Goochland County Clerk of Circuit Court

Welcome! This is an official application for a concealed handgun permit. You must completely and accurately fill-out this application to be considered for a permit.  The making of a materially false statement in an application under this article shall constitute perjury, punishable as provided in § 18.2-434.

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 or the process is not completed by the applicant.


QUESTIONS - PLEASE READ each question carefully and answer as fully as possible. Incorrect information will affect the processing of your application
 

RENEWALS - If you are unable to provide your File# please enter NA into the field and be sure to upload a copy of your current CHP

 

Please read the following before proceeding:

Applicant Information:


Previous Aliases: (please list all previous aliases)

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

Information Related To Your Birth:



Demographic Information:



   

feet inches

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


Email:


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


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)


Present Mailing Address: (if different from residence address)


Spouse Residence Address:


Previous Addresses - For the last 5 years: (please list all previous addresses)

Address Line 1 Address Line 2 City State Zip Country From To

Attach Documentation: please upload the required documentation

To upload documentation, please use the 'Add Files' button below to begin the process. The maximum size of individual files is 5 MB. The address on government issued IDs must match the address on this application.

  • VALID GOVERNMENT ISSUED PHOTO ID (e.g. VA DRIVERS LICENSE / STATE ID, PASSPORT, ID ISSUED BY THE U.S. DEPARTMENT OF DEFENSE)
  • ATTACH A PHOTOCOPY OF THE DOCUMENTATION THAT DEMONSTRATES YOUR COMPETENCE WITH A HANDGUN 
  • IF YOU HAVE HAD YOUR FIREARM RIGHTS RESTORED, PLEASE UPLOAD COPIES OF ALL RELATED COURT DOCUMENTS 
 

Uploaded Files:

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

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Total Fee:

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I, THE UNDERSIGNED, AFFIRM THAT THE INFORMATION CONTAINED IN THIS APPLICATION AND IN ANY ATTACHMENTS TO THIS DOCUMENT IS BOTH CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE. THE WILLFUL MAKING OF A FALSE STATEMENT IN THIS APPLICATION CONSTITUTES PERJURY AND IS PUNISHABLE IN ACCORDANCE WITH §18.2-434 OF THE CODE OF VIRGINIA. I ALSO AFFIRM AND UNDERSTAND THAT THE ISSUANCE OF A CONCEALED HANDGUN PERMIT DOES NOT NECESSARILY ENTITLE ME, THE UNDERSIGNED, TO POSSESS, TRANSPORT OR SELL A FIREARM UNDER STATE OR FEDERAL LAW.

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Application Qualification Questions:

HAVE YOU EVER BEEN CONVICTED OF A FELONY OFFENSE? (INCLUDE FELONY CONVICTIONS OF DRIVING UNDER THE INFLUENCE AND/OR ANY OFFENSE FOR WHICH YOU WERE CONVICTED AS A JUVENILE, WHICH WOULD HAVE BEEN A FELONY IF COMMITTED BY AN ADULT. 

FAILURE TO ACKNOWLEDGE A CONVICTION MAY BE CONSTRUED AS MAKING A MATERIALLY FALSE STATEMENT.

DESCRIBE THE CHARGE FOR WHICH YOU WERE CONVICTED

DATE OF CONVICTION

COUNTY, CITY AND STATE OF CHARGE

HAVE YOU RECEIVED A PARDON OR RESTORATION OF RIGHTS THAT INCLUDES YOUR FIREARM RIGHTS?

IF YES, PROVIDE SUPPORTING DOCUMENTATION.

HAVE YOU BEEN CONVICTED / ADJUDICATED OF AN OFFENSE AS A JUVENILE WHICH WOULD HAVE BEEN A FELONY IF COMMITTED BY AN ADULT?

IF YES, HAVE YOU COMPLETED A TERM OF SERVICE OF NO LESS THAN TWO YEARS IN THE ARMED FORCES OF THE UNITED STATES?  PROVIDE SUPPORTING DOCUMENTATION.

DID YOU RECEIVE AN HONORABLE DISCHARGE?

HAVE YOU BEEN CONVICTED OF A MISDEMEANOR OFFENSE WITHIN THE FIVE-YEAR PERIOD IMMEDIATELY PRECEDING THIS APPLICATION? (INCLUDE MISDEMEANOR CONVICTIONS OF DRIVING UNDER THE INFLUENCE. DO NOT INCLUDE TRAFFIC INFRACTIONS OR THOSE MISDEMEANORS SET FORTH IN TITLE 46.2 CODE OF VIRGINIA.) 

FAILURE TO ACKNOWLEDGE A CONVICTION MAY BE CONSTRUED AS MAKING A MATERIALLY FALSESTATEMENT

DESCRIBE THE CHARGE FOR WHICH YOU WERE CONVICTED

DATE OF CONVICTION

COUNTY, CITY AND STATE OF CHARGE

HAVE YOU RECEIVED A PARDON OR RESTORATION OF RIGHTS THAT INCLUDES YOUR FIREARM RIGHTS?

IF YES, ATTACH SUPPORTING DOCUMENTATION.

HAVE YOU BEEN CONVICTED / ADJUDICATED OF AN OFFENSE AS A JUVENILE WHICH WOULD HAVE BEEN A FELONY IF COMMITTED BY AN ADULT?

IF YES, HAVE YOU COMPLETED A TERM OF SERVICE OF NO LESS THAN TWO YEARS IN THE ARMED FORCES OF THE UNITED STATES? ATTACH SUPPORTING DOCUMENTATION.

DID YOU RECEIVE AN HONORABLE DISCHARGE

HAVE YOU BEEN COMMITTED TO THE CUSTODY OF THE COMMISSIONER OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES

DATE OF COMMITMENT

DATE YOU WERE RELEASED FROM CUSTODY

NAME OF COURT WHICH ENTERED THE ORDER

LOCATION OF COURT (INCLUDE STREET ADDRESS, CITY, COUNTY, AND STATE)

HAVE YOUR FIREARM RIGHTS BEEN RESTORED BY A COURT?

IF YES, HAVE FIVE YEARS ELAPSED SINCE YOU WERE DISCHARGED FROM THE CUSTODY OF THE COMMISSIONER?

IF YES, PROVIDE SUPPORTING DOCUMENTATION.

HAVE YOU BEEN ACQUITTED BY REASON OF INSANITY, ADJUDICATED LEGALLY INCOMPETENT, MENTALLY INCAPACITATED OR ADJUDICATED AN INCAPACITATED PERSON BY A COURT OF VIRGINIA OR ANY OTHER COURT? 

DATE OF ADJUDICATION

NAME OF COURT WHICH ENTERED THE ORDER

LOCATION OF COURT (INCLUDE STREET ADDRESS, CITY, COUNTY, AND STATE)

HAS YOUR COMPETENCY OR CAPACITY HAS BEEN RESTORED BY A COURT?

IF YES, HAVE FIVE YEARS ELAPSED SINCE THE DATE OF RESTORATION?

HAVE YOU BEEN INVOLUNTARILY ADMITTED TO A FACILITY PURSUANT TO VA. CODE § 37.2-809 WHO LATER AGREED TO VOLUNTARY ADMISSION UNDER VA. CODE § 37.2-805?

DATE INVOLUNTARILY ADMITTED

DATE RELEASED FROM THIS ADMISSION

NAME OF COURT WHICH ENTERED THE ORDER

LOCATION OF COURT (INCLUDE STREET ADDRESS, CITY, COUNTY, AND STATE)

HAVE YOUR FIREARM RIGHTS BEEN RESTORED BY A COURT?

IF YES, HAVE FIVE YEARS ELAPSED SINCE YOU WERE RELEASED FROM COMMITMENT?

HAVE YOU BEEN ORDERED TO MANDATORY OUTPATIENT TREATMENT PURSUANT TO VA. CODE § 37.2-809 WHO LATER AGREED TO VOLUNTARY ADMISSION UNDER VA. CODE § 37.2-805?

DATE INVOLUNTARILY ADMITTED

DATE RELEASED FROM THIS ADMISSION

NAME OF COURT WHICH ENTERED THE ORDER

LOCATION OF COURT (INCLUDE STREET ADDRESS, CITY, COUNTY, AND STATE)

HAVE YOUR FIREARM RIGHTS BEEN RESTORED BY A COURT?

IF YES, HAVE FIVE YEARS ELAPSED SINCE YOU WERE RELEASED FROM COMMITMENT?

HAVE YOU BEEN THE SUBJECT OF A TEMPORARY DETENTION ORDER PURSUANT TO VA. CODE § 37.2-809 WHO LATER AGREED TO VOLUNTARY ADMISSION UNDER VA. CODE § 37.2-805?

DATE OF TEMPORARY DETENTION ORDER (TDO)

AFTER BEING SUBJECT TO A TEMPORARY DETENTION ORDER (TDO), DID YOU SUBSEQUENTLY AGREE TO VOLUNTARY ADMISSION PURSUANT TO VA CODE §37.2-805?

NAME OF COURT WHICH ENTERED THE ORDER

LOCATION OF COURT (INCLUDE STREET ADDRESS, CITY, COUNTY, AND STATE)

HAVE YOUR FIREARM RIGHTS BEEN RESTORED BY A COURT?

IF YES, HAVE FIVE YEARS ELAPSED SINCE YOU WERE RELEASED FROM COMMITMENT?

HAVE YOU RECEIVED MENTAL HEALTH TREATMENT OR SUBSTANCE ABUSE TREATMENT IN A RESIDENTIAL SETTING WITHIN THE FIVE YEARS PRIOR TO THE DATE OF THIS APPLICATION?

ARE YOU THE SUBJECT OF, OR NAMED AS A RESPONDENT IN A RESTRAINING ORDER, A PROTECTIVE ORDER, AN EMERGENCY SUBSTANTIAL RISK ORDER OR A SUBSTANTIAL RISK ORDER? AN ACTIVE RESTRAINING, PROTECTIVE ORDER, EMERGENCY SUBSTANTIAL RISK ORDER OR SUBSTANTIAL RISK ORDER MAY BE AN AUTOMATIC DISQUALIFIER IN VIRGINIA. SEE VA. CODE § 18.2-308.1:4, OR 18.2-308.1:6.

ARE YOU ADDICTED TO, OR AN UNLAWFUL USER OR DISTRIBUTOR OF MARIJUANA OR ANY CONTROLLED SUBSTANCE?

ARE YOU AN ALIEN NOT LAWFULLY ADMITTED FOR PERMANENT RESIDENCE IN THE UNITED STATES?

HAVE YOU BEEN DISCHARGED FROM THE ARMED FORCES OF THE UNITED STATES UNDER DISHONORABLE CONDITIONS?

ARE YOU A FUGITIVE FROM JUSTICE?

DO YOU HAVE ANY CRIMINAL CHARGE PENDING?

FAILURE TO ACKNOWLEDGE A PENDING CHARGE MAY BE CONSTRUED AS MAKING A MATERIALLY FALSE STATEMENT.

DESCRIBE THE PENDING CRIMINAL CHARGE AGAINST YOU

DATE OF CHARGE

LOCATION OF COURT (INCLUDE STREET ADDRESS, CITY, COUNTY, AND STATE)

CURRENT STATUS OF CHARGE

HAVE YOU, WITHIN THE THREE-YEAR PERIOD IMMEDIATELY PRECEDING THE DATE OF THIS APPLICATION, BEEN FOUND GUILTY OF ANY DRUG-RELATED CRIMINAL OFFENSE AS SET FORTH IN ARTICLE 1 (§ 18.2-247 ET SEQ.) OF CHAPTER 7 OF TITLE 18.2 OR OF A CRIMINAL OFFENSE FOR THE ILLEGAL POSSESSION OR DISTRIBUTION OF MARIJUANA OR ANY CONTROLLED SUBSTANCE UNDER THE LAWS OF VIRGINIA, ANY OTHER STATE, THE DISTRICT OF COLUMBIA, OR THEUNITED STATES OR ITS TERRITORIES

DESCRIBE THE CHARGE FOR WHICH YOU WERE CONVICTED

DATE OF CONVICTION

COUNTY, CITY AND STATE OF CHARGE

HAVE YOU RECEIVED A PARDON OR RESTORATION OF RIGHTS THAT INCLUDES YOUR FIREARM RIGHTS?

IF YES, PROVIDE SUPPORTING DOCUMENTATION.

HAVE YOU BEEN CONVICTED / ADJUDICATED OF AN OFFENSE AS A JUVENILE WHICH WOULD HAVE BEEN A FELONY IF COMMITTED BY AN ADULT?

IF YES, HAVE YOU COMPLETED A TERM OF SERVICE OF NO LESS THAN TWO YEARS IN THE ARMED FORCES OF THE UNITED STATES?  PROVIDE SUPPORTING DOCUMENTATION.

DID YOU RECEIVE AN HONORABLE DISCHARGE?

HAVE YOU, WITHIN THE THREE-YEAR PERIOD IMMEDIATELY PRECEDING THE DATE OF THIS APPLICATION, BEEN CHARGED WITH ANY OFFENSE ENUMERATED IN THIS PARAGRAPH AND THE TRIAL COURT FOUND THE FACTS OF THE CASE WERE SUFFICIENT FOR A FINDING OF GUILT AND DISPOSED OF THE CASE PURSUANT TO § 18.2-251 OR SUBSTANTIALITY SIMILAR LAW OF VIRGINIA, ANY OTHER STATE, THE DISTRICT OF COLUMBIA, OR THE UNITED STATES OR ITS TERRITORIES?

DESCRIBE THE PENDING CRIMINAL CHARGE AGAINST YOU

DATE OF CHARGE

LOCATION OF COURT (INCLUDE STREET ADDRESS, CITY, COUNTY, AND STATE)

CURRENT STATUS OF CHARGE

ARE YOU CURRENTLY ENROLLED INTO THE VIRGINIA VOLUNTARY DO NOT SELL FIREARMS LIST. ANY PERSON ENROLLED INTO THE VOLUNTARY DO NOT SELL FIREARMS LIST PURSUANT TO CHAPTER 12 (§ 52-50 et seq.) OF TITLE 52 IS PROHIBITED FROM PURCHASING, POSSESSING OR TRANSPORTING A FIREARM

HAVE YOU BEEN CONVICTED AS AN ADULT OR ADJUDICATED DELINQUENT AS A JUVENILE OF AN OFFENSE THAT OCCURRED ON OR AFTER JULY 1, 2021 OF A MISDEMEANOR ASSAULT & BATTERY ON A FAMILY OR HOUSEHOLD MEMBER PURSUANT TO § 18.2-308.1:8 OR ANY SUBSTANTIALLY SIMILAR LAW OF ANY OTHER JURISDICTION? FOR THE PURPOSES OF THIS SECTION “FAMILY OR HOUSEHOLD MEMBER” MEANS (I) A PERSON’S SPOUSE, (II) FORMER SPOUSE OR (III) AN INDIVIDUAL THAT SHARES A CHILD IN COMMON.  IF YES, COMPLETE FORM 1 PART B PAGE 2.

FAILURE TO ACKNOWLEDGE A PENDING CHARGE MAY BE CONSTRUED AS MAKING A MATERIALLY FALSE STATEMENT.

DESCRIBE THE CHARGE FOR WHICH YOU WERE CONVICTED

DATE OF CONVICTION

COUNTY, CITY AND STATE OF CHARGE

HAVE YOU RECEIVED A PARDON OR RESTORATION OF RIGHTS THAT INCLUDES YOUR FIREARM RIGHTS?

IF YES, PROVIDE SUPPORTING DOCUMENTATION.

HAVE YOU BEEN CONVICTED / ADJUDICATED OF AN OFFENSE AS A JUVENILE WHICH WOULD HAVE BEEN A FELONY IF COMMITTED BY AN ADULT?

IF YES, HAVE YOU COMPLETED A TERM OF SERVICE OF NO LESS THAN TWO YEARS IN THE ARMED FORCES OF THE UNITED STATES?  PROVIDE SUPPORTING DOCUMENTATION.

DID YOU RECEIVE AN HONORABLE DISCHARGE?

DO YOU CURRENTLY HAVE A VALID RESIDENT CONCEALED HANDGUN PERMIT ISSUED BY A VIRGINIA CIRCUIT COURT?

NAME OF THE CIRCUIT COURT WHICH ISSUED THE PERMIT

HAVE YOU ATTENDED AN IN-PERSON CLASS OR IN-PERSON TRAINING FOR PROOF OF HANDGUN COMPETENCY?


I, THE UNDERSIGNED, AFFIRM THAT THE INFORMATION CONTAINED IN THIS APPLICATION AND IN ANY ATTACHMENTS TO THIS DOCUMENT IS BOTH CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE. THE WILLFUL MAKING OF A FALSE STATEMENT IN THIS APPLICATION CONSTITUTES PERJURY AND IS PUNISHABLE IN ACCORDANCE WITH §18.2-434 OF THE CODE OF VIRGINIA. I ALSO AFFIRM AND UNDERSTAND THAT THE ISSUANCE OF A CONCEALED HANDGUN PERMIT DOES NOT NECESSARILY ENTITLE ME, THE UNDERSIGNED, TO POSSESS, TRANSPORT OR SELL A FIREARM UNDER STATE OR FEDERAL LAW.

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Please select an appointment below.  This is for presenting your ID and signing the application in our presence for that processing of the application.  You may come to the office at any time between 8:30am and 4:15pm, Monday to Friday, excluding holidays.



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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I, THE UNDERSIGNED, AFFIRM THAT THE INFORMATION CONTAINED IN THIS APPLICATION AND IN ANY ATTACHMENTS TO THIS DOCUMENT IS BOTH CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE. THE WILLFUL MAKING OF A FALSE STATEMENT IN THIS APPLICATION CONSTITUTES PERJURY AND IS PUNISHABLE IN ACCORDANCE WITH §18.2-434 OF THE CODE OF VIRGINIA. I ALSO AFFIRM AND UNDERSTAND THAT THE ISSUANCE OF A CONCEALED HANDGUN PERMIT DOES NOT NECESSARILY ENTITLE ME, THE UNDERSIGNED, TO POSSESS, TRANSPORT OR SELL A FIREARM UNDER STATE OR FEDERAL LAW.

Back To Previous Step

Please select an appointment below.  This is for presenting your ID and signing the application in our presence for that processing of the application.  You may come to the office at any time between 8:30am and 4:15pm, Monday to Friday, excluding holidays.



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


  • Your Appointment Choice Is:

None Selected

Please select an appointment below.  This is for presenting your ID and signing the application in our presence for that processing of the application.  You may come to the office at any time between 8:30am and 4:15pm, Monday to Friday, excluding holidays.



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


  • Your Appointment Choice Is:

None Selected