The information below must be completed to verify whether you are prohibited by Federal or State law to possess or carry a firearm. Please complete this section in its entirety. If you answer yes to any question, you may enter a brief explanation in the comments field below or upload supporting documentation. If you have a conviction and your firearms eligibility has been restored, please provide supporting documentation. For additional information pertaining to firearms eligibility please review Virginia Code §18.2-309 et seq. and 18 U.S.C. § 922 of the Federal Gun Control Act.

Please answer each question.

1.	Have you ever been convicted of an offense as a juvenile that would prohibit you from possessing or carrying a firearm?	No Yes *
2.	Since issuance of your last license, have you been adjudicated mentally defective (which includes a determination by a court, board, commission, or other lawful authority that you are a danger to yourself or to others or are incompetent to manage your own affairs) OR have you ever been committed to a mental institution?	No Yes *
3.	Since issuance of your last license, 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?	No Yes *
4.	Since issuance of your last license, have you been involuntarily admitted to a facility or ordered to mandatory outpatient treatment by any court, board, commission, or other lawful authority?	No Yes *
5.	Are you an alien NOT lawfully admitted for permanent residence in the United States?	No Yes *
6.	Since issuance of your last license, have you been discharged from the Armed Forces of the United States under "Dishonorable Conditions"?	No Yes *
7.	Are you a fugitive from justice?	No Yes *

*Indicates required field.