Reference Questionnaire (For License To Carry Concealed Deadly Weapon) Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Reference Questionnaire (For License To Carry Concealed Deadly Weapon) Form. This is a Delaware form and can be use in Superior Court Statewide.
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Tags: Reference Questionnaire (For License To Carry Concealed Deadly Weapon), Delaware Statewide, Superior Court
SUPERIOR COURT OF THE STATE OF DELAWARE
REFERENCE QUESTIONNAIRE
APPLICANT’S NAME ____________________________ DATE OF BIRTH ____________
APPLICANT’S ADDRESS ___________________________________________________
Street
_______________________________________________________________________
City
County
State
Zip Code
REFERENCE MAY NOT BE RELATED TO APPLICANT
ATTENTION REFERENCE:
The above individual has applied to the State of Delaware for a license to ca rry a concea led deadly weapon.
The applicant is required to furnish five (5) references from resp ectable citizens of the county in which such
applicant resides. Your background knowledge of this individual is essential to our investigation. The
application cannot be app roved withou t this com pleted questionnaire. Please fill out this que stionnaire
com pletely by answering every question, to the best of your ability. If your answer requires an explanation,
use the additional space provided. RETURN THE REFERE NCE TO THE APPLICANT FOR FILING WITH THE
COMPLETED APPLICATION.
REFERENCE’S NAME ____________________________ DATE OF BIRTH _____________
DAYTIME PHONE ____________________
CELL PHONE____________________
REFERENCE’S ADDRESS ___________________________________________________
Street
_______________________________________________________________________
City
County
State
Zip Code
1.
How long have you known the applicant?
2.
Has the applicant ever exhibited a propensity for violence which may reasonably
render applicant’s possession of a handgun a danger to applicant or other law
abiding citizens? Yes
No
If yes, explain
3.
Do you know of any reason why the applicant should not be given a license to
carry a concealed deadly weapon? Yes
No
If yes, explain
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4.
Are you aware of the reason why this applicant has applied for a license to carry
a concealed deadly weapon? Yes
No
If yes, explain
_____
(Additional Space)_
I DO HEREBY DECLARE AND AFFIRM UNDER THE PENALTIES OF PERJURY THAT
THE CONTENTS OF THE FOREGOING REFERENCE ARE TRUE AND CORRECT TO THE BEST
OF MY KNOWLEDGE, INFORMATION, AND BELIEF, AND I SO INDICATE BY SIGNING
BELOW IN THE DESIGNATED SPACE.
Signature
Revised 1/10
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