Ppb 3 Form PDF Details

The PPB 3 form, under the jurisdiction of the State of New York, represents a crucial step for individuals seeking to obtain a pistol/revolver license. As mandated, applicants are required to fill this form with precision, necessitating details that span from personal identification, such as name, date of birth, and Social Security Number, to specifics about the desired license type—carry concealed, possess on premises, or possess/carry during employment. Notably, the form emphasizes the significance of thorough background checks by asking applicants about any past arrests, convictions, substance abuse issues, mental health history, and other factors that could influence the issuance of a firearm license. This exhaustive approach underscores the State's commitment to ensuring that firearms are only accessible to individuals deemed responsible and of sound character, while also aligning with the Federal Privacy Act of 1974 by acknowledging the sensitive nature of personal information yet the necessity of its disclosure for public safety. Additionally, the form outlines the conditions under which the license is valid, including geographical restrictions within New York and the mandate that any changes in address or status be promptly reported to the relevant authorities. Completing the PPB 3 form is not just a procedural necessity; it acts as a filtering mechanism to limit firearm possession to eligible citizens, amidst growing concerns over gun control and public safety.

QuestionAnswer
Form NamePpb 3 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesnew york state police c form, revolver license, nysp c form, nys pistol permit application pdf

Form Preview Example

INSTRUCTIONS: Print or type in black ink only

NYSID Number

 

 

 

 

 

 

 

 

 

PPB 3 (Rev. 06/17)

 

 

 

 

 

 

 

 

 

 

License Number

 

 

 

 

 

 

 

 

 

STATE OF NEW YORK

 

 

 

 

 

 

 

 

 

 

Month

Day

Year

PISTOL /REVOLVER LICENSE APPLICATION

Date of Issue

 

 

 

 

 

County of Issue

 

 

 

 

 

 

Code

Expiration Date

Month

Day

Year

In accordance with the Federal Privacy Act of 1974, you are hereby notified that your Social Security Number is not mandated by law. It is required by the Pistol Permit Bureau as part of the standard for recording Firearms. Failure to disclose your Social Security Number will prohibit your transaction from being recorded. The State Police will release your Social Security Number only for reasons required by law or with your written consent.

Last Name

Suffix

First Name

MI Date of Birth – MM DD YYYY

NY Driver’s License (or NY Non-Driver ID) No.

Gender

Social Security

Race

Height

 

 

 

 

 

 

 

 

 

 

 

ft

 

 

 

 

 

 

 

 

 

 

 

 

Weight Eyes

in

Hair

Citizen of U.S.A

YES NO

Physical Address (Street number, street name, apartment number, city, state, zip code)

Mailing Address (If different from physical address)

Primary Phone Number

Secondary Phone Number

Email Address

 

 

 

 

 

 

 

 

 

 

Employed By

 

Present Occupation

 

Nature of Business

 

 

 

 

Business Address (Street number, street name, apartment number, city, state, zip code)

 

 

I hereby apply for a Pistol / Revolver License to: (Check only one)

Carry Concealed

* Possess on Premises

* Possess / Carry During Employment

( * ) Premise Address or Employer Name and Address must be provided below:

 

 

 

Employer Name (If Carry During Employment)

Address or Other Location (Street number, street name, apartment number, city, state, zip code)

 

 

 

 

 

 

 

 

 

 

A license is required for the following reasons:

Give four character references who by their signature attest to your good moral character.

Last, First, MI

Street Address, (Street number, street name, apartment number, city, state, zip code)

Signature

Have you ever been arrested, summoned, charged or indicted anywhere for any offense, including DWI (except traffic infractions)? If Yes, furnish the following information:

YES

NO

Arrest Date

Police Agency

Charge

Disposition Date

Disposition Court

Disposition

 

 

 

 

 

 

 

 

 

 

 

 

Are you a fugitive from justice?

YES

NO

 

 

 

Are you an unlawful user of or addicted to any controlled substance as defined in section 21 U.S.C. 802?

YES

NO

 

 

 

Are you an alien illegally or unlawfully in the United States?

YES

NO

 

 

 

Are you an alien admitted to the United States who does not qualify for the exceptions under 18 U.S.C. 922 (y)(2)?

YES

NO

 

 

 

Have you been discharged from the Armed Forces under dishonorable conditions?

YES

NO

 

 

 

Have you ever renounced your United States citizenship?

YES

NO

 

 

 

Have you ever suffered any mental illness?

YES

NO

 

 

 

Have you ever been involuntarily committed to a mental health facility?

YES

NO

 

 

 

Have you ever had a pistol / revolver license revoked?

YES

NO

 

 

 

Are you under any firearms suspension or ineligibility order issued pursuant to the provisions of section 530.14 of the

YES

NO

criminal procedure law or section eight hundred forty-two-a of the family court act?

 

 

Have you had a guardian appointed for you pursuant to any provision of state law, based on a determination that as a result of marked subnormal intelligence, mental illness, incapacity, condition or disease you lack the mental capacity to contract or manage your own affairs?

YES

NO

Are you aware of any good cause for the denial of the license?

YES

NO

 

 

 

Are you prohibited from possessing firearms under federal law, including having been convicted in any court of a

 

 

misdemeanor crime of domestic violence or being under indictment for a crime punishable by imprisonment for a term

YES

NO

exceeding one year?

 

 

If the answer to any of the questions above is YES, explain here:

For applicants under twenty-one years of age only:

Have you been honorably discharged from the United States Army, Navy, Marine Corps, Air Force or Coast Guard, or the National Guard of the State of New York?

YES

NO

Photograph

Of Applicant

Taken Within 30 Days

_____

Full Face Only

Knowingly providing false information will be sufficient cause to deny this application and constitutes a crime punishable by fine, imprisonment, or both. I am aware that the following conditions affect any license which may be issued to me:

1.No license issued as a result of this application is valid in the City of New York.

2.Any license issued as a result of this application will be valid only for a pistol or revolver specifically described in the license properly issued by the licensing officer.

3.If I permanently change my address, notice of such change and my new address must be forwarded to the Superintendent of the State Police and in Nassau County and Suffolk County, to the licensing officer of that county, within 10 days of such change.

4.Any license issued as a result of this application is subject to revocation at any time by the licensing officer or any judge or justice of a court of record.

Jurat:

 

 

 

 

Signed and sworn to before me

 

 

 

This

 

day of

 

, 20

 

at

 

 

 

, New York

Signature of Applicant

Signature of Officer Administering Oath

Title of Officer

APPLICATION NOT VALID UNLESS SWORN

Fingerprints submitted electronically by:

Name

 

Rank

 

Organization

Date Submitted

Investigation Report – All information provided by this applicant has been verified:

Name

 

 

Rank

 

 

Organization

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of Investigating Officer

 

 

 

 

 

 

 

 

This application is

Approved – Disapproved (Strike out one)

 

The following restriction(s) is (are) applicable to this license:

Title and Signature of Licensing Officer

If Licensing Officer authorizes the possession of a pistol, revolver or single shot firearm(s) at the time of issue of original license, furnish the following information:

Manufacturer

Pistol / Revolver /

Single Shot

Model

Frame

Only

Caliber(s)

Serial Number

Property Of

Duplicate of this application must be filed with the Superintendent of State Police within 10 days of issuance as required by Penal Law Section 400.00 SUBD.5.

This form is approved by Superintendent of the State Police as required by Penal Law section 400.00, SUBD. 3.

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This PDF form will require particular info to be entered, so be sure to take some time to enter precisely what is required:

1. Firstly, once filling out the ppb 3, begin with the section that features the following blanks:

Tips on how to prepare ppb 3 form ny portion 1

2. Once your current task is complete, take the next step – fill out all of these fields - I hereby apply for a Pistol, Address or Other Location Street, A license is required for the, Give four character references who, Last First MI, Street Address Street number, Signature, Have you ever been arrested, YES, Arrest Date, Police Agency, Charge, Disposition Date, Disposition Court, and Disposition with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Stage number 2 for filling out ppb 3 form ny

It's simple to make a mistake when filling out your Police Agency, consequently you'll want to go through it again before you'll submit it.

3. This subsequent section is rather simple, Have you ever been involuntarily, Have you ever had a pistol, Are you under any firearms, Are you aware of any good cause, Are you prohibited from possessing, If the answer to any of the, YES, YES, YES, YES, YES, and YES - every one of these fields needs to be filled out here.

Step # 3 of submitting ppb 3 form ny

4. This next section requires some additional information. Ensure you complete all the necessary fields - For applicants under twentyone, YES, Knowingly providing false, No license issued as a result of, license properly issued by the, Any license issued as a result of, judge or justice of a court of, Photograph Of Applicant, Taken Within Days, Full Face Only, Jurat, Signed and sworn to before me, This, day of, and New York - to proceed further in your process!

Completing section 4 of ppb 3 form ny

5. Because you reach the completion of your file, you'll find several extra things to complete. Notably, Fingerprints submitted, Name, Date Submitted, Rank, Organization, Investigation Report All, Name, Rank, Organization, Signature of Investigating Officer, This application is Approved, The following restrictions is are, Title and Signature of Licensing, If Licensing Officer authorizes, and Manufacturer must all be filled out.

ppb 3 form ny completion process described (part 5)

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