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Hr218 Application PDF Details

The HR218 application form is a firearms license application form that is used to apply for a concealed carry license in the United States. The form is 8 pages long and contains detailed information about the applicant, including their name, address, birth date, Social Security number, and other personal information. The form also requires detailed information about the firearm that will be carried by the applicant, including make, model, caliber, and serial number. Applicants must also provide detailed justification for why they need a concealed carry license. The HR218 application form must be completed in full and returned to the appropriate authorities for processing. Failure to complete the form correctly or provide all required information may result in a delay or denial of your application.

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Question	Answer
Form Name	Hr218 Application
Form Length	1 pages
Fillable?	Yes
Fillable fields	20
Avg. time to fill out	4 min 19 sec
Other names	hr 218 application, how to apply for hr 218 permit, hr 218 qualification form, hr 218 form

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HR-218 Application

Name: ___________________________________________	Address: __________________________________________
Phone Number: ____________________________________	__________________________________________
SSN (Last Four Digits): _____________________________	City: ______________________________________________
Date of Birth: ______________________________________	State: _____________________________________________
FOP ID Number: ___________________________________	Zip Code: __________________________________________

FOP Lodge Name: __________________________________ FOP Lodge Number: _________________________________

Employment Status:		_______ Active	_______ Retired
Annual Rate: $50.00
Payment Information
____________	I wish to pay by check		(If paying by check, make payable to: FOP Legal Plan, Inc. and submit
			to the address listed at the bottom of this form)
____________	I wish to pay by credit card		(If paying by credit card, complete all information listed below.)
	VISA _________________		Mastercard_________________
	Card Holder Name ______________________________________________________________________
	Card Number ____________________________________________ Exp. Date ____________________
	_______	By checking this box we will automatically renew your policy and deduct payment from
		your account, unless otherwise notified.

Note: Coverage effective dates are the first of every month. Completed applications and payment must be received by Hylant Group on or before the last business day of any month for coverage to start the 1st day of the following month. Applications not fully and accurately completed may result in ineligibility for, and non-payment of benefits.

You must be an FOP member in good standing to participate and be eligible for benefits. Any person who is subsequently determined not to be eligible to participate or to receive benefits as of the date a claim arises, will not receive payment of benefits.

By submitting this form you are certifying that you meet all of the requirements set forth in LEOSA. If you are currently employed as a law enforcement officer by a governmental agency, LEOSA requires, among other things, that you must have powers of arrest, be authorized by the agency to carry a firearm and have met all agency standards to qualify in the use of a firearm. If you are retired as a law enforcement officer from a public agency, LEOSA requires, among other things, that you must have had powers of arrest while employed, must have retired in good standing after a minimum of 15 years of service (or have a duty disability), and MUST HAVE BEEN ISSUED A CERTIFICATION BY YOUR STATE DURING THE MOST RECENT 12 MONTHS stating that you meet state standards applicable to active law enforcement officers for carrying firearms. Not fulfilling these requirements and others set forth by LEOSA will result in no coverage.

FOP Legal Defense Plan | c/o Hylant Group | P.O. Box 1687 | Toledo, OH 43603

Phone: 800-341-6038 | Fax: 419-255-7557 | Email: lynn.young@fop.net

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The next parts will frame the PDF document that you will be creating:

stage 1 to completing hr218 form

In the I, wish, to, pay, by, check I, wish, to, pay, by, credit, card VISA, Mastercard, Card, Holder, Name and Card, Number, Exp, Date area, note the information you have.

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