Ppb 3 Form – Fill Out and Use This PDF

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Ppb 3 Form PDF Details

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Question	Answer
Form Name	Ppb 3 Form
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	new 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)
NYSID Number
License Number										STATE OF NEW YORK
										STATE OF NEW YORK

Month	Day	Year	PISTOL /REVOLVER LICENSE APPLICATION
Date of Issue			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

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

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?	YES	NO

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

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

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.

How to Edit Ppb 3 Form Online for Free

ppb 3 can be completed online effortlessly. Simply use FormsPal PDF tool to get the job done fast. To keep our editor on the leading edge of efficiency, we work to put into operation user-driven features and improvements regularly. We are always looking for suggestions - assist us with reshaping PDF editing. To get the ball rolling, consider these easy steps:

Step 1: First of all, access the pdf tool by pressing the "Get Form Button" at the top of this page.

Step 2: With the help of this online PDF tool, it is easy to accomplish more than just complete blank fields. Express yourself and make your documents look great with customized textual content added in, or modify the file's original input to excellence - all comes along with an ability to incorporate your personal graphics and sign it off.

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.

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!

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)

Step 3: Be certain that the information is accurate and then press "Done" to conclude the process. Get your ppb 3 when you join for a 7-day free trial. Conveniently gain access to the pdf document from your FormsPal account page, along with any modifications and changes being conveniently synced! FormsPal guarantees your data privacy by having a secure method that in no way records or shares any personal data provided. Feel safe knowing your files are kept safe when you use our tools!

Ppb 3 Form – Fill Out and Use This PDF

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