Welcome! This is an official application for an annual permit to purchase a pistol or handgun.  This online application is for residents of Polk County, Iowa only.  You must completely and accurately fill-out this application to be considered for a permit. Any falsification of the information within this application will result in the denial of this application for a purchase permit.

A permit to acquire weapons requires a fee of $11 and a valid driver's license or non-operator I.D. that contains your photograph and current address issued by the Iowa Department of Transportation. A permit to acquire is valid for one year from the date of issue.  If the permit is denied, $5.00 will be reimbursed to the applicant. The Sheriff's Office will retain the remainder for processing and handling of the application.

Please read the following before proceeding:

Applicant Information:


Previous Aliases: (please list all previous aliases)

Previous Last Name Previous First Name

Information Related To Your Birth:


Demographic Information:


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


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


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)


Request for Gun Purchase Permit.


Select Purchase Option:


Total Fee:

$0

I do hereby authorize a review and full disclosure of all records concerning myself, as required by Iowa Code Ch. 724 and Iowa Administrative Code 661—Ch 91, to any duly authorized agent of an Iowa sheriff or the Commissioner of the Iowa Department of Public Safety, whether the said records are of a public, private or confidential nature.

The intent of this authorization is to give my consent for full and complete disclosure of records of psychiatric treatment, substance abuse treatment, consultation and/or court ordered involuntary committal for treatment including those records held by hospitals, clinics, private practitioners, the U.S. Veteran’s Administration and clerks of court, as necessary to verify that I meet the requirements of the state of Iowa and the United States for the acquisition and possession of a firearm. I understand that the information contained in these records will be used for no purpose other than those stated above, and will be kept strictly confidential by the office of the issuing official.

I understand that any information obtained which is developed directly or indirectly, in whole or part, upon this release authorization will be considered in determining my qualification for obtaining a permit to acquire pistols/revolvers in the state of Iowa. I also certify that any person(s) who may furnish such information concerning me shall not be held accountable for providing accurate information, and I do hereby release said person(s) from any and all liability which may be incurred as a result of furnishing such information.

I understand that all information provided on this application form is considered public record and may be disclosed upon request.

I certify that all information, including supporting documentation, provided in this application is true and correct, and I understand that I may be convicted of a class “D” felony pursuant to Iowa Code section 724.17 if I make what I know to be a false statement of material fact on this application or if I submit what I know to be any materially falsified or forged documentation in connection with this application.

Clear Form

Survey Questions:

Do you have charges pending in any state for a felony, or any other crime for which the court could sentence you to imprisonment for more than one year?

Have you ever been convicted in any court of a felony, or any other crime involving a firearm or explosives for which the court could have sentenced you to imprisonment for more than one year, even if you received a shorter sentence including probation?

Are you a fugitive from justice (outstanding arrest warrants)?

Are you an unlawful user of, or addicted to, any controlled substance?

Have you ever been adjudicated mentally defective (which includes a determination by a court, board, commission, or other lawful authority that you are a danger to yourself or to others or are incompetent to manage your own affairs) OR have you ever been committed to a mental institution?

Have you been discharged from the Armed Forces under dishonorable conditions?

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?

Have you ever been convicted in any court of a misdemeanor crime of domestic violence?

Are you a citizen of the United States? (IF NO, immigrant must provide alien registration number (ARN); nonimmigrant must provide I-94 registration number and documentation showing an exception to the nonimmigrant alien prohibition (e.g., valid hunting license issued in any state, letter from the U.S. Attorney General granting a waiver, etc.)

Have you ever renounced your United States citizenship?



I do hereby authorize a review and full disclosure of all records concerning myself, as required by Iowa Code Ch. 724 and Iowa Administrative Code 661—Ch 91, to any duly authorized agent of an Iowa sheriff or the Commissioner of the Iowa Department of Public Safety, whether the said records are of a public, private or confidential nature.

The intent of this authorization is to give my consent for full and complete disclosure of records of psychiatric treatment, substance abuse treatment, consultation and/or court ordered involuntary committal for treatment including those records held by hospitals, clinics, private practitioners, the U.S. Veteran’s Administration and clerks of court, as necessary to verify that I meet the requirements of the state of Iowa and the United States for the acquisition and possession of a firearm. I understand that the information contained in these records will be used for no purpose other than those stated above, and will be kept strictly confidential by the office of the issuing official.

I understand that any information obtained which is developed directly or indirectly, in whole or part, upon this release authorization will be considered in determining my qualification for obtaining a permit to acquire pistols/revolvers in the state of Iowa. I also certify that any person(s) who may furnish such information concerning me shall not be held accountable for providing accurate information, and I do hereby release said person(s) from any and all liability which may be incurred as a result of furnishing such information.

I understand that all information provided on this application form is considered public record and may be disclosed upon request.

I certify that all information, including supporting documentation, provided in this application is true and correct, and I understand that I may be convicted of a class “D” felony pursuant to Iowa Code section 724.17 if I make what I know to be a false statement of material fact on this application or if I submit what I know to be any materially falsified or forged documentation in connection with this application.

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