Form Dpssp 4012 PDF Details

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Form NameForm Dpssp 4012
Form Length1 pages
Fillable fields0
Avg. time to fill out15 sec
Other namesDisapproved, DPSSP, FIREARM, STATUTES

Form Preview Example



Louisiana Department of Public Safety and Corrections

Office of State Police

PO Box 66375

Baton Rouge, LA 70896

FIREARM(S) – As Defined in LRS 40:1781 (3).



Applicant Information




Telephone No.

















Parish of Residence








Social Security Number








Employer Identification Number







Is a Federal Firearms License required? No


Federal Firearms License #








Firearm Data

Name and Address of










Type of Firearm



Caliber, Gauge, or Size










Length of Barrel







Serial Number



Overall Length







Additional Description or Data Appearing on Firearm:














Place Where Firearm is to be Kept

Street Address

City, State, Zip Code












Are you eligible to possess a Firearm under State and Federal law?






If NO, state details of disposition, date, offense, etc.











UNDER PENALTY OF PERJURY, I DECLARE that I have examined this application, and to the best of my knowledge and belief it is true, correct, and complete.


Signature of Applicant


















Department Use Only


By authority of the Secretary, this application to register a firearm has been examined and the application is:



Reviewing Official



***********************NOTE: FORM MUST BE SUBMITTED IN DUPLICATE. ****************************

DPSSP 4012 (Rev. 01/07)

How to Edit Form Dpssp 4012 Online for Free

STATUTES can be completed online in no time. Simply open FormsPal PDF editor to do the job fast. To have our tool on the cutting edge of practicality, we strive to implement user-oriented features and improvements regularly. We're always glad to get suggestions - join us in revampimg PDF editing. Here's what you would need to do to get started:

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It will be straightforward to fill out the pdf using this practical tutorial! This is what you should do:

1. It is very important fill out the STATUTES correctly, hence be careful when filling in the areas comprising all of these blanks:

Step no. 1 of filling out dpssp 4012 application to register firearm

2. When this part is completed, you'll want to add the necessary details in Parish, Home, Business, Are you eligible to possess a, Yes, If NO state details of disposition, UNDER PENALTY OF PERJURY I DECLARE, Signature of Applicant, Department Use Only, Date, By authority of the Secretary this, Disapproved, Approved NOTE FORM MUST BE, Reviewing Official, and Date so you can proceed to the third part.

Home, UNDER PENALTY OF PERJURY I DECLARE, and By authority of the Secretary this in dpssp 4012 application to register firearm

When it comes to Home and UNDER PENALTY OF PERJURY I DECLARE, make certain you get them right in this current part. Both of these are considered the most important ones in this page.

Step 3: Before finishing your form, make sure that all blanks have been filled out properly. Once you verify that it is correct, click on “Done." Right after registering afree trial account with us, it will be possible to download STATUTES or email it immediately. The file will also be readily available through your personal account with your each and every modification. FormsPal is devoted to the personal privacy of all our users; we make sure all personal information coming through our system stays secure.