accordance with the Washington State statute.

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Applicant Information:

Last Name: ^{(official ID)}

First Name:

Middle Name:

Maiden Name:

Suffix: ^{(jr, sr, etc.)}

SSN:

SSN: ^(confirm)

Current Concealed Permit Information: ^{enter your existing permit # and the issuing county}

CPL#:

Issuing County:

Issue Date:

Expiration Date:

Previous Names/Aliases: ^{(please list all previous aliases)}

Previous Last Name	Previous First Name	Previous Middle Name	City Where Changed	State	Court File #

Driver's License / Non-Operator ID: ^{(or other State Issued ID)}

^{ID Number:}

^{Issuing State:}

Information Related To Your Birth:

Date of Birth:

Current Age:

Birth City:

Birth State:

Birth Country:

Are you a US Citizen?

Yes No

Prohibitions applicable to certain aliens. Federal law makes it unlawful for aliens who are illegally or unlawfully in the United States to receive or possess firearms. In addition, subject to certain exemptions, aliens who are in a non-immigrant status are prohibited from possessing or receiving firearms in the United States.

A non-immigrant alien is not subject to this prohibition if the alien:

is in possession of a valid hunting license or permit lawfully issued in the United States;
is an official representative of a foreign government who is accredited to the United States Government or his or her government’s mission to an international organization having its headquarters in the United States; or
has received a waiver from the prohibition from the Attorney General of the United States.

See 18 USC 922(y)(2) for additional exceptions.

In order to determine whether applicants who are not United States citizens are prohibited from possessing firearms under Federal law, it is necessary to obtain answers to the following questions:

^{Country of Citizenship}

Are you a permanent resident alien?

Yes No

Are you a legal alien temporarily residing in Washington?

Yes No

Height:

^feet ^inches

Weight:

Hair Color:

Eye Color:

Scars/Marks/Tattoos:

Telephone Number: ^{(###-###-####)}

^Primary:

^Work:

^{Mobile Phone:}

^Fax:

Updates via text message?

Yes No

Email:

^Address:

^Confirm:

Please Create A Password: ^{(you can use this to track progress, and we may need to contact you during the process)}

Password:

Password: ^(confirm)

Password Information: In order to comply with CJIS standards we have employed the use of a password complexity monitor. As you enter your password, we will display an indicator of complexity. You will only be able to submit passwords that are sufficiently complex as to be considered 'safe' by CJIS standards. The visual indicator will turn Blue or Green to indicate that your password is safe.

Important: CJIS requires we maintain a strict password policy and system of checks. As such, we check the following items as you enter your new password:

The password must be a minimum length of eight (8) characters on all systems
The password must not be a dictionary word
The password must not be the same as your email address
The password must not be a proper name

Current Residence Address: ^{(this may be different than your mailing address)}

Address Line 1:

Address Line 2:

City:

State : ^(region)

Zip Code: ^{(postal code)}

Country:

^{Mailing Address Different:}

Yes No

Present Mailing Address: ^{(if different from residence address)}

Address Line 1:

Address Line 2:

City:

State : ^(region)

Zip Code: ^{(postal code)}

Country:

Attach Documentation:

To upload documentation, please use the button below to begin the process. Please scan each document individually. The maximum size of individual files is 5 MB. If you wish to upload documentation, Examples of relevant documentation are:

A copy of your proof of identification (e.g. current passport, a current Washington state driver’s license, a current Washington state identification card, equivalent out of state identification, law enforcement identification, or military identification card)
Court orders (Firearms restorations, juvenile sealings, expungements, etc…).
Court documents (dispositions, name changes, etc…).
Previous CPL (if you are submitting an application to renew your CPL.)
Permanent Resident card (green card), if applicable. Note: An original Permanent Resident card is required to be verified before you can take possession of your CPL.

Uploaded Files:

If you cannot upload these documents, click on the checkbox to indicate that you will email pd-records@mercergov.org the documents after your submission.

Add files...

Please select a document type then, click on the “Attach” button to complete the upload process.

Select Your Application Type:

Replacement Concealed Pistol License

Total Fee:

$0

SIGNING THIS APPLICATION AUTHORIZES THE WASHINGTON HEALTH CARE AUTHORITY, 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 LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.

CAUTION: ALTHOUGH STATE AND LOCAL LAWS DO NOT DIFFER, FEDERAL LAW AND STATE LAW ON THE POSSESSION OF FIREARMS DIFFER. IF YOU ARE PROHIBITED BY FEDERAL LAW FROM POSSESSING A FIREARM, YOU MAY BE PROSECUTED IN FEDERAL COURT. A STATE LICENSE IS NOT A DEFENSE TO FEDERAL PROSECUTION

Coupon Code:

Your Initials:

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

To Reserve An Appointment Select The Date & Time Below

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Coupon Code:

Your Initials:

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Mercer Island Police Department

Concealed Pistol License Application Please Enter All Information

Please read the following before proceeding:

Applicant Information:

Current Concealed Permit Information: ^{enter your existing permit # and the issuing county}

Previous Names/Aliases: ^{(please list all previous aliases)}

Driver's License / Non-Operator ID: ^{(or other State Issued ID)}

Information Related To Your Birth:

Demographic Information:

Telephone Number: ^{(###-###-####)}

Email:

Please Create A Password: ^{(you can use this to track progress, and we may need to contact you during the process)}

Current Residence Address: ^{(this may be different than your mailing address)}

Present Mailing Address: ^{(if different from residence address)}

Attach Documentation:

Uploaded Files:

Select Your Application Type:

Total Fee:

$0

Application Qualification Questions:

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

Concealed Pistol License Application Please Enter All Information

Add An Address

Add An Alias

Add a reference

Update a reference

Please read the following before proceeding:

Applicant Information:

Current Concealed Permit Information: enter your existing permit # and the issuing county

Previous Names/Aliases: (please list all previous aliases)

Driver's License / Non-Operator ID: (or other State Issued ID)

Information Related To Your Birth:

Demographic Information:

Telephone Number: (###-###-####)

Email:

Please Create A Password: (you can use this to track progress, and we may need to contact you during the process)

Current Residence Address: (this may be different than your mailing address)

Present Mailing Address: (if different from residence address)

Attach Documentation:

Uploaded Files:

Select Your Application Type:

Total Fee:

$0

Application Qualification Questions:

You Must Select An Appointment: your appointment will be confirmed prior to checkout

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

Your Appointment Choice Is:

No Appointments Available

Your signature is required.

Error processing application

Error processing application

You must be a US Citizen

Required field missing

Required field missing

Permit Expired

Permit Expired

Permit Expired

No Appointments Available

Permit Expires Soon

Permit Expired

Donations cant be taken with cash

You Must Select An Appointment: your appointment will be confirmed prior to checkout

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

Your Appointment Choice Is:

No Appointments Available

You Must Select An Appointment: your appointment will be confirmed prior to checkout

To Reserve An Appointment Select The Date & Time Below

Showing the first available appointment date

Please select a time below:

Your Appointment Choice Is:

No Appointments Available

Current Concealed Permit Information: ^{enter your existing permit # and the issuing county}

Previous Names/Aliases: ^{(please list all previous aliases)}

Driver's License / Non-Operator ID: ^{(or other State Issued ID)}

Telephone Number: ^{(###-###-####)}

Please Create A Password: ^{(you can use this to track progress, and we may need to contact you during the process)}

Current Residence Address: ^{(this may be different than your mailing address)}

Present Mailing Address: ^{(if different from residence address)}

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}

You Must Select An Appointment: ^{your appointment will be confirmed prior to checkout}