Instructions for Pistol Permit Applicants. If you have any questions call
|
|
|
- Walter Young
- 10 years ago
- Views:
Transcription
1 Instructions for Pistol Permit Applicants. If you have any questions call Description of forms in this Packet: Form PPS-19: This form is a checklist of all the documents you will need to provide to the Pistol Permit Unit at the Sheriff s Office on the day of your interview. This checklist should be turned in at the time of your interview. Your interview will follow your fingerprinting and a preliminary background investigation. Your interview will be scheduled by an investigator at the Pistol Permit Unit of the Orange County Sheriff s Office. Form PPS-05: This form is titled Pistol Permit Pedigree Sheet. Complete the form as indicated. Form PPS-15: This form is titled Arrest Affidavit. Complete this form as indicated. An investigation will take place to verify the information you provide as truthful and accurate. If you have ever been arrested you should begin contacting the respective courts because an original copy of the disposition is required. Form PPS-06: This form is titled Additional Arrests. This form is for your use in the event that you have more than two (2) arrests to document. On your application that you will receive at fingerprinting, there is space to document two (2) arrests. Form PPS-25: This form is titled Notice to Pistol Permit Applicants. This is simply a notification that you the applicant have sixty days from the date you are fingerprinted to turn in all necessary documentation along with your completed application. If you do not return your paperwork in a timely manner, your fingerprints will need to be redone and you will incur an additional fingerprinting fee. Form PPS-16: This form is titled Pistol Permit Background Investigation Character Reference Questionnaire. You are required to provide four (4) character references along with your pistol permit application. Print four (4) copies of this form. Your references must complete this form, appear before a notary swearing that the content is truthful and accurate, and sign the form in the presence of the notary. Your references must meet the following criteria: Must live in Orange County Cannot be related to you or to each other (not even by marriage) Cannot live in the same household NYS Firearms License Request for Public Records Exemption: This form is a state form and is optional for you to complete. You must complete this form if you wish for your information concerning your firearms license application and/or your firearms license to not be a public record.
2 Call (845) to schedule an appointment for fingerprinting. The following pages are a guide to completing the application you receive at your fingerprinting. The day you are fingerprinted you will be given two original applications, they will have your photo on the front and your fingerprints on the back. These (2) originals must be returned with the four (4) reference sheets. Keep these instructions as a guide for completing your original applications which you will receive at fingerprinting. Front of Application 1. Fill in: Employed by: Nature of Business: Business Address: Check Carry Concealed License is required for the following reason; (Enter the reasons you are requesting a permit. If you are requesting an unrestricted permit, you will state unrestricted here. You must write a separate letter requesting an unrestricted permit.) 2. SUPPLY FOUR CHARACTER REFERENCES There are four lines for references on the front of your application Your references must live in Orange County. They cannot be related to you or each other. (Not even by marriage) They cannot live in the same household. Each of your four references completes the reference sheet (Form PPS-16), goes before a notary, swears to the content and signs in front of the notary. (The SS on the reference stands for sworn statement, not social security number) After the reference sheets are returned to you, your references need to write their name and address on both of your applications under the reference section and sign. 3. Arrest Information IMPORTANT: You must disclose ALL arrests including juvenile, youthful offender and/or sealed. Have you been arrested? If No, Check and Initial by No Have you been arrested? If Yes, Check and Initial by Yes and see additional instructions below. Applicants with Arrests: List first two arrests on your application. Third or more on additional arrest form. Original Certificate of Disposition from the Court of jurisdiction, must be unsealed!! Letter of Explanation: In own words, a summary of what lead to your arrest. Submit one Court Disposition and one Letter of Explanation for each arrest. 4. Bring both of your applications to a Notary and swear to the answers of the six questions. The notary will fill out the bottom section and you will sign under your photo. Any YES answers must be explained on the last two lines or on a separate sheet of paper and signed. For clarification Jurat means truthfully signing in the presence of a Notary.
3 Back of Application: 5. On the rear of both of your applications make sure you signed after your address after US. 6. Enter your gun Information: Manufacturer, Pistol or Rev, Serial number, Model, Property of (see below); Enter the first five guns on the rear of both applications. Enter additional guns on additional gun sheet Note: If you purchased a gun from a gun store it is still property of that gun store. If you re an active Police Officer it is your property. If you are Co-Sharing guns it is the property of the person giving you the authority to co-share. If you are sharing a gun you must obtain a notarized letter from the owner stating he/she is allowing you to share and describing the guns he/she is sharing with you. A legible copy front and back of their pistol permit showing the guns listed must also be submitted. 7. Refer to your Pistol Permit Application Checklist for Other Documents to Return Including: Original Gun Safety Course: Must Meet NRA, NYS or FBI Standards DD214 for military. Good for ten years, MUST SHOW PROFICIENCY WITH A PISTOL. Your Arrest Affidavit: completed (answer question after question mark yes or no) and notarized. Two (2) utility bills with your name and address. (The bills must be from your Electric, Gas, Water, Phone or Cell phone bill). If no bills are addressed to you at your residence, you must provide the name of the billed party. That individual must furnish two bills along with a notarized letter stating that you are a resident of their household. Return two (2) self addressed letter sized envelopes with stamps attached. No return address. Active/Retired Police and Corrections: Good Guy Letter, Voucher (PETS). Letter to the Judge requesting unrestricted full carry. **Return your application with all documents between the hours of 1:00pm to 3:00 pm on Monday thru Saturday, 9am to 1pm on Wednesday. ** X
4 PISTOL PERMIT APPLICATION CHECKLIST Name: D.O.B. SO: Please advise applicants to bring the following documents to the interview: Computer printed turn by turn directions from OC Sheriff s Office using starting address at 110 Wells Farm Road to their residence (if no computer available, you may hand write turn by turn directions). 2 utility Bills with Applicant s Name and Address Valid New York State Driver s License Original & copy of Gun Safety Certificate Information on ALL firearms that are going to be put on their permit including the Caliber, Make, Model, Serial Number, Etc., and the Gun store Receipt or Voucher Certified copy of Court Dispositions for ALL prior arrests A letter describing the circumstances of all prior arrests Original & copy of the their Good Guy letter (Police & Peace Officers) A letter to the Judge {To Whom It May Concern} requesting an Unrestricted Full Carry permit Valid Identification card (Police & Peace Officers) Two (2) self addressed & stamped envelopes Arrest Affidavit Must be Submitted by all Applicants. Return your application with all documents between the hours of 2:00pm to 6:00 pm on Monday Tuesday, Thursday and Friday. Wednesday 9am to 12 noon. PPS 19 rev. 08/07/2014
5 PISTOL PERMIT PEDIGREE SHEET Print or Type in BLACK Ink Only Name: Last First Middle Date of Birth: Social Security Number: Sex: Residence Address: (Street number, street name, bldg. number, apartment number) (City, State, Zip Code) Business/Employer Name: Business/Employer Address: (Street number, street name, bldg. number, apartment number) (City, State, Zip Code) Local Police Dept.: Work Police Dept.: Home Phone: Work Phone: Cell Phone: Address: Race: Hispanic: Non Hispanic: Height: Eyes: Weight: Hair: Drivers License Number: State: For office use: Date: Livescan Number: PPS 05 rev. 08/13/2014
6 ARREST AFFIDAVIT Your pistol license application specifically states: Have you ever been arrested or indicted anywhere for any offense, including D.W.I. (Except Traffic Infractions)? You MUST state any and all, including sealed arrests regardless of whether or not you were convicted. IMPORTANT: You must disclose all arrests including juvenile, youthful offender and/or sealed. An investigation will take place to verify the information provided. You MUST also provide any and all police interactions during your application process. You will provide this information in writing within five (5) business days of any police interaction. ANY OMISSION OF FACT OR ANY FALSE STATEMENT WILL BE SUFFICIENT CAUSE TO DENY THIS APPLICATION AND CONSTITUTES A CRIME PUNISHABLE BY FINE, IMPRISONMENT OR BOTH. Any false statements made herein is a class A misdemeanor pursuant to section of the New York State Penal Law. Please print the following information: Full Name: Physical Address: LOCATION CITY STATE ZIP CODE Mailing Address: (if different) LOCATION CITY STATE ZIP CODE Contact Phone ( ) ( ) ( ) (Numbers) HOME WORK CELLULAR Applicant s Signature Signed and sworn to before me this day of, 20 Notary Public PPS-15 rev. 08/07/2014
7 Additional Arrests Print or Type in Black Ink Only Date Police Agency Charge(s) Disposition- Court and Date PPS-06 rev.08/07/2014
8 Notice to Pistol Permit Applicants: YOU HAVE 60 DAYS TO RETURN THE APPLICATION TO THE SHERIFF S OFFICE AFTER YOU ARE FINGERPRINTED. NEW FINGERPRINTS MUST BE TAKEN FOR YOUR PERMIT IF THE PAPERWORK IS NOT RETURNED WITHIN 60 DAYS. YOU WILL HAVE TO PAY ANOTHER FINGERPRINTING FEE AND THIS CAN ONLY BE DONE AT THE ORANGE COUNTY SHERIFF S OFFICE. Signature Acknowledging the Above Date Investigator Name Shield # When you return your paperwork you will have the investigator sign below. This is your receipt of when and to whom you submitted your paperwork. Submitted to Investigator: Shield #: Date PPS-25 rev. 08/07/2014
9 PISTOL PERMIT BACKGROUND INVESTIGATION CHARACTER REFERENCE QUESTIONNAIRE Name DOB: Date: Physical Address Mailing Address Daytime phone Evening phone In regards to the pistol license application of 1. How long have you known the applicant? 2. Is applicant related to you? 3. To your knowledge has the applicant ever engaged in illegal activity? 4. To your knowledge is the legal residence of the applicant in Orange County? 5. In your opinion, do you believe the applicant to be of good moral character? Remarks, if any: NOTICE: ANY FALSE STATEMENTS THAT ARE MADE IN THIS DOCUMENT ARE PUNISHABLE AS A CLASS A MISDEMEANOR PURSUANT TO SECTION OF THE PENAL LAW. PRINT NAME SIGNATURE STATE OF NEW YORK : : SS: COUNTY OF : On the day of 20 before me personally came To me known, or provided to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he executed the same in his capacity, and that by his signature on the instrument, the individual, or the person upon behalf of which the individual acted, executed the instrument. NOTARY PUBLIC PPS-16 rev. 08/08/2014
10 NYS Firearms License Request for Public Records Exemption Pursuant to section (5) (b) of the NYS Penal Law I am: [ ] an applicant for a firearms license [ ] currently licensed to possess a firearm in NYS Name Date of Birth Address City State Firearms License # (if applicable) Date Issued Licensing Authority / County of Issuance or Application I hereby request that any information concerning my firearms license application or firearms license not be a public record. The grounds for which I believe my information should NOT be publicly disclosed are as follows: (check all that are applicable) [ ] 1. My life or safety may be endangered by disclosure because: [ ] A. I am an active or retired police officer, peace officer, probation officer, parole officer, or corrections officer; [ ] B. I am a protected person under a currently valid order of protection; [ ] C I am or was a witness in a criminal proceeding involving a criminal charge; [ ] D. I am participating or previously participated as a juror in a criminal proceeding, or am or was a member of a grand jury; [ ] 2. My life or safety or that of my spouse, domestic partner or household member may be endangered by disclosure for some other reason explained below: (Must be explained in item 5 below) [ ] 3. I am a spouse, domestic partner or household member of a person identified in A, B, C or D of question 1. (Please check any that apply) A B C D [ ] 4. I have reason to believe that I may be subject to unwarranted harassment upon disclosure. 5. (Please provide any additional supportive information as necessary) I understand that false statements made herein are punishable as a class A misdemeanor. I further understand that upon discovery that I knowingly provided any false information, I may be subject to criminal penalties and that this request for an exemption shall become null and void. Signature Date
Office of the Sheriff
Office of the Sheriff Pistol Permit Applications Guidelines Permit must be completed neatly and filled out prior to turning it in for processing. Any application that is not completed neatly will be rejected
Quincy Police Department One Sea Street Quincy, MA 02169 (617) 479-1212 TTY: (617) 376-1375
PAUL KEENAN CHIEF OF POLICE Quincy Police Department One Sea Street Quincy, MA 02169 (617) 479-1212 TTY: (617) 376-1375 Please complete the attached Firearms Application. All questions must be answered
Private Protective Services - Contract Security Company Application, Page 1
Private Protective Services - Contract Security Company Application, Page 1 STATE OF TENNESSEE DEPARTMENT OF COMMERCE & INSURANCE DIVISION OF REGULATORY BOARDS PRIVATE PROTECTIVE SERVICES 500 JAMES ROBERTSON
BAIL BOND LICENSE APPLICATION FOR CORPORATE SURETY OF:
BAIL BOND LICENSE APPLICATION FOR CORPORATE SURETY OF: DATE SUBMITTED: FOR CONSIDERATION BY THE DALLAS COUNTY BAIL BOND BOARD ** please provide one original and one redacted copy ** DALLAS COUNTY BAIL
Criminal Justice Selection Center
Send all mail to: Gulf Coast Criminal Justice Selection Center http://www.gulfcoast.edu/north_bay/selection Our physical location: Criminal Justice Selection Center North Bay Campus, Abbott Building 5230
Note: We do not buy out Law Enforcement Contracts.
Sheriff s Office Applicants Re: Application Process In order to speed your application process, only submit your application after you have obtained all of the following information: Complete an application
Memphis Police Department Police Officer Application Packet
Memphis Police Department Police Officer Application Packet MINIMUM REQUIREMENTS 54 Semester Hours at an Accredited College or University or Two years of continuous Military Service with an honorable discharge
*****THIS FORM IS NOT A PROTECTIVE ORDER APPLICATION OR A PROTECTIVE ORDER*****
SHAREN WILSON CRIMINAL DISTRICT ATTORNEY OF TARRANT COUNTY, TEXAS PROTECTIVE ORDER UNIT Family Law Center Phone Number 817-884-1623 200 East Weatherford Street # 3040 Fax Number 817-212-7393 Fort Worth,
GEORGIA BOARD OF PHARMACY 2 Peachtree Street, N.W. 36 th Floor Atlanta, Georgia 30303
GEORGIA BOARD OF PHARMACY 2 Peachtree Street, N.W. 36 th Floor Atlanta, Georgia 30303 PHARMACY TECHNICIAN INFORMATION SHEET AND CHECKLIST In accordance with O.C.G.A. 26-4-28, the Georgia Board of Pharmacy
Monroe County Pistol Permit Department Office Information & Frequently Asked Questions Directory
Page 1 Monroe County Pistol Permit Department Office Information & Frequently Asked Questions Directory Office Information.............................................................. 2 Applying for a
*****THIS FORM IS NOT A PROTECTIVE ORDER APPLICATION OR A PROTECTIVE ORDER*****
SHAREN WILSON CRIMINAL DISTRICT ATTORNEY OF TARRANT COUNTY, TEXAS PROTECTIVE ORDERS Family Law Center Phone Number 817-884-1623 200 East Weatherford Street # 3040 Fax Number 817-212-7393 Fort Worth, Texas
Certified Process Server APPLICANT CHECKLIST
Certified Process Server APPLICANT CHECKLIST THE TWENTIETH JUDICIAL CIRCUIT OF FLORIDA The Twentieth Judicial Circuit Court is implementing a few changes to the requirements to qualify for certification.
GEORGIA PEACE OFFICER STANDARDS AND TRAINING COUNCIL APPLICATION FOR POLICE CHAPLAIN CERTIFICATION
GEORGIA PEACE OFFICER STANDARDS AND TRAINING COUNCIL APPLICATION FOR POLICE CHAPLAIN CERTIFICATION Return to: GEORGIA PEACE OFFICER STANDARDS AND TRAINING COUNCIL P.O. Box 349 Clarkdale, Georgia 30111
2. Present residence address no. street town state zip code. Mailing address, only if mail delivery is not available to residence address
Form # A-1 (Rev. 11/12/09) Notary Public Unit Office of the Secretary of the State State of Connecticut PO Box 150470 Hartford, CT 06115-0470 FOR OFFICE USE ONLY Trans. # Acct. # Date of Appt. APPLICATION
Brazos County Precinct 3 Volunteer Fire Department P.O. Box 5453 Bryan, TX 77805 www.pct3vfd.com Fighting Fires and Saving Lives, Since 1977
Brazos County Precinct 3 Volunteer Fire Department P.O. Box 5453 Bryan, TX 77805 www.pct3vfd.com Fighting Fires and Saving Lives, Since 1977 Dear Applicant: Thank you for your interest in becoming a member
Department of Police SOUTHINGTON, CONNECTICUT 06489
Department of Police SOUTHINGTON, CONNECTICUT 06489 Chief John F. Daly 69 Lazy Lane Southington, Connecticut 06489 HEADQUARTERS: TEL (860) 378-1600 FAX (860) 378-1605 ABOUT THE SOUTHINGTON POLICE DEPARTMENT
LAS VEGAS METROPOLITAN POLICE DEPARTMENT APPLICATION FOR CONCEALED FIREARM PERMIT GENERAL INFORMATION AND INSTRUCTIONS
LAS VEGAS METROPOLITAN POLICE DEPARTMENT APPLICATION FOR CONCEALED FIREARM PERMIT GENERAL INFORMATION AND INSTRUCTIONS I) INITIAL APPLICATION ($97.50) A) Training 1) Applicant must complete a Basic Firearms
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW FORM 12.980(f), PETITION FOR INJUNCTION FOR PROTECTION AGAINST REPEAT VIOLENCE
INSTRUCTIONS FOR FLORIDA SUPREME COURT APPROVED FAMILY LAW FORM 12980(f), PETITION FOR INJUNCTION FOR PROTECTION AGAINST REPEAT VIOLENCE When should this form be used? If you or a member of your immediate
Restoration of Civil Rights
Restoration of Civil Rights Application for More Serious Offenses PLEASE READ CAREFULLY: Persons who have been convicted of a violent offense, an offense against a minor, or an election law offense must
PERSONAL HISTORY STATEMENT
NORTH CAROLINA CRIMINAL JUSTICE EDUCATION AND TRAINING STANDARDS COMMISSION CRIMINAL JUSTICE STANDARDS DIVISION TELEPHONE: (919) 716-6470 It is the determination of the Commission that these questions
Instructions for Sealing a Criminal Record. (Expungement)
Instructions for Sealing a Criminal Record (Expungement) TABLE OF CONTENTS What is Expungement/Sealing of Record?... 1 Why Get an Expungement?...1 Who Can Use This Packet?...1 Can I Get My Record Expunged?...2
**Additional information may be requested at the discretion of the Board.**
Oklahoma State Board of Dentistry 2920 N Lincoln Blvd., Ste. B OKC, OK 73105 (405)522-4844 Oklahoma State Board of Dentistry CHECKLIST- DDS/ SPECIALTY/ RDH BY CREDENTIALS *In order to be eligible for licensure
Solicitor Permit Application
Solicitor Permit Application The City of Dunwoody has established the following application to allow for registration of persons, firms, or corporations to engage in the business of soliciting or calling
NOTE: ALL FEES ARE NON-REFUNDABLE
Louisiana Department of Public Safety and Corrections Office of State Police Louisiana Concealed Handgun Permit Application Packet Submit applications to: Concealed Handgun Permit Unit, P.O. Box 66375,
Kentucky Motor Vehicle Commission SALESPERSON LICENSE APPLICATION IMPORTANT NOTICE REGARDING ALL SALES PERSONNEL
IMPORTANT NOTICE REGARDING ALL SALES PERSONNEL All persons employed by a dealership in a sales capacity, even if on a temporary basis, and those individuals identified in 605 KAR 1:050 Section 5 must be
PHARMACY TECHNICIAN REGISTRATION REQUIREMENTS
California State Board of Pharmacy 1625 N. Market Blvd, Suite N219, Sacramento, CA 95834 Phone (916) 574-7900 Fax (916) 574-8618 www.pharmacy.ca.gov STATE AND CONSUMER SERVICES AGENCY DEPARTMENT OF CONSUMER
Massachusetts Board of Registration in Pharmacy. Pharmacy Technician Registration Application
The Massachusetts Board of (Board) has contracted with Professional Credential Services (PCS) to process registration applications from pharmacy technicians. Applicants must submit all information directly
Alabama State Board of Pharmacy 111 Village Street. Birmingham, AL 35242 www.albop.com APPLICATION FOR PHARMACIST LICENSURE EXAMINATION
Alabama State Board of Pharmacy 111 Village Street. Birmingham, AL 35242 www.albop.com APPLICATION FOR PHARMACIST LICENSURE EXAMINATION 1, (First) (Middle/Maiden) (Last) of (Street) (City) (County) (State)
ARKANSAS STATE POLICE ALARM SYSTEMS COMPANY RENEWAL APPLICATION
ARKANSAS STATE POLICE ALARM SYSTEMS COMPANY RENEWAL APPLICATION FOR OFFICE USE ONLY EFFECTIVE 8-2015 EXPIRES PROCESSED BY NOTICE: Information contained on this application is considered a public record
ARKANSAS STATE POLICE SECURITY OR INVESTIGATION COMPANY APPLICATION
ARKANSAS STATE POLICE SECURITY OR INVESTIGATION COMPANY APPLICATION FOR OFFICE USE ONLY EFFECTIVE 8-2015 EXPIRES PROCESSED BY NOTICE: Information contained on this application is considered a public record
STEP 5 - EDUCATION You must request Official Transcripts verifying your education, to be sent directly from your college or university.
INFORMATION & INTRUCTIONS FOR CPA CERTIFICATION This application is for CPA Licensure by Original Certification based on an applicant s passing the CPA Examination in another state. The applicant will
Criminal Justice Institute
May 22, 2014 Dear Student: Thank you for your interest in obtaining your Florida certification as a law enforcement or correctional officer. The Equivalency-of-Training process enables one to become exempt
Basic Law Enforcement Training Application. Asheville-Buncombe Technical Community College 340 Victoria Rd. Asheville, North Carolina 28801
Basic Law Enforcement Training Application Asheville-Buncombe Technical Community College 340 Victoria Rd. Asheville, North Carolina 28801 INSTRUCTIONS: Using a typewriter or legibly printing in ink, fill
CITY OF SALINA MUNICIPAL COURT DIVERSION INFORMATION AND APPLICATION
CITY OF SALINA MUNICIPAL COURT DIVERSION INFORMATION AND APPLICATION A diversion is a written agreement between the City Prosecutor and the defendant. During the diversion period, the prosecutor agrees
PROTECTIVE ORDER UNIT QUESTIONNAIRE FANNIN COUNTY CRIMINAL DISTRICT ATTORNEY S OFFICE
PROTECTIVE ORDER UNIT QUESTIONNAIRE FANNIN COUNTY CRIMINAL DISTRICT ATTORNEY S OFFICE HOW TO USE THE QUESTIONNAIRE USE BLACK INK ONLY blue ink and other colors of ink are difficult to read, especially
Application for New Louisiana Pharmacy Technician Candidate Registration
Louisiana Board of Pharmacy 3388 Brentwood Drive Baton Rouge, Louisiana 70809-1700 Telephone 225.925.6496 ~ Facsimile 225.925.6499 www.pharmacy.la.gov ~ E-mail: [email protected] Application for New
AMENDMENTS TO THE RULES OF SUPERINTENDENCE FOR THE COURTS OF OHIO
AMENDMENTS TO THE RULES OF SUPERINTENDENCE FOR THE COURTS OF OHIO Amendments to Rule 10.05 of the Rules of Superintendence for the Courts of Ohio and related forms were adopted by the Court and become
Please contact 800.854.9846 if you have additional questions regarding your claim.
Upon receipt of this completed packet, Kinecta Federal Credit Union will research your claim. The Credit Union will resolve your claim within 10 business days or will contact you directly for additional
Huron County Juvenile Court
Huron County Juvenile Court Instructions for: CHILD CARE POWER OF ATTORNEY AND CARETAKER AUTHORIZATION AFFIDAVIT This packet was prepared for your convenience and ease in filing a child care power of attorney
INFORMATION FOR ASBESTOS HANDLING LICENSE APPLICANTS
STATE OF NEW YORK > DEPARTMENT OF LABOR DIVISION OF SAFETY AND HEALTH LICENSE AND CERTIFICATE UNIT BUILDING 12, ROOM 161 STATE CAMPUS ALBANY, NY 12240 (518) 457>2735 GENERAL INFORMATION INFORMATION FOR
Grandparent s Power of Attorney Information and Forms
NOTICE AND DISCLAIMER Grandparent s Power of Attorney Information and Forms The forms in this packet have been provided to you as a public service by the Butler County Juvenile Court. Although you may
Dental Hygiene Application Checklist
New Jersey Office of the Attorney General Division of Consumer Affairs New Jersey State Board of Dentistry 124 Halsey Street, 6th Floor, P.O. Box 45005 Newark, New Jersey 07101 (973) 504-6405 Dental Hygiene
OFFICE OF THE DISTRICT ATTORNEY Third Judicial District Of Kansas Chadwick J. Taylor, District Attorney
OFFICE OF THE DISTRICT ATTORNEY Third Judicial District Of Kansas Chadwick J. Taylor, District Attorney Shawnee County Courthouse Fax: (785) 251-4909 200 SE 7th Street, Suite 214 Family Law Fax: (785)
ACCELERATED REHABILITATIVE DISPOSITION APPLICATION
OFFICE OF THE WARREN COUNTY DISTRICT ATTORNEY WARREN COUNTY COURT HOUSE 204 Fourth Avenue WARREN, PENNSYLVANIA 16365 Phone 814-728-3460 FAX 814-728-3483 ACCELERATED REHABILITATIVE DISPOSITION APPLICATION
FRUITA POLICE DEPARTMENT
FRUITA POLICE DEPARTMENT Personal History Form for Police Officer Applicants Personal Full Legal Last First Middle Name Sex Height Weight Hair Eyes Social Security Number Driver s License No. State Expiration
IDENTITY THEFT PACKET
Police Department Edward A. Flynn Chief of Police TO WHOM IT MAY CONCERN: IDENTITY THEFT PACKET This packet contains the forms necessary for you to file an UNAUTHORIZED USE OF AN INDIVIDUAL S PERSONAL
DEPARTMENT OF HEALTH. APPLICATION FOR LIMITED LICENSURE and Instructions
DEPARTMENT OF HEALTH BOARD OF CLINICAL SOCIAL WORK, MARRIAGE AND FAMILY THERAPY AND MENTAL HEALTH COUNSELING APPLICATION FOR LIMITED LICENSURE and Instructions APPLICATION FOR LIMITED LICENSURE INSTRUCTIONS
Electrical, Plumbing, Home Appliance Repair & (Electronics) Suffolk County License Application
Steven Bellone Suffolk County Executive Frank Nardelli Commissioner SUFFOLK COUNTY DEPARTMENT OF LABOR, LICENSING & CONSUMER AFFAIRS P.O. Box 6100, Hauppauge, NY 11788-0099 (631) 853-4600 FAX (631) 853-4825
How To Become A Police Officer In Maine
JOHN ELIAS BALDACCI GOVERNOR STATE OF MAINE DEPARTMENT OF PUBLIC SAFETY MAINE CRIMINAL JUSTICE ACADEMY 15 OAK GROVE ROAD VASSALBORO, MAINE 04989 MICHAEL P. CANTARA COMMISSIONER JOHN B. ROGERS DIRECTOR
Application for License as Home Inspector passport sized color photographs of head and shoulders. Photos must be of
Attach with paper clip two (2) Application for License as Home Inspector passport sized color photographs of head and shoulders. Photos must be of LA. STATE BOARD OF HOME INSPECTORS passport quality. Print
3. The Check Writer must NOT have asked the acceptor to HOLD or DELAY DEPOSIT of the check, even for a very brief period of time.
Procedures and Requirements for filing a Worthless Check Complaint with the Office of the State Attorney s Office, Broward County, Florida Phone 954-831-8444 1. The check must have been accepted in Broward
Proposed Method of Payment: Self Pay VA Assistance Financial Aid Bright Futures Florida Prepaid Paid Agency Sponsor/Agency Name:
Recruit Application Applicant Name: Street Address: Daytime telephone: Cell phone: E-Mail : @ Sex: Race: Social Security #: BAT Score: Desired Class: Law Enforcement Basic Recruit Program (Day Class) Law
New York State Division of Criminal Justice Services SECURITY GUARD PROGRAM SECURITY GUARD INSTRUCTOR APPLICATION
SECURITY GUARD PROGRAM SECURITY GUARD INSTRUCTOR APPLICATION IA THIS FORM IS USED TO APPLY FOR THE INITIAL SECURITY GUARD INSTRUCTOR CERTIFICATION. FORMS PRESENTED FOR FILING MUST CONTAIN ORIGINAL SIGNATURES.
Application Checklist of Requirements for Interior Design Certification (N.J.S.A. 45:3-38)
New Jersey Office of the Attorney General Division of Consumer Affairs New Jersey State Board of Architects Interior Design Examination and Evaluation Committee 124 Halsey Street, 3rd Floor, P.O. Box 45001
STEP 1: STEP 2: STEP 3: TEXAS BOARD OF PARDONS AND PAROLES FULL PARDON APPLICATION INSTRUCTIONS
STEP 1: TEXAS BOARD OF PARDONS AND PAROLES FULL PARDON APPLICATION INSTRUCTIONS BEFORE YOU BEGIN you must have the following documents to complete the application. 1. Offense reports for all arrests including
ALL PERMITS ARE ISSUED ONLY AFTER A SATISFACTORY BACKGROUND INVESTIGATION. YOU WILL BE NOTIFIED BY MAIL OF THE PERMIT ISSUANCE OR DENIAL.
THE COUNTY OF CHESTERFIELD VIRGINIA CHESTERFIELD COUNTY POLICE DEPARTMENT 10001 IRON BRIDGE ROAD, CHESTERFIELD, VA 23832 APPLICATION FOR PRECIOUS METAL DEALERS PERMIT NON TRANSFERABLE Application Fee:
APPLICATION FOR PRIVATE SECURITY COMMANDER CERTIFICATION
APPLICATION FOR PRIVATE SECURITY COMMANDER CERTIFICATION The application must be completed in its entirety, signed, and notarized. Attach additional documentation as requested. The following criteria must
Grandparent Power of Attorney (POA) Checklist
Grandparent Power of Attorney (POA) Checklist Check off all statements which are true. If any statement is not true, do not check the statement. The POA cannot be filed unless all statements are checked
APPLICATION FOR THE POSITION OF POLICE OFFICER VILLAGE OF MARISSA, ILLINOIS EQUAL OPPORTUNITY EMPLOYER
APPLICATION FOR THE POSITION OF POLICE OFFICER VILLAGE OF MARISSA, ILLINOIS EQUAL OPPORTUNITY EMPLOYER Date Received For Official Use Only Full-Time Only Part-Time Only Full-Time or Part-Time INSTRUCTIONS:
Columbia College Police Department Howard M. Cook Chief 1301 Columbia College Drive Columbia, SC 29203
Columbia College Police Department Howard M. Cook Chief 1301 Columbia College Drive Columbia, SC 29203 All Columbia College Police Department Applicants Pre-Employment Requirements Thank you for your interest
CERTIFICATE OF REHABILITATION & PARDON INSTRUCTION PACKET
SUPERIOR COURT OF CALIFORNIA COUNTY OF SAN DIEGO CERTIFICATE OF REHABILITATION & PARDON INSTRUCTION PACKET FORMS INCLUDED IN THIS PACKET General Information Certificate of Rehabilitation SDSC Form #CRM-208
May 6, 2015. Admission to Nursing Program, GENERIC OPTION August 2015. Dear Potential Applicant:
May 6, 2015 Admission to Nursing Program, GENERIC OPTION August 2015 Dear Potential Applicant: Thank you for your interest in the nursing program at Polk State College. This packet contains vital information
INSTRUCTIONS FOR COMPLETING DBPR ABT 6013 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO APPLICATION FOR DISTRIBUTOR S SALESPERSON OF WINE OR SPIRITS
INSTRUCTIONS FOR COMPLETING DBPR ABT 6013 DIVISION OF ALCOHOLIC BEVERAGES AND TOBACCO APPLICATION FOR DISTRIBUTOR S SALESPERSON OF WINE OR SPIRITS If you have any questions or need assistance in completing
Walnut Creek Police Department 1666 N. Main St. Walnut Creek, CA 94596 Ph: (925) 943-5844 Fax: (925) 943-5811
It i Walnut Creek Police Department 1666 N. Main St. Walnut Creek, CA 94596 Ph: (925) 943-5844 Fax: (925) 943-5811 CHECKLIST FOR MASSAGE ESTABLISHMENT / TECHNICIAN PERMIT Print and complete this packet
POWER OF ATTORNEY., the parent(s), the undersigned, residing at, in the county of, state of, hereby appoint the child s
POWER OF ATTORNEY Case No. I/we,, the parent(s) of, the undersigned, residing at, in the county of, state of, hereby appoint the child s grandparent,, residing at, in the state of Ohio, with whom the child
San Antonio Police Department FORGERY DETAIL 315 S. Santa Rosa SAN ANTONIO, TX 78207 (210)-207-7451 OFFICE (210)-207-4070 FAX
San Antonio Police Department FORGERY DETAIL 315 S. Santa Rosa SAN ANTONIO, TX 78207 (210)-207-7451 OFFICE (210)-207-4070 FAX Identity Theft Packet SAPD case # Assigned Detective: The San Antonio Police
APPLICATION FOR EMPLOYMENT Please TYPE or print using BLACK or BLUE ink
Name: First Last 11878 Avenue of Industry San Diego, CA 92128 Telephone: (858) 675-4200 Fax: (858) 675-9241 APPLICATION FOR EMPLOYMENT Please TYPE or print using BLACK or BLUE ink Date Application Completed:
NON DUI ARD ACCELERATED REHABILITATIVE DISPOSITION (ARD)
NON DUI ARD ACCELERATED REHABILITATIVE DISPOSITION (ARD) ARD is for first time offenders only. It is a probationary program that, when completed, will result in the charges being dismissed against the
LICENSING PROCEDURES FOR AUTOMOBILE CLUB AGENTS (MOTOR CLUB AGENTS)
LICENSING PROCEDURES FOR AUTOMOBILE CLUB AGENTS (MOTOR CLUB AGENTS) Requirements for an Automobile Club (Motor Club) Agent License (1) Completed, signed and notarized application (2) $20.00 filing fee
APPLICATION FOR DOMESTIC RECIPROCITY LICENSE. The State Board of Cosmetology may grant license by reciprocity, without examination, if:
2401 NW 23rd Street, Suite 84 Reciprocity Department 405.522.7620 Fax 405.521.2440 MARY FALLIN GOVERNOR SHERRY G. LEWELLING EXECUTIVE DIRECTOR APPLICATION FOR DOMESTIC RECIPROCITY LICENSE The State Board
THOROUGHBRED RACING VENDOR LICENSE FORM
THOROUGHBRED RACING VENDOR LICENSE FORM Name of Applicant: ----------OFFICE USE ONLY---------- Date: License Year: License.: Cash: / Check.: Credit Card Amount: Total Fees Received: Reviewer: New Renewal
PHARMACY TECHNICIAN APPLICATION & INSTRUCTIONS
PHARMACY TECHNICIAN APPLICATION & INSTRUCTIONS IMPORTANT INFORMATION: Complete this application if you are applying to the Board for a pharmacy technician registration. You must answer all questions on
Please be mindful that the most commonly omitted items from the New DUI Program Application are: Completed application for each stakeholder/ partner
DUI Alcohol or Drug Use Risk Reduction Program Owner Checklist All applicants including partners, corporate officers, and/or controlling stockholders must sign the Statement of Completion at the bottom
Volunteer Intern/Clerk Applications. Academic Status. Undergrad Graduate Student Law Student (1L) (2L) (3L) (Circle One) Application Term
OFFICE OF THE STATE S ATTORNEY COOK COUNTY, ILLINOIS ANITA ALVAREZ 69 W. Washington, Suite 3200 STATE S ATTORNEY Chicago, Illinois 60602 Volunteer Intern/Clerk Applications Academic Status Undergrad Graduate
GLYNN COUNTY SHERIFF S OFFICE IS AN EQUAL OPPORTUNITY EMPLOYER
P.O. Box 793 100 Sulphur Springs Road Brunswick, GA 31520 Telephone: (912) 554-7600 * Fax: (912) 554-7681 Web Page Address: www.glynncountysheriff.org INSTRUCTIONS AND INFORMATION PLEASE READ CAREFULLY
How to Clear an Arrest from Your Record in Texas (Expunction)
How to Clear an Arrest from Your Record in Texas (Expunction) Can I clear an arrest from my record? You may be able to clear an arrest from your record through a process called expunction if: charges were
How to Use the California Identity Theft Registry
How to Use the California Identity Theft Registry A Guide for Victims of Criminal Identity Theft Tips for Consumers Consumer Information Sheet 8 June 2014 What Is Criminal Identity Theft?...1 How You May
Application Checklist
Application Checklist POSITION APPLIED FOR: Indian Preference shall not be claimed without proof. Submitted applications without copies of verification documents, unanswered questions, omitted dates, omitted
OFFICE OF THE DISTRICT ATTORNEY Third Judicial District Of Kansas Chadwick J. Taylor, District Attorney
OFFICE OF THE DISTRICT ATTORNEY Third Judicial District Of Kansas Chadwick J. Taylor, District Attorney Shawnee County Courthouse Fax: (785) 251-4909 200 SE 7th Street, Suite 214 Family Law Fax: (785)
Dental Assistant Application Checklist
New Jersey Office of the Attorney General Division of Consumer Affairs New Jersey State Board of Dentistry 124 Halsey Street, 6th Floor, P.O. Box 45005 Newark, New Jersey 07101 (973) 504-6405 Dental Assistant
August 18, 2015. Admission to Nursing Program, GENERIC OPTION January 2016. Dear Potential Applicant:
August 18, 2015 Admission to Nursing Program, GENERIC OPTION January 2016 Dear Potential Applicant: Thank you for your interest in the nursing program at Polk State College. This packet contains vital
Judicial Council of Georgia
Form 1 Judicial Council of Georgia CERTIFIED PROCESS SERVER APPLICATION 1. Name (Last Name) (First Name) (Middle Initial) 2. Address City State ZIP 3. Work Telephone ( ) 4. Alternate Telephone ( ) 5. of
APPLICATION FOR A TEACHER S LICENSE - DENTISTRY OR DENTAL HYGIENE
Maryland State Board of Dental Examiners Spring Grove Hospital Center Benjamin Rush Building 55 Wade Avenue Catonsville, Maryland 21228 (410) 402-8510 APPLICATION FOR A TEACHER S LICENSE - DENTISTRY OR
30 Day Limited Permits for Professional Engineers and Land Surveyors
THE STATE EDUCATION DEPARTMENT / THE UNIVERSITY OF THE STATE OF NEW YORK / ALBANY, NY 12234 Office of the Professions, State Board for Engineering and Land Surveying PHONE: 518-474-3817 ext. 140 FAX: 518-473-6282
GEORGIA BOARD OF DENTISTRY 2 Peachtree Street, N.W. 6 th Floor Atlanta, Georgia 30303 www.gbd.georgia.gov
APPLICATION FOR VOLUNTEERS IN DENTISTRY/DENTAL HYGIENE INITIAL LICENSURE GEORGIA BOARD OF DENTISTRY 2 Peachtree Street, N.W. 6 th Floor Atlanta, Georgia 30303 www.gbd.georgia.gov Please read the instructions
Livescan cards, when received, apply electronically to the DCI & FBI records
Juveniles should be fingerprinted upon being taken into custody for any serious or aggravated misdemeanor or felony charge and the Final Disposition Report started Livescan electronically submits cards
SOUTH CAROLINA STATE BOARD OF COSMETOLOGY
SOUTH CAROLINA STATE BOARD OF COSMETOLOGY INSTRUCTIONS FOR SCHOOL APPLICATION YOUR APPLICATION PACKET SHOULD INCLUDE: 1. FLOOR PLANS. 2. SURETY BOND. 3. STUDENT CONTRACT. 4. CURRICULUM. 5. CHECK OR MONEY
ATTORNEY S REQUESTS FOR ACCESS TO MASSACHUSETTS CRIMINAL RECORDS
ATTORNEY S REQUESTS FOR ACCESS TO MASSACHUSETTS CRIMINAL RECORDS Attorneys are permitted to access the Massachusetts criminal offender record information (CORI) of both clients and non-clients with certain
APPLICATION FOR A PEDDLER, SOLICITOR OR TRANSIENT MERCHANT LICENSE. Fee $60 per Solicitor
CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 763-572-3523 www.fridleymn.gov Check # License # Expiration April 30, APPLICATION FOR A PEDDLER, SOLICITOR OR TRANSIENT MERCHANT LICENSE Business
Mississippi State Board of Nursing Home Administrators 1755 Lelia Drive, Ste. 305, Jackson, MS 39216 (601) 362-6914 www.msnha.ms.
1755 Lelia Drive, Ste. 305, Jackson, MS 39216 (601) 362-6914 www.msnha.ms.gov Application Information Sheet Administrator-in-Training Program (AIT) It is reasonable for you to expect a time frame of nine
