Atf Permit Form – Fill Out and Use This PDF

Sole Proprietor

Partnership

Corporation

Limited Liability Company

Other (Specify)

Credit/Debit Card Billing Address:

Address:

Owned

A Leased/Rented*

Other (Specify)

19.Does User Permit Applicant Intend to Transport Explosive Materials in Interstate or Foreign Commerce? (If "yes," state where)

20.Does User Permit Applicant Intend to Purchase Explosive Materials in Interstate or Foreign Commerce? (If "yes," state where)

No

Yes Federal Firearms License #: No

Applicant's Signature

Title

Date

Disapproved* * (Fee will be refunded)

Reason for Disapproval/Termination

Signature of Licensing Official

Date

(Name and Title)

ATF E-Form 5400.13/5400.16 Revised November 2018

Instructions

1.Issuance of your license or permit under 18 U.S.C., Chapter 40, will be delayed if the fee is omitted or incorrect, or if the application is incomplete or otherwise improperly prepared. This application should be submitted at least 90 days prior to the time the license or permit is required.

2.Submit the original of this form (either typewritten or printed legibly) and total fees payable to the Bureau of Alcohol, Tobacco, Firearms, and Explosives to the post office box listed above. (CAUTION: Submission of this application does NOT authorize you to engage in any of the activities covered by the requested license or permit. The license or permit must be received before operations commence.) Include your social security or employer identification number on your check or money order.

3.If separate sheets are needed to respond to the questions, they must be identified with your name and address at the top of the page and reference the question number being explained.

4.A separate or additional license is not required for storage facilities operated by the applicant as an integral part of one business premises, or to cover a location used by the applicant solely for maintaining required records.

5.One PERMIT is required for an individual or business entity to acquire use, or transport explosives.

6.A separate application and LICENSE fee are required for each premises on which explosive materials are, or will be, manufactured, imported, or distributed.

7.It is not necessary for a licensed manufacturer or licensed importer (for purposes of sale or distribution) to also obtain a dealer's license in order to engage in business on his or her licensed premises as a dealer in explosives materials. In the case of a licensed manufacturer, a separate license is not required with respect to on site manufacturing.

8.A photograph of each responsible person listed in item 11 MUST accompany this application. The photograph must be 2 x 2 inches in size, clearly showing a full frontal view of the features of the responsible person with head bare, with the distance from the top of the head to the point of the chin approximately 1 1/4 inches, and which shall have been taken within the last 6 months prior to the date of application.

A completed FD-258 (Fingerprint Identification Card) for each responsible person, including sole proprietors, MUST also accompany this application. The fingerprints must be clear for accurate classification and must be taken at a local law enforcement agency. In addition, if you are an alien, you must place your U.S.-issued alien number or admission number in the miscellaneous block of the FD-258.

9.This application must include the names and identifying information of EACH employee authorized to possess explosive materials in the course of his/her employment with the applicant. This information MUST be submitted on ATF F 5400.28, Employee Possessor Questionnaire, and included with the submission of this application.

10.For item 22 use the attached Explosives Storage Magazine Description Worksheet to describe each storage facility (magazine). You may photocopy the worksheet if you have more than one magazine. For the purpose of this worksheet, "barricade" is defined as the effective screening of a magazine containing explosive materials from another magazine, a building, a railway, or a highway, either by a natural barricade or by an artificial barricade. To be properly barricaded, a straight line from the top of any sidewall of the magazine containing explosive materials to the eave line of any other magazine or building, or to a point 12 feet above the center of a railway or highway, will pass through the natural or artificial barricade. A "contingency plan" is required in the event the explosive materials cannot be used within the same day of receipt. For example, a sufficient "contingency plan" would include a letter or statement from someone having approved storage facilities allowing the applicant use of his facilities should the need arise.

11.The certification in item 23 must be signed (executed) by the owner, a partner, or in the case of a corporation, association, etc., by an officer duty authorized to sign for the applicant.

12.If you have any questions relating to this application, please contact the ATF Federal Explosives Licensing Center, 244 Needy Road, Martinsburg, WV 25405, (877) 283-3352, or review information online at www.atf.gov.

13.If the application is approved, the ATF Federal Explosives Licensing Center (FELC) will forward an explosives license or permit to you. If the application is denied, you will be advised in writing of the reason(s) for the denial. If the application is abandoned, denied, or withdrawn, your application fee will be refunded. However, in order to refund the fee, a social security number or employer identification number is

REQUIRED.

14.Additional forms can be downloaded from ATF's website in Adobe PDF format at www.atf.gov/forms/download/atf-f5400-13.pdf. The form can be ordered using ATF's Online Distribution Center Order Form at www.atf.gov/dcof or by calling ATF's Distribution Center at (202)648-6420.

Definitions

1.Under Indictment or Information or Convicted in Any Court. An indictment, information, or conviction in any Federal, State, or local court.

2.Alien. An alien in the United States means any person who is not a citizen or national of the United States.

3.Responsible Person. An individual who has the power to direct the management and policies of the applicant pertaining to explosive materials. For example, responsible persons generally include sole proprietors and explosives facility site managers. In the case of a corporation, association, or similar organization, responsible persons generally include corporate directors and officers, as well as stockholders who have the power to direct management and policies.

4.Employee Possessor. An employee possessor is an individual who has actual or constructive possession of explosive materials during the course of his employment. Actual possession exists when a person is in immediate possession or control of explosive materials (e.g., an employee who physically handles explosive materials as part of the production process; an employee who handles explosive materials in order to ship, transport, or sell them; or an employee, such as a blaster, who actually uses explosive materials).

Constructive possession exists when an employee lacks direct physical control over explosive materials, but knowingly has the power and intention to exercise dominion and control over the explosive materials, either directly or indirectly through others (e.g., an employee at a construction site who keeps keys for magazines in which explosive materials are stored, or who directs the use of explosive materials by other employees.)

5.A User Permit. A User Permit authorizes the holder, on a continuing basis, to acquire for his own use and not for resale, explosive materials from an explosives licensee in interstate or foreign commerce, and to transport explosive materials so acquired in interstate or foreign commerce. A User Permit is issued for 3 years and is renewable.

6.Limited Permit. A limited permit authorizes the holder to receive for his use explosive materials from a licensee or permittee in his State of residence on no more than 6 occasions during the 12-month period in which the permit is valid. A limited permit does not authorize the receipt or transportation of explosive materials in interstate or foreign commerce.

7.Manufacturer. Any person engaged in the business of manufacturing explosive materials for purposes of sale or distribution or for his own use.

8.Importer. Any person engaged in the business of importing or bringing explosive materials into the United States for purposes of sale or distribution.

9.Dealer. Any person engaged in the business of distributing explosive materials at wholesale or retail.

10.High Explosives. Explosive materials which can be caused to detonate by means of a blasting cap when unconfined (for example, dynamite).

11.Low Explosives. Explosive materials which can be caused to deflagrate when confined (for example, black powder).

12.Blasting Agents. Any material or mixture, consisting of fuel and oxidizer, intended for blasting, not otherwise defined as an explosive: Provided that the finished product, as mixed for use or shipment, cannot be detonated by means of a numbered eight test blasting cap when unconfined (for example, ammonium nitrate fuel oil).

Note: There are now five broad categories of explosives licenses and permits that shall determine the type of business each licensee or permittee is engaged in: Manufacturer of Explosives, Dealer of Explosives, Importer of Explosives, User of Explosives, and Limited Permit (Intrastate Only).

Exceptions

1.A person who has been convicted of a felony, or any other crime, for which the judge could have imprisoned the person for more than one year, is not prohibited from shipping, transporting, possessing, or receiving explosives if: (1) the conviction was properly invalidated by a court on the basis that the conviction was unconstitutional; (2) in the case of a Federal conviction, the person received a Presidential pardon; or (3) ATF granted relief from Federal explosives disabilities under 18 U.S.C. 845(b), 27 CFR 555.142.

2.For purposes of this form, aliens can be responsible persons if they are lawful permanent residents or lawful nonimmigrants (or refugees/ asylees). 18 U.S.C. 842(d)(7); (i)(5).

Privacy Act Information

The following information is provided pursuant to Sections 3 and 7(b) of the Privacy Act of 1974 (5 U.S.C. 552a(e)(3));

1.Authority. Solicitation of this information is made pursuant to 18 U.S.C. 843(a). Disclosure of this information by the applicant is mandatory if the applicant wishes to obtain a Federal explosives license or permit.

2.Purpose. To identify the applicant; to identify the location of the premises; to determine the eligibility of the applicant to obtain such license or permit; to determine the ownership of the business or operations; and to identify responsible persons in the business or operations.

3.Routine uses. The information will be used by ATF to make a determination as set forth in paragraph 2. In addition, information may be directly disclosed to other Federal, State, foreign and local law enforcement and regulatory agency personnel to verify information on the application and to aid in the performance of their duties with respect to the regulation of explosives unless such disclosure is prohibited by law. Finally, the information may be disclosed to member of the public in order to verify the information on the application where such disclosure is not prohibited by law.

4.Effects of not supplying the requested information. Failure to supply complete information will delay processing and may cause denial of the application.

5.Disclosure of social security number. Disclosure of the individual's social security number is voluntary. Under 18 U.S.C. 842(f), 843, and Executive Order 9397, November 22, 1943, ATF has the authority to solicit an individual's social security number. The number may be used to verify the individual's identity.

Paperwork Reduction Act Notice

This request is in accordance with the Paperwork Reduction Act of 1995. The information collection is used to determine the eligibility of the applicant to engage in certain operations, to determine the location and extent of operations, and to determine whether the operations will be in conformity with Federal laws and regulations. The information requested is required to obtain or retain a benefit and is mandatory by statue (18 U.S.C. 843).

The estimated average burden associated with this collection is 1 hour and 30 minutes per respondent or recordkeeper, depending on individual circumstances. Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be directed to Reports Management Officer, Document Services Section, Bureau of Alcohol, Tobacco, Firearms, and Explosives, Washington, DC 20226.

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.