Worcester County. 2 documents captured.
Firearm Permits | Ashburnham, MA
Departments
Police
Police Resources
Firearm Permits
Firearm Permits
To renew or apply for a new LTC or FID card, please first read the licensing instructions.
Firearms Licensing Instructions (PDF)
Until Further Notice
All renewal license to carry applications need to be mailed with a check made out to the "town of Ashburnham" in the amount of $100.
For all new applications, please mail in the application and firearms safety certificate. You will receive a call once your application can be processed.
Forms
Firearms Change of Address Form (PDF)
Firearms Application Form (PDF)
FIREARM LICENSE APPLICATION GUIDANCE
AS THE TOWN OF ASHBURNHAM FIREARMS LICENSING AUTHORITY IT IS OUR DESIRE TO
PROCESS YOUR LICENSE APPLICATION AS THOROUGHLY AND TIMELY AS POSSIBLE AND YOU CAN
HELP. MISSING AND/OR INACCURATE INFORMATION WILL DELAY THE PROCESS AND MAY RESULT
IN THE APPLICATION BEING DENIED. PLEASE READ CAREFULLY AND UNDERSTAND THE
INFORMATION BELOW AS IT ADVISES YOU OF THE STATE AND /OR FEDERAL LAW. IT IS NOT WITHIN
OUR DISCRETION TO CHANGE OR DISREGARD THEM.
IF YOU APPLICATION IS DENIED, it is usually due to one of the following reasons:
• Disqualifying criminal record;
• False answer to any question on the application;
• False answer to any question asked by the licensing officer or his/her designee; and/or
• Criminal information omitted from (or not attached to) the application is required
All previous in-state and out–of–state criminal appearances are considered to determine the “suitability”
of all firearm license applicants. This check will include “sealed records.”
The application asks specific questions regarding your personal background, past criminal history, etc.
You must answer all questions fully and truthfully. Failure to do so could result in your
application being denied. You do not have to list any non-criminal traffic offenses.
Question #4 on the application asks, “Have you ever appeared* in any court as a defendant for any
criminal offense?” The key word is “appeared” not necessarily mean arrested. Having been arrested and
convicted of a crime does not necessarily prohibit someone from getting a license to carry firearms or an
FID card, not listing it will.
*Please note; “ever appeared” includes all, regardless of where, adult and juvenile court appearances. It
does not matter if you were found “not guilty,” “not delinquent,” the charges were “dismissed,” or the case
was “continued without a finding,”etc. You must account for all appearances. All court appearances will
be discovered during our application process. You must indicate if you have a “sealed record” and the
offense. When we discover missing or inaccurate information for Question #4, we often hear “I forgot
about it,” or “they told me it wouldn’t show up,” or “it never showed up before,” or “it was so long ago, I
didn’t think it mattered,” etc. Appearing in a court of law is a memorable event in someone’s live and all
must be listed on your application.
If necessary, you may contact the Massachusetts Criminal History Systems Board to learn how to obtain
your Massachusetts criminal record check (iCORI), before you submit your application.
Request a certified copy of a personal CORI, including advocate, attorney, and open access requests:
www.mass.gov/how-to/request-cori-as-an-individual
By signing below, you acknowledge your understanding of the above information.
DATE: ___________________
PRINTED NAME: ____________________________________ SIGNATURE:_____________________________
23.5.FO
Revised 12/2023
THE COMMONWEALTH OF MASSACHUSETTS PD USE ONLY
EXECUTIVE OFFICE OF PUBLIC SAFETY AND SECURITY FTN: _______________
Department of Criminal Justice Information Services
200 Arlington Street, Suite 2200, Chelsea, MA 02150 LIC #: _______________
TEL: 617-660-4600 | TTY: 617-660-4606 | mass.gov/cjis
Submit this form and direct any questions to
your local police department
MASSACHUSETTS RESIDENT LTC/FID/MACHINE GUN APPLICATION
FOR NEW/RENEWAL OF A FIREARMS IDENTIFICATION CARD OR LICENSE TO CARRY
FIREARMS OR LICENSE TO POSSES A MACHINE GUN (M.G.L c. 140, §§ 129B, 131)
CHECK ONE:
New Applicant*
Renewal - Most Recent License to Carry/FID Number:
*NOTE: If application is for a first firearms identification card or license to carry firearms, a copy of the Firearms Safety Certificate or
Hunter Safety Course Certificate must be attached, unless exempt by statute. If this is a renewal application, a lost/stolen firearms
affidavit must be submitted.
LICENSE APPLICATION TYPE (Check Only One):
Firearms Identification Card - Restricted (self-defense spray)
Firearms Identification Card
License to Carry
License to Possess a Machine Gun
Gun Club License (Only the Colonel of the State Police can issue a club license)
EXCEPT FOR SIGNATURE, PRINT OR TYPE ALL REQUESTED INFORMATION:
Last Name First Name Middle Name Suffix
Residential Address City State Zip Code Telephone Number
Mailing Address City State Zip Code Telephone Number
Date of Birth Place of Birth (City, State, Country)
Mother's First Name Mother's Maiden Name Father's First Name Father's Last Name
Height Weight Build Complexion Hair Color Eye Color
Occupation Social Security Number (Optional) Drivers License Number
Employed By Business Address
City/Town State Zip Telephone Number
LTC-FID Application – Revised May 2015 Page 1 of 4
ANSWER THE FOLLOWING QUESTIONS COMPLETELY AND ACCURATELY:
1. Are you a citizen of the United States? YES NO
If lawful permanent resident alien, give
green card number and resident date Green Card Number Resident Since (date)
If naturalized, give date, place
and naturalization number Date Place Naturalization No.
2. Have you ever renounced your U.S. citizenship? YES NO
3. What is your age? ________ (You must be 21 to apply for a LTC, 18 to apply for a FID card, or 14 to 17 with
submission of a certificate of parent or guardian granting permission to apply for a FID card or FID card – Restricted).
4. Have you ever been arrested or appeared in court as a defendant for any criminal offense? YES NO
5. Are you the subject of any pending criminal charges? YES NO
6. Have you ever been convicted of a felony? YES NO
7. Have you ever been convicted of the unlawful use, possession, or sale of controlled substances
as defined in M.G.L. c. 94C, § 1? YES NO
8. Have you ever been convicted of a violent crime or a crime of domestic violence? YES NO
9. Have you ever been convicted as an adult or adjudicated a youthful offender or delinquent child
in any state or federal jurisdiction? YES NO
10. Are you now, or have you ever been the subject of a restraining order issued pursuant to M.G.L. c. 209A,
or a similar order issued by another jurisdiction? YES NO
11. Are you currently the subject of any outstanding arrest warrant in any state or federal jurisdiction? YES NO
12. Have you ever been committed to any hospital or institution for mental illness, or alcohol or substance abuse? YES NO
13. Has any firearms license issued under the laws of any state or territory ever been suspended, revoked,
or denied? YES NO
14. Have you been discharged from the armed forces of the United States under dishonorable conditions? YES NO
15. Have you been the subject of an order of the probate court appointing a guardian or conservator? YES NO
If you answered "YES" to any of the questions 2-15, give details which must include dates,
circumstances and location; use a separate sheet of paper if necessary.
LTC-FID Application – Revised May 2015 Page - 2 of 4
Have you ever used or been known by another name? YES NO
If “YES”, provide name and explain:
Other than Massachusetts, in what state(s), territory(ies), or jurisdiction(s) have you lived? NONE
Have you ever held a firearms license in any other state, territory or jurisdiction? YES NO
If "YES", when, where, and license number?
List the name and addresses of two references (as required by your licensing authority)
Last Name First Name
Address City/Town State Zip
Last Name First Name
Address City/Town State Zip
Reason(s) for requesting the issuance of a card or license:
Unrestricted Target & Hunting Sporting Employment
Use lines below to indicate the reason(s) you are requesting the license; use a separate sheet of paper if necessary)
WARNING Any person who knowingly files an application containing false information shall be punished by a fine of not less than
$500 nor more than $1,000 or by imprisonment for not less than 6 months nor more than 2 years in a house of correction, or by both
such fine and imprisonment (M.G.L c.140, §§ 129B(8), 131(h)).
I declare the above facts are true and complete to the best of my knowledge and belief and I understand that any false answer(s)
will be just cause for denial or revocation of my license to carry firearms. I understand that filing an application that contains false
information is a criminal offense.
Signed under the penalties of perjury this day of
day month year
Signature of Applicant:
LTC-FID Application – Revised May 2015 Page - 3 of 4
Massachusetts License to Carry (LTC)/Firearms Identification Card (FID) Affidavit
Complete this form only if you are renewing your firearms license.
License Holder Name: ________________________________________________
Current LTC or FID card Number: ________________________________________________
Please select one:
A. (No firearm(s) lost or stolen since previous issuance of LTC or FID card)
1. I am renewing a Massachusetts firearms identification (FID) card or license to carry
(LTC) firearms.
2. I have not lost one or more firearms or had any firearms stolen since the renewal or
issuance of my last FID card or LTC.
B. (Firearm(s) reported lost or stolen since previous issuance of LTC or FID card)
1. I am renewing a Massachusetts firearms identification (FID) card or license to carry
(LTC) firearms.
2. I have lost one or more firearms or have reported stolen one or more firearms since
the renewal or issuance of my last FID card or LTC.
List all lost or stolen firearms below; use additional sheets as necessary.
Lost or Date Reported Reported to Type Make Model Serial Number Case Number
Stolen Lost or Stolen (Police Dept.)
The above information is true and accurate to the best of my knowledge and belief.
SIGNED UNDER THE PENALTIES OF PERJURY:
Signature:____________________________________ Date:_________________________
LTC-FID Application – Revised May 2015 Page - 4 of 4
The provisions a municipal licensing page most often touches: G.L. c. 140, § 131 (licenses to carry), G.L. c. 140, § 121F (applications, suitability, judicial review), G.L. c. 140, § 131P (the safety certificate).