Form Dssp158 PDF Details

Understanding the intricacies of the Dssp158 form is paramount for individuals seeking certification in firearms proficiency in the State of New Hampshire. Administered by the Department of Safety Division of State Police, this form serves as a testament to the proficiency and understanding an individual possesses regarding firearms handling, safety, and the judicious use of force. The form comprehensively covers personal information, including the applicant's name, address, employer details, and position. It mandates a rigorous firearms instruction session, spanning four hours, covering not only firearms techniques and safety but also the critical legal and ethical frameworks governing the use of deadly force. The evaluation process is meticulously outlined, offering two distinct pathways for qualification: handgun qualifications with specified distances, rounds, and shooting positions or an alternative approved course. The Dssp158 form also includes a shotgun familiarization course, reflecting its comprehensive approach to firearms training. It culminates in a pass/fail assessment, determined by a course of fire that applicants must complete successfully, adhering to the stringent criteria set forth by the New Hampshire State Police. The completion of this form and the subsequent certification underscore an individual’s capacity to responsibly manage and operate firearms within the prescribed legal and ethical constraints.

QuestionAnswer
Form NameForm Dssp158
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesdssp158 nh firearm proficiency certification locations form

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State of New Hampshire

DEPARTMENT OF SAFETY

DIVISION OF STATE POLICE

FIREARMS PROFICIENCY CERTIFICATION

1)

Name __________________________________________ Date of Birth _______________________

 

(Print name of individual)

 

 

 

2)

Address ___________________________________________________________________________

 

(No. Street)

(City or Town)

(State)

(Zip Code)

3)

Present Employer ___________________________________________________________________

 

 

(If self-employed, so state)

 

 

4)Employer’s Address _________________________________________________________________

5)Position ___________________________________________________________________________

INSTRUCTOR TO PLACE AN X IN THE APPROPRIATE BOX WHEN COMPLETED.

4 Hours of instruction on firearms techniques and safety, laws on use of deadly force, and the moral

and ethical use of force. Date:

 

Location:

CHOOSE EITHER A OR B: Check box chosen

A

Handgun Qualifications as Follows:

DISTANCE

ROUNDS

FORMAT

TIME

A. 3 Yards

4

2

Sets of 2 from Holster Strong Hand

3 Sec.

B. 5 Yards

6

3

Rounds 15 Degree Cant Right Hand

7 Sec.

3

Rounds 15 Degree Cant Left Hand

 

 

 

C. 7 Yards

6

1

Set of 6 Rnds. Cover Down Holster

8 Sec.

D. 10 Yards

6

1

Set of 6 Rnds. Cover Down Holster

10 Sec.

 

 

2

Right Side Tilt Out

 

 

 

2

Right Side Kneeling

 

E. 15 Yards

8

 

(Reload)

25 Sec.

2

Left Side Tilt Out

 

 

 

 

 

2

Left Side Kneeling

 

 

 

(All Strong Hand)

 

 

2 each

Stand 5 Ft. Behind Cover, Upon Command

8 Sec.

F. 25 Yards

segment

Move into Kneeling Position Behind Cover,

each

 

6 Total

(Strong Side) Drawing Weapon Fire 2 Rnds.

segment

Note: Reloading given numerous weapons, mag. capacity, and calibers will be done upon need by student, except Section E.

 

 

 

This course of fire must be fired twice consecutively and passing both times.

 

 

 

36 Rounds Total

- Q Target - 27 contacts for 75% Pass/Fail

 

 

 

B

 

An alternative course, which has been pre-approved by the Division of the

 

 

 

 

New Hampshire State Police – Permits and License Unit.

 

 

 

 

 

(Must submit copy of course with this form).

 

TYPE OF WEAPON QUALIFIED (CHECK ONLY ONE):

Revolver

Semi-Automatic

FIRING RANGE RESULTS:

(Place an X in correct box)

 

 

 

 

 

PASS

 

 

FAIL

Date

Location

 

 

 

 

 

 

 

 

 

 

 

 

 

DSSP158 (Rev. 09/12)

Shotgun familiarization as follows: (Required of all security officers whose employers issue or have as part of their equipment, shotguns)

SHOTGUN FAMILIARIZATION COURSE

Rifled Slugs:

- Start from car carry condition

- Used sustained reloading techniques

50 Yards: 1 round; standing, from the shoulder

 

40 Yards:

2 rounds; 1 standing, from the shoulder; 1 kneeling

25 Yards:

2 rounds; 1 standing, from the shoulder; 1 kneeling

CHANGE TARGET

00 BUCKSHOT (#9 pellet or #12 pellet)

12-15 Yards: 2 rounds; 1 standing, from the shoulder; 1 kneeling (depending on tightness of pattern)

12 Yards: 3 rounds; 1 standing, from the shoulder; 2 kneeling

EVALUATE TARGETS

Target: 2-FBI Q target or similar proportion silhouette target. Instructor verbally delegates target(s)

Scoring: Rifled Slug-

Buckshot-

Use scoring rings. Assign a value of 2 points to scoring area of highest value, 1 point to area of next highest value and no value to rest of target.

2 points per hit on entire silhouette for #9 pellet buckshot, or 1.5 points per hit for #12 pellet loads.

Maximum total equals 100 points.

DateLocation

Has complied with the annual firearms proficiency requirements of NH RSA 106-F:8-a.

Has failed to comply and must be re-examined.

Name of Instructor (Print or Type)

Date

Signature of Firearms Instructor

Date

Signature of Applicant

Applicant must provide positive identification to instructor at time of qualification. (Driver’s license, guard license, photo I.D.)

Instructor’s Comments:

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