(a) The license application shall be in writing, under penalty of perjury, on a standard form adopted by the Illinois State Police and shall be accompanied by the documentation required in this Section and the applicable fee. Each application form shall include the following statement printed in bold type: “Warning: Entering false information on this form is punishable as perjury under Section 32-2 of the Criminal Code of 2012.”
     (b) The application shall contain the following:
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Terms Used In Illinois Compiled Statutes 430 ILCS 66/30

  • State: when applied to different parts of the United States, may be construed to include the District of Columbia and the several territories, and the words "United States" may be construed to include the said district and territories. See Illinois Compiled Statutes 5 ILCS 70/1.14

         (1) the applicant’s name, current address, date and
    
year of birth, place of birth, height, weight, hair color, eye color, maiden name or any other name the applicant has used or identified with, and any address where the applicant resided for more than 30 days within the 10 years preceding the date of the license application;
        (2) the applicant’s valid driver’s license number
    
or valid state identification card number;
        (3) a waiver of the applicant’s privacy and
    
confidentiality rights and privileges under all federal and state laws, including those limiting access to juvenile court, criminal justice, psychological, or psychiatric records or records relating to any institutionalization of the applicant, and an affirmative request that a person having custody of any of these records provide it or information concerning it to the Illinois State Police. The waiver only applies to records sought in connection with determining whether the applicant qualifies for a license to carry a concealed firearm under this Act, or whether the applicant remains in compliance with the Firearm Owners Identification Card Act;
        (4) an affirmation that the applicant possesses a
    
currently valid Firearm Owner’s Identification Card and card number if possessed or notice the applicant is applying for a Firearm Owner’s Identification Card in conjunction with the license application;
        (5) an affirmation that the applicant has not been
    
convicted or found guilty of:
            (A) a felony;
             (B) a misdemeanor involving the use or threat of
        
physical force or violence to any person within the 5 years preceding the date of the application; or
            (C) 2 or more violations related to driving while
        
under the influence of alcohol, other drug or drugs, intoxicating compound or compounds, or any combination thereof, within the 5 years preceding the date of the license application;
        (6) whether the applicant has failed a drug test for
    
a drug for which the applicant did not have a prescription, within the previous year, and if so, the provider of the test, the specific substance involved, and the date of the test;
        (7) written consent for the Illinois State Police to
    
review and use the applicant’s Illinois digital driver’s license or Illinois identification card photograph and signature;
        (8) unless submitted under subsection (a-25) of
    
Section 4 of the Firearm Owners Identification Card Act, a full set of fingerprints submitted to the Illinois State Police in electronic format, provided the Illinois State Police may accept an application submitted without a set of fingerprints, in which case the Illinois State Police shall be granted 30 days in addition to the 90 days provided under subsection (e) of Section 10 of this Act to issue or deny a license;
        (9) a head and shoulder color photograph in a size
    
specified by the Illinois State Police taken within the 30 days preceding the date of the license application; and
        (10) a photocopy of any certificates or other
    
evidence of compliance with the training requirements under this Act.
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