Arizona Department of Public Safety Online CCW Application

Applicant Information:

Last Name: ^{(official ID)}

First Name:

Middle Name:

Maiden Name:

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

SSN:

SSN: ^(confirm)

Expiration Date Information:

Expiration Date:

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

Previous Last Name	Previous First Name	Previous Middle Name

Information Related To Your Birth:

Date of Birth:

Current Age:

Birth City:

Birth State:

Birth Country:

Height:

^feet ^inches

Weight:

Hair Color:

Eye Color:

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

^Primary:

^Work:

^{Mobile Phone:}

^Fax:

Updates via text message?

Yes No

Qualification Date:

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)}

Country:

^{Mailing Address Different:}

Yes No

State : ^(region)

City:

Zip Code: ^{(postal code)}

Address Line 1:

Address Line 2:

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

Country:

State : ^(region)

City:

Zip Code: ^{(postal code)}

Address Line 1:

Address Line 2:

Attach Documentation: please upload the required 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.

The LEOSA form completed by a qualified instructor - https://www.azdps.gov/sites/default/files/media/LEOSA_Application.pdf (REQUIRED for NEW and RENEWAL)
A photocopy of your photographic law enforcement identification credentials. (REQUIRED for NEW)
A letter from the agency with which you were employed that verified your employment status and that you meet the requirements of a qualified retired law enforcement officer listed below. (REQUIRED for NEW)
- The letter must:
  - Be on the agency’s letterhead.
  - Include your name, employee badge number, rank, and dates of employment.
  - Attest that the applicant meets the requirement of a qualified retired law enforcement officer.
  - Attest that the applicant has been issued a photographic law enforcement identification card.
  - Include the name, title, identification number, and contact phone number of an individual at the agencywho can verify employment information.

Uploaded Files:

I am requesting a REPLACEMENT and do not have a required upload.

Add files...

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

Select Purchase Option:

LEOSA LEOSA - RENEWAL LEOSA - REPLACEMENT LEOSA - REPLACEMENT - Within 60 days of issuance

Total Fee:

$0

Your Initials:

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

← prior month
← prior week

first available →
next week →
next month→

None Selected

I attest under penalty of perjury that all statements made on this application are true.

I further attest that I have reviewed and am knowledgeable of Arizona Revised Statutes, Title 13, Chapters 4 and 31.

By signing the application, you are agreeing to the Privacy Act. Please CLICK HERE to view.

Coupon Code:

Your Initials:

Back To Previous Step

Arizona Department of Public Safety

LEOSA Application
Please Enter All Information

Please read the following before proceeding:

Applicant Information:

Expiration Date Information:

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

Information Related To Your Birth:

Demographic Information:

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

Qualification Date:

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: please upload the required documentation.

Uploaded Files:

Select Purchase Option:

Total Fee:

$0

Survey Questions:

Select Appropriate Immigrant Classification: ^{(only choose one)}

Which of the following exceptions set forth in 18Z USC 922(y) do you meet?:

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:

LEOSA Application Please Enter All Information

Add An Address

Please read the following before proceeding:

Applicant Information:

Expiration Date Information:

Previous Aliases: (please list all previous aliases)

Information Related To Your Birth:

Demographic Information:

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

Qualification Date:

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: please upload the required documentation.

Uploaded Files:

Select Purchase Option:

Total Fee:

$0

Survey Questions:

Select Appropriate Immigrant Classification: (only choose one)

Which of the following exceptions set forth in 18Z USC 922(y) do you meet?:

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.

Additional Information Required

Error processing application

Donations cant be taken with cash

LEOSA Application
Please Enter All Information

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

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)}

Select Appropriate Immigrant Classification: ^{(only choose one)}

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