Norfolk County. 1 document captured.
WALPOLE POLICE DEPARTMENT
FIREARMS LICENSE APPLICATION
[REQUIREMENTS]
50 South Street Phone: 508.668.1095
Walpole, Massachusetts 02081 Fax: 508.668.0531
Please read carefully as missing information will delay processing
APPLICATION: Complete the State approved Application for New/Renewal of a Firearms
Identification Card (FID) or License to Carry Firearms (LTC) in its entirety. Be sure to check
both the front and back-sides of the application to ensure completion. All applicants must also
sign and date the Authorization form/Acknowledgment of the limits on the use of deadly force.
Applicants are urged to carefully consider Question 4, found on Page 2 of the
application. The question refers to any criminal charges brought forth against you. If
you appeared in court as a defendant, you must answer the question “YES” and provide
as much detail as possible. Failure to answer this question accurately and completely is
grounds for denial of the application.
LICENSING FEE: Applicants must submit a State regulated, non-refundable administrative
fee with the completed application.
FEE SCHEDULE
Type of License Cost Fee Exemptions/Notes
License to Carry – Firearms or Stun Guns $100 Free for renewals 70 years old and older
License to Carry – Machine Gun $100 None
FID 18 and older $100 Free for renewals 70 years old and older
FID under age 18 $25 No Fee Exemption
No Fee Exemption
FID – Mace and Pepper Spray only $25
Permit required for under 18 only
HELPFUL RESOURCES:
www.mass.gov/eopss/firearms-reg-and-laws/frb
(Firearms Forms, Frequently Asked Questions, Mass Gun Laws)
www.mass.gov/lists/massachusetts-firearms-laws
(Approved Firearms Safety Courses, Approved Firearm Safety/Locking Devices)
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REFERENCE THE CHECKLISTS ON NEXT THREE (3) PAGES TO ENSURE YOU
SUBMIT ALL OF THE REQUIRED PAPERWORK
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Revised October 2024
WALPOLE POLICE DEPARTMENT
FIREARMS LICENSE APPLICATION
[SUMMARY CHECKLIST]
50 South Street Phone: 508.668.1095
Walpole, Massachusetts 02081 Fax: 508.668.0531
NEW APPLICANT CHECKLISTS
License to Carry – Firearms
License to Carry – Stun Guns Only
License to Possess a Machine Gun
New Applicant and FID Upgrade to LTC Requirements
Ages 21 and over only
$100 Check or Money Order made out to Town of Walpole.
Completed Application (skip page 4 of 4)
Signed and Dated Authorization form/Acknowledgement of the limits on the use of
deadly force
Certified Birth Certificate, Passport, or Certificate of Naturalization (no photocopies)
Proof of Residency (copy of tax bill, utility bill, bank statement, voter registration etc.)
Mass State Police Basic Firearms Safety Certificate; or
Certificate issued by the Division of Fisheries and Wildlife
License to Possess a Machine Gun Applicants only –All machine gun license applicants are
now required to possess an Federal Firearms License, Type 3 (Curios and Relics), and must
submit a copy of that license with their application.
Two (2) Self Addressed Stamped Envelopes (Business Sized #10 – 4.25”x9.5”)
FID
New Applicant
Ages 18 and over
$100 Check or Money Order made out to Town of Walpole.
Completed Application (skip page 4 of 4)
Signed and Dated Authorization form/Acknowledgement of the limits on the use of
deadly force
Certified Birth Certificate, Passport, or Certificate of Naturalization (no photocopies)
Proof of Residency (copy of tax bill, utility bill, bank statement, voter registration etc.)
Mass State Police Basic Firearms Safety Certificate; or
Certificate issued by the Division of Fisheries and Wildlife
Two (2) Self Addressed Stamped Envelopes (Business Sized #10 – 4.25”x9.5”)
Revised October 2024
WALPOLE POLICE DEPARTMENT
FIREARMS LICENSE APPLICATION
[SUMMARY CHECKLIST]
50 South Street Phone: 508.668.1095
Walpole, Massachusetts 02081 Fax: 508.668.0531
NEW APPLICANT CHECKLISTS Cont’d
FID
New Applicant
Under 18 years old and at least 15 years old
$25 Check or Money Order made out to Town of Walpole
Completed Application (skip page 4 of 4)
Signed and Dated Authorization form/Acknowledgement of the limits on the use of
deadly force
Certified Birth Certificate, Passport, or Certificate of Naturalization (no photocopies)
Proof of Residency (copy of tax bill, utility bill, bank statement, voter registration etc.)
Letter from a parent or guardian granting permission for the child to obtain an FID Permit.
Mass State Police Basic Firearms Safety Certificate; or
Certificate issued by the Division of Fisheries and Wildlife
Two (2) Self Addressed Stamped Envelopes (Business Sized #10 – 4.25”x9.5”)
iii
Revised October 2024
WALPOLE POLICE DEPARTMENT
FIREARMS LICENSE APPLICATION
[SUMMARY CHECKLIST]
50 South Street Phone: 508.668.1095
Walpole, Massachusetts 02081 Fax: 508.668.0531
RENEWAL CHECKLISTS
License to Carry – Firearms - Renewals
License to Carry – Stun Guns Only - Renewals
License to Possess a Machine Gun - Renewals
Ages 21 and over only
$100 Check or Money Order made out to Town of Walpole. Application fee is waived if the
applicant is 70 years old or older
Proof of Residency (copy of tax bill, utility bill, bank statement, voter registration etc.)
(only required for new residents renewing in Walpole for the first time; New residents to
Walpole also must include a photocopy of their most recent LTC Card).
Completed Application (Complete all four (4) pages including affidavit – lost/stolen
firearms
Signed and Dated Authorization form/Acknowledgement of the limits on the use of
deadly force
Machine Gun Applicants only –All machine gun license applicants are now required to
possess an Federal Firearms License, Type 3 (Curios and Relics), and must submit a copy of
that license with their application.
Two (2) Self Addressed Stamped Envelopes (Business Sized #10 – 4.25”x9.5”)
FID Renewals
All Ages
$100 Check or Money Order made out to Town of Walpole. Application fee is waived if the
applicant is 70 years old or older
Proof of Residency (only required for new residents renewing in Walpole for the first time;
New residents to Walpole also must include a photocopy of their most recent LTC Card).
Completed Application (Complete all four (4) pages including affidavit – lost/stolen
firearms
Signed and Dated Authorization form/Acknowledgement of the limits on the use of
deadly force
Two (2) Self Addressed Stamped Envelopes (Business Sized #10 – 4.25”x9.5”)
Revised October 2024
PRIVACY ACT STATEMENT – CIVIL FINGERPRINTING
Authority: The FBl's acquisition, preservation, and exchange of fingerprints and associated information
is generally authorized under 28 U.S.C. 534. Depending on the nature of your application,
supplemental authorities include Federal statutes, State statutes pursuant to Pub.
L. 92-544, Presidential Executive Orders, and federal regulations. Providing your fingerprints and
associated information is voluntary; however, failure to do so may affect completion or approval of
your application.
Principal Purpose: Certain determinations, such as employment, licensing, and security clearances,
may be predicated on fingerprint-based background checks. Your fingerprints and associated
information/biometrics may be provided to the employing, investigating, or otherwise responsible
agency, and/or the FBI for the purpose of comparing your fingerprints to other fingerprints in the FBl's
Next Generation Identification (NGI) system or its successor systems (including civil, criminal, and
latent fingerprint repositories) or other available records of the employing, investigating, or otherwise
responsible agency. The FBI may retain your fingerprints and associated information/biometrics in
NGI after the completion of this application and, while retained, your fingerprints may continue to be
compared against other fingerprints submitted to or retained by NGI.
Routine Uses: During the processing of this application and for as long thereafter as your fingerprints
and associated information/biometrics are retained in NGI, your information may be disclosed
pursuant to your consent, and may be disclosed without your consent as permitted by the Privacy Act
of 1974 and all applicable Routine Uses as may be published at any time in the Federal Register,
including the Routine Uses for the NGI system and the FBl's Blanket Routine Uses. Routine uses
include, but are not limited to, disclosures to: employing, governmental or authorized non-
governmental agencies responsible for employment, contracting, licensing, security clearances, and
other suitability determinations; local, state, tribal, or federal law enforcement agencies; criminal
justice agencies; and agencies responsible for national security or public safety.
Applicant Notification and Record Challenge
Your fingerprints will be used to check the criminal history records of the FBI. You have the
opportunity to complete or challenge the accuracy of the information contained in the FBI
identification record. The procedure for obtaining a change, correction, or updating an FBI
identification record are set forth in Title 28, CFR, 16.34. You can find additional information on the FBI
website at www.fbi.gov/about-us/cjis/background-checks.
LTC-FID Application Page - 5 of 5
THE COMMONWEALTH OF MASSACHUSETTS PD USE ONLY
EXECUTIVE OFFICE OF PUBLIC SAFETY AND SECURITY FTN: _______________
Department of Criminal Justice Information Services
LIC #: _______________
mass.gov/firearms-services
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 Carry - Stun Gun Only
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 July 2022 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 Page - 2 of 5
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
Please explain why you are requesting a license:
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 Page - 3 of 5
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 Page - 4 of 5
WALPOLE POLICE DEPARTMENT
FIREARMS LICENSE APPLICATION
[POLICY AND APPLICATION]
AUTHORIZATION FORM
I have applied for a License to Carry Firearms or a Firearms Identification Card with the Walpole Police
Department.
I hereby authorize the Licensing Authority of the Walpole Police Department to thoroughly investigate my
background as necessary to determine my suitability for the issuance of a License to Carry Firearms or
Firearms Identification Card. I fully understand that the existence of any criminal record will not only be
checked with the Massachusetts Board of Probation, but as necessary with any other law enforcement agency
or state Board of Probation.
ACKNOWLEDGEMENT OF THE LIMITS ON THE USE OF DEADLY FORCE
In accordance with the authority granted by Massachusetts General Laws, C 140 Section 131, the licensing
authority of the Town of Walpole has determined that every applicant for a license to carry firearms and every
licensee shall be familiar with the legal limits on the use of deadly force under the laws of the Commonwealth
of Massachusetts. Accordingly, all such applicants are required to read and sign this memorandum certifying
that they have read it and understand it.
Deadly Force in Self‐Defense; General Rule
Before a person may resort to deadly force he must have (1) reasonable grounds to believe that he or she is in
imminent danger of death or serious bodily injury from which he or she can save himself only by using deadly
force; (2) have availed himself of all possible means to avoid physical combat before resorting to the use of
deadly force and (3) use no more force than is reasonably necessary in all circumstances of the case.
In a Dwelling House
In the prosecution of a person who is an occupant of a dwelling charged with killing or injuring one who was
unlawfully in said dwelling, it shall be a defense that the occupant was in his dwelling at the time of the
offense and that he acted in the reasonable belief that the person unlawfully in said dwelling was about to
inflict great bodily harm or death upon said occupant or upon another person lawfully in said dwelling, and
that such other occupant used reasonable means to defend himself or such other person lawfully in said
dwelling.
I certify that I have read the above memorandum of the limits of the use of deadly force and that I understand
said memorandum.
______________________________ ______________________________
Signature of Applicant Date
______________________________ ______________________________
Printed Name of Applicant Email Address of Applicant
Revision: September 2019
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).