AcroForm
firearms_initial.pdf
D7516159894A1D45AD871DF9BF03E316
Rev. January 2022 Page 1 of 8 BUSINESS, CONSUMER SERVICES AND HOUSING AGENCY • GAVIN NEWSOM, GOVERNOR DEPARTMENT OF CONSUMER AFFAIRS BUREAU OF SECURITY AND INVESTIGATIVE SERVICES P.O. Box 989002, West Sacramento, CA 95798-9002 P (916) 322-4000 | P (800) 952-5210 | F (916) 575-7290 | www.bsis.ca.gov FIREARMS PERMIT INITIAL APPLICATION NOTE: Read Fee Amount Due under Instructions carefully to help ensure payment of correct fee amount. An application received without full payment will not be processed and will be returned to the applicant. IMPORTANT: Read all instructions on Pages 5-8. An incomplete or incorrect application will delay processing. U.S. ARMED FORCES PRIORITY REQUESTS ☐ Check box if you have served, or are currently serving, in the U.S. Armed Forces. Disclosure is voluntary. If you check the box, submit proof of your military service (e.g. DD-214, DD-256, V-MET record, military orders, military I.D., etc.) with your application. ☐ Check box if you are a spouse or domestic partner of an active duty member of the U.S. Armed Forces assigned to a California duty station. Disclosure is voluntary. If you check the box, submit the following documentation with your application (You may be asked to provide original documents). • Certificate of marriage or domestic partnership or other legal union with an active duty member of the U.S. Armed Forces who is assigned to a duty station in this state under official active duty military orders. • Verification of current licensure as private security guard or security officer in another state, district, or territory of the U.S. REFUGEE, ASYLEE, OR SPECIAL IMMIGRANT VISA HOLDER APPLICANTS Business and Professions Code section 135.4 provides that the Bureau must expedite, and may assist, the initial licensure process for certain applicants described below. ☐ Check this box if any of the following statements apply to you: • You were admitted to the United States as a refugee pursuant to section 1157 of title 8 of the United States Code; • You were granted asylum by the Secretary of Homeland Security or the United States Attorney General pursuant to section 1158 of title 8 of the United States Code; or, • You have a special immigrant visa and were granted a status pursuant to section 1244 of Public Law 110- 181, Public Law 109-163, or section 602(b) of title VI of division F of Public Law 111-8, relating to Iraqi and Afghan translators/interpreters or those who worked for or on behalf of the United States government. Disclosure is voluntary. If you checked the box above you must attach evidence/documentation of your status as a refugee, asylee, or special immigrant visa holder. Failure to do so may result in application review delays. ACCEPTABLE EVIDENCE/DOCUMENTATION • Form I-94, Arrival/Departure Record, with an admission class code such as “RE” (Refugee) or “AY” (Asylee) or other information designating the person a refugee or asylee. • Special immigrant visa that includes the visa category of “SI” or “SQ.” • Permanent Resident Card (Form I-551), commonly known as a “Green Card,” with a category designation indicating that the person was admitted as a refugee or asylee. • An order from a court of competent jurisdiction or other documentary evidence that provides reasonable assurance that the applicant qualifies for expedited licensure. Pursuant to Business and Professions Code Section 115.4, beginning July 1, 2024, the bureau shall expedite the initial licensure process for an applicant who is an active duty member of the US Armed Forces and enrolled in the US Department of Defense SkillBridge program. Do you request expediting of your application under this authority? (If you select YES, you must attach documentation of enrollment to this application.)
Rev. January 2022 Page 2 of 8 THIS SECTION TO BE COMPLETED BY APPLICANT COMPLETE ELECTRONICALLY ON COMPUTER OR PRINT CLEARLY IF HANDWRITTEN Last Name First Name Middle Name Fee Amount (SEE INSTRUCTIONS) $ SSN/ITIN: Date of Birth: (MM, DD, YYYY) (SEE INSTRUCTIONS) Address of Record (Address, City, State, and Zip Code) MANDATORY (SEE INSTRUCTIONS) Confidential/Residence Address: (SEE INSTRUCTIONS) Telephone No.: Email Address: (Optional) (SEE INSTRUCTIONS) Provide the number and expiration date for the license(s) you hold or are applying for that you wish to have associated with your firearms permit. If you are currently applying for a license, write “applying” in the space provided for the license number. NOTE: You cannot associate a firearms permit with a Private Patrol Operator License organized as a corporation, or a Private Investigator or Alarm Company Operator License organized as a corporation or limited liability company (See Instructions). License Type License No. Exp. Date License Type License No. Exp. Date PI (Sole Owner/ Partners Only) Security Guard 2 PI (QM) 1 PPO (Sole Owner/ Partners Only) PPO (QM) 1 Alarm Agent Alarm Company (Sole Owner/ Partners Only) Alarm Company (QM) 1) Provide the number and expiration date of the license on which you serve as the qualified manager. 2) Read Firearms Assessment Information under General Information of Instructions if requesting to associate firearms permit with a security guard registration. Check if you are an ACTIVE DUTY PEACE OFFICER, as defined in Chapter 4.5, (commencing with section 830) of Title 3 of Part 2 of the Penal Code, or a federal qualified law enforcement officer, as defined in section 926B of Title 18 of the United States Code. If you are an active duty peace officer, as defined in Chapter 4.5, (commencing with section 830) of Title 3 of Part 2 of the Penal Code or a federal qualified law enforcement officer as defined in section 926B of Title 18 of the United States Code, you may be exempt from completing a BSIS firearms training course by providing proof of your peace officer status and proof of having completed a course of study in the use of firearms. (BPC 7583.22 and 7542). Verification of your active duty status can be satisfied by providing a legible copy of the front and back of your peace officer identification card. Acceptable proof of having completed a course of study in the use of firearms include a copy of your POST profile, a copy of your Basic/Specialized Basic POST course completion certificate, or a letter signed by your agency’s Range Master or Commanding Officer attesting to your completion of a firearms training course. NOTE: This exemption does not apply to applicants who are only associating the firearms permit to a license issued under the Alarm Company Act. See BSIS website for additional information at www.bsis.ca.gov.
Rev. January 2022 Page 3 of 8 IMPORTANT INFORMATION - READ CAREFULLY: I understand that a BSIS firearms permit authorizes me to carry an exposed (i.e. non-concealed) loaded firearm only of the caliber(s) listed on my permit card and only while performing the duties of the license associated with the permit. I also understand that a BSIS firearms permit does not authorize me to carry a concealed loaded firearm. Lastly, I understand that if I am a private patrol operator or alarm company operator licensee; a registered security guard or alarm agent, or a qualified manager for a private patrol operator or alarm company operator licensee, I can only wear or use an exposed firearm while on duty when in uniform. Mandatory Disclosure Language Submission of the requested information is mandatory. The Bureau of Security and Investigative Services (BSIS) of the Department of Consumer Affairs (Department) cannot process your Firearms Permit Initial Application unless all requested information is provided. Per the Information Practices Act, the Chief of the BSIS is responsible for maintaining the information in this application. You have the right to review the records maintained on you by the BSIS or Department unless the records are exempt from disclosure by section 1798.40 of the Civil Code. Your completed application becomes the property of the BSIS and will be used by authorized personnel to determine your eligibility for a license, registration or permit. Information on your application may be transferred to other governmental or law enforcement agencies, as permitted by law. Pursuant to the California Public Records Act (Gov. Code § 6250 et seq.) and the Information Practices Act (Civ. Code § 1798.61), the names and addresses of persons possessing a license, certificate, permit or registration may be disclosed by the BSIS unless otherwise specifically exempt from disclosure under the law. The BSIS makes every effort to protect the exempt personal information you provide us. The information you provide, however, may be disclosed in response to a court or administrative order, a subpoena, or a search warrant. Pursuant to Business and Professions Code section 30, providing your social security number is mandatory and will be used primarily for tax enforcement purposes and for compliance with any judgment or order for family support in accordance with section 17520 of the Family Code. Your social security number may also be used for verification of licensure or examination status for national examination where licensure is reciprocal with a requesting state. If you fail to provide your social security number, you will be reported to the Franchise Tax Board (FTB), which may assess a $100 penalty against you. Further, pursuant to section 30, subdivision (n) your social security number together with your name, date of birth, and license information may be shared with the Office of the Chancellor of the California Community Colleges. The State Board of Equalization (BOE) and the FTB may share taxpayer information with the BSIS. You are required to pay your state tax obligation. This application may be denied or your license may be suspended if the state tax obligation is not paid and your name appears on either the BOE or FTB certified list of top 500 tax delinquencies. For questions about this notice or access to your record, you may contact the BSIS by mail at Bureau of Security and Investigative Services, Attn: Public Records Liaison, P.O. Box 980550, Sacramento, CA 95798-0550; by phone at (800) 952-5210; or by e-mail at bsis@dca.ca.gov. For questions about the Department’s Privacy Policy, you may contact the Department of Consumer Affairs at 1625 North Market Boulevard, Sacramento, CA 95834, by phone at (800) 952-5210 or by e-mail at dca@dca.ca.gov. I DECLARE UNDER PENALTY OF PERJURY, UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT: • I personally completed this application; • To the best of my knowledge all statements on this application are true and correct; • I have completed the training requirements (i.e. range for each caliber, classroom and exam) to obtain a BSIS firearms permit or am an active duty peace officer who has successfully completed a firearms training course; • I am not presently subject to any State of California or Federal prohibition from owning or being in possession of a firearm; and • With full knowledge that all statements herein are subject to investigation and that any false, dishonest, or incomplete answer to any question on the application may be grounds for denial or subsequent revocation of my firearms permit and any other license(s) I hold, or may subject me to criminal prosecution. Applicant Signature Date
Rev. January 2022 Page 4 of 8 CERTIFICATION OF FIREARMS RANGE QUALIFICATION TRAINING THIS PAGE TO BE COMPLETED BY THE BSIS CERTIFIED FIREARMS INSTRUCTOR DO NOT RELEASE THE APPLICATION FORM to the applicant until you have completed all information required on this page. 1. Draw a line through and initial unused boxes in the Applicant Training Information Table below. 2. Do not provide corrected information. If you make an error, start a new form. Applicant Name ___________________________________________________________________________________ COMPLETE ELECTRONICALLY ON COMPUTER OR PRINT CLEARLY IF HANDWRITTEN Facility Name____________________________________________ Facility Phone #___________________________ Facility Address____________________________________________________________________________________ Facility Certificate # TFF____________________________ Expiration Date____________________________ Instructor Name____________________________________ Instructor Phone #_________________________ Instructor License # TIF_____________________________ Expiration Date___________________________ APPLICANT TRAINING INFORMATION All information below must be handwritten (print clearly) by the Firearms Training Instructor (See Instructions) TRAINING INFORMATION Date of Classroom Instruction Written Exam Date and Exam Score 1 Range Qualification Date 2 1. Applicant must pass Bureau-approved firearm training written exam with a score of 86% or greater. Indicate actual percentage score (See Instructions). 2. Completion of range qualification must be after completion of the classroom training and passage of the written exam, and must be completed within 30 days of the classroom instruction (B&P Code § 7585.6). QUALIFIED CALIBER(S) NOTE: The range qualifications (50 rounds for practice and 50 rounds for score) must be completed by firing live ammunition. The use of a firearms simulator to qualify for an initial firearms permit is prohibited. CITIZENSHIP OR PERMANENT RESIDENT VERIFICATION (See Instructions) Document Type: _______________________________________________________________________________ Expiration Date _______________________________________________________________________________ (Indicate expiration if passport, permanent resident or I-327 document is used) I declare under penalty of perjury, under the laws of the State of California, that I am the instructor who completed this page of the application and that to the best of my knowledge: • The information I provided on this page is true and correct. • The applicant completed a Powers to Arrest Training Course as prescribed by the Bureau. • The applicant completed the firearms classroom training as prescribed by the Bureau prior to range training, and the applicant passed the Bureau-approved written firearms exam with a score of 86 percent or more. • The applicant qualified with a minimum score of 80 percent on a course of fire, having fired live ammunition with the same caliber(s) of weapon as listed on this application. ________________________________________________________ ___________________________ Instructor Signature Date Signed
Rev. January 2022 Page 5 of 8 INSTRUCTIONS FOR COMPLETING FIREARMS PERMIT INITIAL APPLICATION Application Checklist 1. All sections of the Firearms Permit Initial Application must be completed with applicant and instructor signatures provided. The applicant must fill out the first two (2) pages of the application. Only the Firearms Instructor who completed the training is authorized to complete the Certification of Firearms Range Qualification Training (Page 3). 2. Fee Amount Due: The application fee for an initial Firearms Permit is $100.00. 3. Fee Payment: An application received without payment of the full fee amount owed (see Item 2) will not be processed and will be returned to the applicant. Make check payable to Bureau of Security and Investigative Services or BSIS. Do not submit cash by mail. Application fees are non-refundable. 4. Provide fingerprints by one of the following methods: • Live Scan: DO NOT LIVE SCAN UNTIL YOU HAVE SUBMITTED AN APPLICATION. Submit your fingerprints through a Department of Justice (DOJ) approved Live Scan Operator. Live Scan locations can be found at https://oag.ca.gov/fingerprints/locations. You will need to submit fingerprints with the firearms permit application even if you previously submitted fingerprints for a BSIS license you currently hold. If you are applying for both a qualifying BSIS license and a firearms permit, you may submit a combination Live Scan form. With a combination Live Scan form, you submit one set of fingerprints for the qualifying BSIS license and the firearms permit. However, the DOJ does not release the results for the qualifying license and the firearms permit until the FBI and DOJ criminal history responses AND the DOJ Bureau of Firearm response are all complete. Please visit the Bureau’s website further instructions and for a list of Live Scan forms: https://www.bsis.ca.gov/forms_pubs/livescan/index.shtml. After submitting your fingerprints, you check the status of your background check results by visiting https://applicantstatus.doj.ca.gov/. Please note, you will need to provide the ATI number located at the bottom of the Live Scan form and your date of birth to check on the status. IMPORTANT: Unless the DOJ system specifically states that the “California/FBI responses were sent to the agency,” the Bureau is still waiting for the results. • Hard Card Fingerprint Cards: If you are unable to submit fingerprints via a Live Scan operator or live outside of California and cannot access a Live Scan Operator in this State, you must submit two fingerprint hard cards. Instructions for completing and submitting fingerprint cards along with its processing time are posted on the Bureau’s website at: https://www.bsis.ca.gov/forms_pubs/livescan/index.shtml. 5. Mail your application, Hard Card Fingerprint Cards (if applicable), and check to: Bureau of Security and Investigative Services P.O. Box 989002 West Sacramento, CA 95798-9002 General Information 1. Firearms Assessment: A firearms permit applicant requesting to associate the permit to their security guard registration must take and pass an assessment for the purposes of determining if he/she possesses, at the time of the assessment, appropriate judgment, restraint, and self-control to carry a firearm while on duty (Business and Professions Code Sections 7583.23 and 7583.47). NOTE: IF REQUIRED TO TAKE THE ASSESSMENT, YOU MUST PASS THE ASSESSMENT PRIOR TO SUBMITTING YOUR APPLICATION TO THE BUREAU. IF YOU SUBMIT AN APPLICATION WITHOUT HAVING PASSED THE ASSESSMENT, YOUR APPLICATION WILL BE DEEMED DEFICIENT. THE COST OF THE ASSESSMENT IS $60.00 AND IS PAID DIRECTLY TO THE VENDOR ADMINISTERING THE ASSESSMENT. There are other situations when the association of a firearms permit to a security guard registration will require the requestor to take and pass the assessment. For information about when the assessment is and is not required, visit BSIS’ website: www.bsis.ca.gov/firearmsassessment. 2. Allow 60 days to process your application. DO NOT contact the Bureau to check on the status of your application unless it is over 60 days from date of submission. You will be notified in writing if your application is deficient.
Rev. January 2022 Page 6 of 8 3. Use the Firearms Permit Initial Application. An incorrect or outdated form is deficient and the completion of a new application on the correct form will be required. Current forms are available on the Bureau’s website at http://www.bsis.ca.gov in Forms and Publications under the Licensees tab. 4. The range qualifications (50 rounds for practice and 50 rounds for score) for an initial Firearms Permit must be completed by firing live ammunition; the use of a firearms simulator for range qualifications is prohibited. 5. Firearms Permit/Qualifying License Association Information: A BSIS firearms permit authorizes the permit holder to carry an exposed firearm while performing the duties of only those license types listed on the firearms permit itself. For example, a permit holder who only has a security guard registration listed on his/her firearms permit and who also holds a private investigator (PI) license cannot work armed while carrying out the duties of a PI licensee. The firearms permit card must list the private investigator license for the permitholder to work as an armed PI licensee. Applicant Information 1. The applicant must fill out the first two (2) pages of the application. Applicants are not permitted to complete ANY portion of the Certification of Firearms Range Qualification Training (Page 3). 2. Date of Birth: Due to a change in the law, firearms permit applicants must be at least 21 years of age (Business and Professions Code sections 7542.2, 7583.23, and 7596.3). 3. Email Address: While optional, providing an email address may expedite the Bureau’s communication with you if additional information is required to process this form. 4. Address Information: By law, an applicant is required to provide their residence address. The residence address can be designated as the Address of Record or the Confidential Address. Address of Record (AOR): This is the address that will appear on your permit and where the Bureau will mail your permit and any future correspondence relating to your permit. The AOR is also the address that will be disclosed in response to public records requests and/or public sales requests. If providing a Post Office Box or an address other than your residence address as your AOR, you must provide your residence address as a Confidential Address. Confidential/Residence Address: If AOR is not your residence address, you must provide your residence address. 5. Type(s) of License Currently Held – Complete requested information for each license type you hold or are applying for that you wish to have associated with your firearms permit. The application will not be processed unless you are applying for and have been approved or currently hold a valid license as a private investigator (PI), private patrol operator (PPO), or alarm company operator (ACO); you are a qualified manager associated with a valid PPO or PI licensee; you possess a valid certificate as an alarm company operator qualified manager; or possess a valid registration as a security guard or alarm agent. NOTE: You can only carry a firearm while performing the duties of the license associated with the firearms permit. Also, officers of a PPO or PI licensee organized as a corporation, or members, managers, or officers of a PI licensee organized as limited liability company (LLC) are not a licensee; they are agents of the licensed corporation or LLC. Officers, managers or managing members who wish to hold a firearms permit must themselves hold a qualifying license. Instructor Information 1. Only the Bureau-certified Firearms Training Instructor who provided the training to the applicant is permitted to complete the Certification of Firearms Range Qualification Training (Page 3). 2. Caliber Boxes – Draw a line through unused caliber boxes in the Applicant Training Information Table to prevent the addition of information after you have signed and released the form. 3. Do not make revisions to the form. If you need to change information, start a new form. The Bureau has no way of knowing if the change was made by the instructor or someone else. 4. Citizenship or Permanent Resident Verification -- Provide specific information regarding the document presented by the applicant. For example, if a passport is provided, indicate the country of issuance (e.g., U.S. Passport, Canadian Passport, etc.). Also, “Citizenship Certificate” is not an actual document issued by the U.S. government. Indicate the specific title for the document (e.g., U.S. Citizen Identification Card, Certificate of United States Citizenship, Certificate of Naturalization). Indicating a general document title is a deficiency and will delay the processing of the application. See Attachment I of Firearms Training Manual for acceptable documents to verify citizenship/residency and the corresponding title of each document.
Rev. January 2022 Page 7 of 8 5. Written Firearms Exam Scoring Instructions – The BSIS Firearms Training Written Examination is worth 52 points. There are 50 written questions worth one-point each plus two handgun diagrams with each diagram worth one-point each. The applicant must correctly label each part of a handgun diagram to receive the one- point credit for that diagram. If one item is incorrectly labeled, the applicant does not get a point for the diagram. To pass the exam, the applicant must obtain a score of 86% or higher. An 86% score equals 45 correct responses. To determine an applicant’s percentage score, divide the total number of correct responses by 52. 6. Due to changes in the law and Bureau operations, this application is periodically updated. Please routinely check the Bureau’s website so that you are using the most current version. Important Information Once Firearms Permit is Issued 1. Address Change: You must notify the Bureau of any change in your address of record or residence address within 30 days from the date of change. Failure to provide timely notice may result in the issuance of fine. An address change may be completed online via BreEZe if you have a BreEZe account, or via an Address Change (Personal) form. The form may be emailed to bsis@dca.ca.gov or mailed to Bureau of Security and Investigative Services, P.O. Box 989002, West Sacramento, CA 95798-9002. See Item 3 under Applicant Information for address requirements. 2. Proof of Permit Issuance: Holders of a firearms permit associated with a Security Guard registration may work with a print out of the approved permit from the Department of Consumer Affairs’ License Search website at www.search.dca.ca.gov along with a valid picture ID while waiting to receive the hardcopy permit in the mail. Important Information for Renewing a Firearms Permit 1. A renewal reminder will be mailed to your address of record approximately 90 days prior to your firearms permit’s expiration. Please note that the reminder is not a firearms permit renewal application. 2. Renew timely – By law, the renewal application must be submitted at least 60 days prior to expiration, and a firearms permit cannot be renewed after expiration. Failing to submit your application at least 60 days before expiration may result in your firearms permit not being renewed before expiration of the current permit’s term. NOTE: Applications received more than 90 days before expiration will be returned. IMPORTANT: A firearms permit cannot be renewed after expiration. If a complete renewal application is not received by the expiration of your current permit, you will need to apply for a new initial firearms permit. (BPC 7542, 7583.32 & 7596.7). 3. Range Qualification Requirement - To renew a firearms permit, the permitholder must have completed four range qualifications as follows: two (2) range qualifications during each 12-month period of the current permit’s two-year term with no two (2) range qualifications completed closer than four (4) months apart. Also, only one qualification in each twelve-month period may be completed by firearm simulator, and only a simulator that complies with the requirements listed below may be used for a qualification. NOTE: Failing to adhere to the required qualification schedule and/or firearm simulator use limitation will result in the permitholder being ineligible for renewal and the need to apply for a new initial firearms permit. See suggested range qualification schedule below. Firearm Simulator Requirement: The firearm simulator MUST meet all the following requirements: (1) Provide a realistic imitation of the operation of an actual firearm including the weight, recoil, action, flash, and sound of a firearm at discharge, (2) Have the ability to match the caliber of the actual firearm the individual is qualifying to carry, and (3) Simulate the loading and reloading of an actual firearm. (Title 16, Division 7, Section 631 of CA Code of Regulations). 4. Range Qualifications - As each range qualification is separate, you may complete each one with a single Bureau-certified firearms instructor and firearms training facility or with multiple instructors and facilities. 5. Two-Hour Training Course Requirement: Prior to each of the four (4) Range Qualifications, applicant must have completed the training course on use of force and de-escalation of the use of force. (Title 16, Division 7, Section 633 of the California Code of Regulations)
Rev. January 2022 Page 8 of 8 6. Written Firearms Examination Requirement: A condition for renewal is the applicant passing the written Firearms Examination in the BSIS Firearms Training Manual with a score of 86% or greater. The law does not specify during which qualification the applicant must complete the written exam. The Bureau recommends the applicant take it in the second 12-month period of the current permit term. 7. For additional information regarding firearms permit renewals, see the Bureau’s Firearms Permit Renewal Application Form and the Bureau’s website at www.bsis.ca.gov. Suggested Range Qualification Schedule As a courtesy, the table below provides suggested range qualification schedules for renewal of a firearms permit. Adherence is not a mandatory provision for renewal, but a suggestion by the Bureau of typical schedules that satisfy the requirements for renewal and allow for timely renewal of the permit. To use the table, first check the expiration date on your firearms permit, find your permit’s expiration month on the table, and follow the schedule detailed in the row. Each schedule provides sufficient time to submit your firearms permit renewal application at least 60 days before expiration, as required by law. Expiration Month First Range Qualification Second Range Qualification Third Range Qualification Fourth Range Qualification January May-June October-November April-May September-October February June-July November-December May-June October-November March July-August December-January June-July November-December April August-September January-February July-August December-January May September-October February-March August-September January-February June October-November March-April September-October February-March July November-December April-May October-November March-April August December-January May-June November-December April-May September January-February June-July December-January May-June October February-March July-August January-February June-July November March-April August-September February-March July-August December April-May September-October March-April August-September