OFFICE OF THE

DUTCHESS COUNTY CLERK

BRADFORD KENDALL RECORDS DIVISION ANNE-MARIE DIGNAN
County Clerk 22 Market Street, 2nd Floor Deputy County Clerk
POUGHKEEPSIE, NY 12601
(845) 486-2125 MARIA BELL
WWW.DUTCHESSNY.GOV Record Room Supervisor

REQUEST FOR PISTOL PERMIT TRANSFER FROM DUTCHESS COUNTY

Date: ______________________

• Please print your name clearly: ____________________________________

• $5.00 U.S. check or money order payable to “Dutchess County Clerk”.

• $5.00 U.S. check or money order payable to _________________County.

(County where you are moving)

• Old address: _________________________________________________

(Street Address-not PO Box)
_________________________________________________

• New address: _________________________________________________

(Street Address-not PO Box)

__________________________________________________

• Pistol Permit number and date of issue: _______________________________

• Your Signature: ________________________________________________

(Required)

Return this form to: Dutchess County Clerk

County Office Building
22 Market Street
Poughkeepsie, New York 12601
Attn: Pistol Permits