Ae Form 190 6D – Fill Out and Use This PDF

APPLICATION TO CONDUCT FBI NATIONAL INSTANT CRIMINAL BACKGROUND CHECK

(AE Reg 190·6fCNE·C6F In8t 5300.15PfUSAFE In8t 31-205)

Data required by the Privacy Act of 1974

Authority: 10 USC 3013 and Article 53. Supplementary Agreement to the NATO SOFA.

Principal purpose(s): To obtain information necessary to establish the applicant's reliability (Zuverillssigkeit) under the German Weapons Law ｰｲ･ｲ･ｱｵｩｳｾ･＠to the issuance of a Waffenbesitzkarle (German Weapons Possession Card). The information provided will be forwarded to the United States Federal Bureau of Investigation for the purposes of providing a basis for an electronic background investigation (National Instant Criminal Background Check System). the results of which will be provided to the Waffenbesitzkarle issuing agency.

Routine use!s): Social security numbers are required by the U.S. Forces for control purposes. as well as for use in conducting background investigations. Date of birth. place of birth. and civilian address in Germany are required by German law. The form is to be completed by the individual applicant. and the contents certified as applicable by competent military authorities. One copy of this form will BE kept by the USAREUR Vehicle Regitry and one copy will be provided to the German agency issuing the Waffenbesitzkarle. Other routine uses are listed at 58 Federal Register 10002.

Mandatory or voluntary disclosure and effect on individual not providing Information: The information is mandatory under German law and the USAREUR registration program. and is administered according to the German Weapons Law. German implementing ordinances. and AE Regulation 190-6/CNE·C6F Instruction 5300. 15P/USAFE Instruction 31-205. An individual can refuse to complete this form. but by doing so will give up the right to obtain. possess. and use a privately owned firearm in Germany.

Part I - Personal Information (to be completed by applicant)

Name (last. first. Mill Name (F

Social security number (SSN); Kenn-Nummer Gradel Dlenstrang Sexl Geschlecht

D

Malel MlInnlich

D

FemalelWeiblich

Date of birth! Geburtsdatum	Place of birthl Geburtsort	Heightl GrOlle	Welghtl Gewicht	Racel Rasse
Marital status! Familienstand	Nationality! StaatsangehOrigkeit	Job! Berof

		DMilitary	DCivilian	D	Family member
	ILocation! Ort	Aktiver Militardienst	Ziviles Gefolge		FamilienangehOriger
Military address, unit no. and box no.l Dienstanschrift		APO! Feldpostamt	Military telephonel Dienstte/efonnr.

Spouse's name (last, first, MI)! Name der £hefrau/des £hemannes

Date of stationing In Germany on current tour

stationiart in Deutschland seit

Applicant's statement

1.Pursuant to the German Weapons Law, applicable German implementing ordinances. and AE Regulation 190-6!CNE·C6F Instruction 5300.15P/USAFE Instruction

31-205. I intend to apply for the issuance of a Waffenbesitzkarte German Weapons Possession Card). I understand that to qualify for its issuance, I must establish my reliability within the meaning of the German Weapons Law. I herewith apply for and authorize the conduct of a background name check using the National Instant Criminal Background Check System (NICS). Federal Bureau OF Investigation (FBI), and authorize and agree to release of the results to authorized representatives of the German Government and U.S. Army authorities and representatives as authOrized under Army regulations and applicable U.S. laws. I understand and agree that in the event NICS responds with a "deny" report that I may initiate an appeal of the denial under NICS operating procedures. The area provost marshal with responsibility will assist in Initiating the criminal justice purpose request for NICS and other FBI data.

2.I am a member of the U.S. Forces, or a member of the CiVilian component. or a dependent of such member within the meaning of Art. I, NATO SOFA. I understand that authorization to possess and use a privately owned firearm (POF) in Germany is subject to applicable provisions ot German laws and regulations, and that I am subject to these provisions. I further understand that violation of such German laws or regulations. or applicable U.S. Forces regulations. may result in revocation OF my right to retain possession and ownership of a POF in Germany.

Part II - Approving authority

Name and grade of approving authority			Military telephone number
Organization and APO			Signature
		Part III - Reliabilityl Zuverlllssigkeit
Where was the police background requested?! Wo wurde ein pollzeiliches FOhrungszeugnis beantragt?
Date investigation completed		Result of Investigation		O Favorablel Nicht fondig		)
Untersuchung abgeschlossen am		£rgebnis der Untersuchung		(ohne Bedenken)
				D Unfavorable! Unvorteilhaft
Signature of the approving provost marshal
Unterschrift des Leiters der Stabsabteilung Militllrpolizei
					Official stampl Dienststempel
AE Form 190·60, Part A, AUG 09		Previous editions are obsolete.				Verso 01.00 Page 1 of 1