Edgecombe Permit Form – Fill Out and Use This PDF

It is the policy of the Edgecombe County Sheriff’s Office that the pistol permit be issued to an applicant when and if it has been shown that the applicant has met all the necessary requirements for the issuance of said permit.

Upon receipt of the completed application by the Edgecombe County Sheriff’s Office, there will be a waiting period of as much as seven (7) working days before the application is approved or denied.

The applicant:

must be a resident of Edgecombe County.

can not be under indictment or on probation or parole or under a suspended sentence at the time he/she is applying for a pistol permit.

can not be a convicted felon.

can not be an unlawful user or abuser of illegal drugs, prescription drugs nor alcohol.

should not have been committed to a mental institution.

should not have been convicted of serious misdemeanors, especially those involving assaults and/or resisting or obstruction of a law enforcement officer. All information on the application should be accurate.

upon returning the application, must produce two (2) valid identification documents, one of which must have a photo affixed.

The affidavit:

(the person swearing to the good character and reputation of the applicant) must be at least 21 years of age and must sign it before a notary public.

should not be a relative of the applicant.

should be of good character and reputation themselves.

can not be someone who has a criminal history (other than minor traffic offenses).

should be someone in law enforcement, your supervisor, landlord, elected official, pastor or prominent citizen in the community.

The application process is quite different from what normally had been required; however, I feel that with the increase in the number of weapons being sold and used, it is time to make every effort to insure that those who are receiving pistol permits are deserving of same.

Thank you,

James L. Knight

Sheriff of Edgecombe County

JLK:lmp

AFFIDAVIT

I, the undersigned, hereby depose and say that I am at least twenty-one (21) years of age and that I have been personally acquainted with the applicant for a period of _______ years. The applicant is a legal resident of Edgecombe County and is of good moral

character. I have read the answers given by the applicant on the reverse hereon and certify them to be true and correct to the best of my knowledge. I am not aware of any reason why the applicant should not be issued a gun permit. I recommend that the Sheriff of Edgecombe County issue a license allowing the applicant to purchase or acquire the weapon requested on the gun permit application.

Full Name of Affiant: _________________________________________________ Race: _______ Male_______ Female _______

Full Address of Affiant: _______________________________________________________________________________________

Place of Employment: ________________________________________________________________________________________

Home Phone: ________________________________ Work Phone: ________________________ Birth Date: _________________

Social Security No: ______________________________Driver’s License Number: ____________________________________

1.Are you presently under indictment or have you ever been convicted of a felony or any crime punishable by more that two

	years?	Yes ______ No______
2.	Are you a fugitive from justice? (Are there outstanding warrants against you?)	Yes ______ No ______

3.Are you an unlawful user of or addicted to alcohol, marijuana or any depressant, stimulant, or narcotic drug?

Yes ______ No _____

Signature of Affiant: ________________________________________________________

I, _____________________________________________, a Notary Public in and for said County, do hereby certify that the person

whose name is written above personally appeared before me this day and acknowledge the due execution of the foregoing instrument in writing for the purpose herein expressed.

Witnessed my hand and seal on this ______ day of ______________, _______

___________________________________________________ My Commission Expires ___________________________________

Notary Public

SUPPLEMENTARY QUESTIONS FOR APPLICANTS

FOR A PERMIT TO PURCHASE A HANDGUN

Prohibitions applicable to certain aliens: Federal law makes it unlawful for aliens who are illegally or unlawfully in the United States to receive or possess firearms. In addition, subject to certain exemptions, aliens who are in a non-immigrant status are prohibited from possessing or receiving firearms in the United States.

A non-immigrant alien is not subject to this prohibition if the alien:

1)is in possession of a valid hunting license or permit lawfully issued in the United States;

2)is an official representative of a foreign government who is accredited to the United States Government or his or her government’s mission to an international organization having its headquarters in the United States; or

3)has received a waiver from the prohibition from the Attorney General of the United States.

See 18 USC 922 (y)(2) for additional exceptions. In order to determine whether applicants who are not U.S. citizens are prohibited from possessing firearms under Federal Law, it is necessary to obtain answers to the following questions.

1)Name: ______________________________________________________

2)	Are you a citizen of the United States? ____ Yes ____ No

If the answer to Question 2 is “yes”, there is no need to answer questions 3-8. Go directly to the certification statement in question 9.

Sheriff: If the answer to Question 2 is “yes”, use “C” in the citizenship (CTZ) field of the QN or QNP transaction form.

3)What is your country of citizenship? List more that one if applicable. ________________________

________________________________________________________________________________

4)What is your place of birth? __________________________________________________________

(City and Country)

5)What is you INS-issued alien number or admission number? ________________________________

6)Are you an alien illegally in the United States? ___________________________________________

7)Are you a non-immigrant alien? ______________________________________________________

Sheriff: If the answer to Question 7 is “yes”, use “N” in the Citizenship (CTZ) field. If the answer to Question 7 is “no” use “F” in the Citizenship (CTZ) field of the QN or QNP transaction form.

8a) Do you fall within any of the exemptions to the nonimmigrant alien prohibitions set forth in 18 USC 922(y)?

8b) If you answered “yes” to question 8a, under which exemption do you fall? Please attach documentation to support your entitlement to the claimed exemption, if applicable.

Sheriff: If the answer to Question 8a is “yes”, indicate the exemption indicated in 8b in the Exception Documentation (EXC) field of the QN or QNP transaction form.

9)I certify that the above answers are true and correct.

__________________________________________________	______________________
Applicant’s Signature	Date