Ri 012 Form PDF Details

In the evolving landscape of firearm legislation and safety measures, the Michigan State Police have established the RI-012 form, a comprehensive guide and application for obtaining a Concealed Pistol License (CPL) in Michigan. The form, dated January 2019, serves as a vital resource for individuals seeking to navigate the legal requisites and procedural steps necessary for the lawful carrying of a concealed pistol within the state. It encompasses an array of crucial information, including state and federal requirements for eligibility, such as age, residency, and the lack of disqualifying criminal history. Furthermore, it outlines the process for submitting an application, which involves a mandatory pistol safety training course, furnishing a passport-quality photograph when necessary, and paying applicable fees. A standout feature of the RI-012 form is the detailed breakdown of misdemeanors and other legal statutes, clarifying actions and conditions that could preclude applicants from obtaining a license. Importantly, it also navigates applicants through the process of renewal, emergency licensing conditions, and the intricacies of fingerprinting and background checks – essential components for ensuring public safety and compliance with the law. By distilling complex legal standards and procedures, the RI-012 form functions as a critical tool for both prospective CPL holders and law enforcement agencies, facilitating a shared understanding of Michigan’s commitment to responsible gun ownership and community safety.

QuestionAnswer
Form NameRi 012 Form
Form Length8 pages
Fillable?No
Fillable fields0
Avg. time to fill out2 min
Other namesmichigan concealed form, ri 012 concealed pistol application, michigan pistol application form, ri 012 michigan state police

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Michigan State Police

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Authority: MCL 28.425

Compliance: Voluntary

CONCEALED PISTOL LICENSE GUIDE AND APPLICATION

Please refer to this guide to complete the Concealed Pistol License (CPL) Application found on pages 7-8. The information within this guide is required to be provided to CPL applicants.

A complete copy of the firearms laws of this state shall be furnished to an individual upon filing an application. Individuals may view a complete copy of the firearms laws of this state on the Michigan Legislature's website at www.legislature.mi.gov/publications/firearms.pdf, the Michigan State Police's (MSP) website at www.michigan.gov/firearms, or by visiting a local library.

CPL Requirements

A.State Requirements

An applicant for a Michigan CPL must:

1.Be at least 21 years of age.

2.Be a citizen of the United States or an alien lawfully admitted into the United States.

3.Be a legal resident of Michigan and reside in Michigan for at least six months immediately prior to application. An applicant is a resident of Michigan if at least one of the following applies:

The applicant possesses a valid, lawfully obtained Michigan driver's license or official Michigan personal identification card.

The applicant is lawfully registered to vote in Michigan.

The applicant is on active duty status with the United States Armed Forces and is stationed outside of Michigan, but Michigan is the applicant's home of record.

The applicant is on active duty status with the United States Armed Forces and is permanently stationed in Michigan, but the applicant's home of record is another state.

Note: The county clerk shall waive the six-month residency requirement if one of the following applies:

For an emergency license, if the applicant is a petitioner for a personal protection order issued under MCL 600.2950 or MCL 600.2950a.

For an emergency license, if the county sheriff determines that there is clear and convincing evidence to believe that the safety of the applicant or the safety of a member of the applicant's family or household is endangered by the applicant's inability to immediately obtain a license to carry a concealed pistol.

For a new resident, if the applicant holds a valid concealed pistol license issued by another state at the time the applicant’s residency in this state is established.

4.Have knowledge and training in the safe use and handling of a pistol by successfully completing an appropriate pistol safety training course or class.

5.Not be subject to an order or disposition for any of the following:

Involuntary hospitalization or involuntary alternative treatment.

Legal incapacitation.

Personal protection order.

Bond or conditional release prohibiting purchase or possession of a firearm.

Finding of not guilty by reason of insanity.

6.Not be prohibited from possessing, using, transporting, selling, purchasing, carrying, shipping, receiving, or distributing a firearm under MCL 750.224f.

7.Not have been convicted or adjudicated as a juvenile of a felony in Michigan or elsewhere, and a felony charge against the applicant is not pending in Michigan or elsewhere at the time he or she applies for a CPL.

8.Not have been dishonorably discharged from the United States Armed Forces.

9.Not have been convicted or adjudicated as a juvenile of a misdemeanor violation of any of the following in the eight years immediately preceding the date of the application and a charge for a misdemeanor violation of any of the following is not pending against the applicant in this state or elsewhere at the time he or she applies for a CPL:

MCL 257.617a, failing to stop when involved in a personal injury accident

MCL 257.625, operating while intoxicated or with any presence of a Schedule 1 controlled substance or cocaine, punishable as a second offense under, MCL 257.625(9)(b)

MCL 257.625m, operating a commercial motor vehicle with alcohol content, punishable as a second offense under MCL 257.625m(4)

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MCL 257.626, reckless driving

MCL 257.904(1), operating while license suspended/revoked/denied or never applied for a license, punishable as a second or subsequent offense

MCL 259.185, operating an aircraft while under the influence of intoxicating liquor or a controlled substance with prior conviction

MCL 290.629, hindering or obstructing certain persons performing official weights and measures duties

MCL 290.650, hindering, obstructing, assaulting, or committing bodily injury upon director of the Department of Agriculture or authorized representative of the director

MCL 324.80176, operating a vessel under the influence of alcoholic liquor or a controlled substance, or with an unlawful blood alcohol content, punishable as a second or subsequent offense under MCL 324.80177(1)(b)

MCL 324.81134, operating an off-road vehicle (ORV) under the influence of alcoholic liquor or a controlled substance or with an unlawful alcohol content, punishable as a second or subsequent offense under MCL 324.81134(8)(b)

MCL 324.82127, operating a snowmobile under the influence of alcoholic liquor or a controlled substance, or with an unlawful blood alcohol content, or with any presence of a Schedule 1 controlled substance or cocaine, punishable as a second or subsequent offense under MCL 324.82128(1)(b)

MCL 333.7403, possessing a controlled substance, controlled substance analogue, or prescription form

MCL 462.353, operating a locomotive under the influence of alcoholic liquor or a controlled substance, or while visibly impaired, punishable as a second offense under MCL 462.353(4)

MCL 722.677, displaying sexually explicit matter to minors

MCL 750.81, assault or domestic assault

MCL 750.81a(1) or (2), aggravated assault or aggravated domestic assault

MCL 750.115, breaking and entering or entering without breaking

MCL 750.136b(7), fourth-degree child abuse

MCL 750.145n, vulnerable adult abuse

MCL 750.157b(3)(b), solicitation to commit a felony

MCL 750.215, impersonating a peace officer or medical examiner

MCL 750.223, illegal sale of a firearm or ammunition

MCL 750.224d, illegal use or sale of a self-defense spray or foam device

MCL 750.226a, sale or possession of a switchblade

MCL 750.227c, improper transporting or possessing a loaded firearm in or upon a vehicle

MCL 750.229, accepting a pistol in pawn

MCL 750.232, failure to register the purchase of a firearm or a firearm component

MCL 750.232a, improperly obtaining a pistol, making a false statement on an application to purchase a pistol, or using or attempting to use false identification of another to purchase a pistol

MCL 750.233, intentionally pointing or aiming a firearm without malice

MCL 750.234, discharging a firearm while intentionally aimed without malice

MCL 750.234d, possessing a firearm on prohibited premises

MCL 750.234e, brandishing a firearm in public

MCL 750.234f, possession of a firearm in public by an individual less than 18 years of age

MCL 750.235, discharging a firearm pointed or aimed intentionally without malice causing injury

MCL 750.235a, parent of a minor who violates the Firearms Chapter of the Michigan Penal Code in a weapon-free school zone

MCL 750.236, setting a spring or other gun, or any trap or device

MCL 750.237, carrying, possessing, using, or discharging a firearm while under the influence of alcoholic liquor or a controlled substance, while having an unlawful alcohol content, or while visibly impaired

MCL 750.237a, weapon-free school zone violation

MCL 750.335a, indecent exposure

MCL 750.411h, stalking

MCL 750.520e, fourth-degree criminal sexual conduct

Former MCL 750.228, failure to have a pistol inspected

MCL 752.861, careless, reckless, or negligent use of a firearm resulting in injury or death

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MCL 752.862, careless, reckless, or negligent use of a firearm resulting in property damage

MCL 752.863a, reckless discharge of a firearm

A violation of a law of the United States, another state, or a local unit of government of this state or another state substantially corresponding to a violation described above

10.Not have been convicted or adjudicated as a juvenile of a misdemeanor violation of any of the following in the three years immediately preceding the date of application and a charge for a misdemeanor violation of any of the following is not pending against the applicant in this state or elsewhere at the time he or she applies for a license:

MCL 257.625, operating while intoxicated, visibly impaired, under 21 years of age with any bodily alcohol content, or with any presence of a Schedule 1 controlled substance or cocaine

MCL 257.625a, refusal of commercial motor vehicle operator to submit to a preliminary chemical breath test

MCL 257.625k, ignition interlock device reporting violation

MCL 257.625l, circumventing or tampering with an ignition interlocking device

MCL 257.625m, operating a commercial motor vehicle with alcohol content, punishable under MCL 257.625m(3)

MCL 259.185, operating an aircraft under the influence of intoxicating liquor or a controlled substance

MCL 324.81134, operating an ORV under the influence of alcoholic liquor or a controlled substance, with an unlawful alcohol content, with any presence of a Schedule 1 controlled substance or cocaine, or while visibly impaired

MCL 324.82127, operating a snowmobile under the influence of alcoholic liquor or a controlled substance, with an unlawful blood alcohol content, with any presence of a Schedule 1 controlled substance or cocaine, or while visibly impaired

MCL 333.7401 to 333.7461, controlled substance violation

MCL 462.353, operating a locomotive under the influence of alcoholic liquor or a controlled substance, while visibly impaired, or with an unlawful alcohol content, punishable under MCL 462.353(3)

MCL 750.167, disorderly person

MCL 750.174, embezzlement

MCL 750.218, false pretenses with intent to defraud or cheat

MCL 750.356, larceny

MCL 750.356d, second or third-degree retail fraud

MCL 750.359, larceny from vacant structure or building

MCL 750.362, larceny by conversion

MCL 750.362a, refuse or neglect to return vehicle, trailer, or other tangible property delivered on a rental or lease basis with intent to defraud the lessor

MCL 750.377a, malicious destruction of personal property

MCL 750.380, malicious destruction of real property

MCL 750.535, buying, receiving, possessing, concealing, or aiding in the concealment of stolen, embezzled, or converted property

MCL 750.540e, malicious use of service provided by telecommunications service provider

A violation of a law of the United States, another state, or a local unit of government of this state or another state substantially corresponding to a violation described above

11.Not have been found guilty but mentally ill of any crime and has not offered a plea of not guilty of, or been acquitted of, any crime by reason of insanity.

12.Is not currently and has never been subject to an order of involuntary commitment in an inpatient or outpatient setting due to mental illness.

13.Not have a diagnosed mental illness at the time the application is made that includes an assessment that the individual presents a danger to himself or herself or to another, regardless of whether he or she is receiving treatment for that illness.

14.Not be under a court order of legal incapacity in this state or elsewhere.

15.Have a valid state-issued driver’s license or personal identification card.

B.Federal Requirements

Pursuant to MCL 28.426, a CPL may not be issued to a person prohibited under federal law from possessing or transporting a firearm as determined through the federal National Instant Criminal Background Check System (NICS). Questions regarding the NICS check should be directed to the Federal Bureau of Investigation (FBI) NICS Section at 1-877-FBI-NICS (877-324-

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6427).

Application Process (Standard License)

The applicant must file this application with the county clerk in the county in which he or she resides. The application shall be signed under oath by the applicant. The oath shall be administered by the county clerk or his or her representative.

1.The applicant must also:

Include a certificate stating that the applicant has completed the required pistol safety training course.

If an applicant does not have a digitized photograph on file with the Michigan Secretary of State, include a passport-quality photograph.

Pay all applicable fees. For all non-renewal or non-emergency applications, a $100.00 non-refundable application and licensing fee is payable to the county clerk. The county clerk will provide a receipt for payment of fees.

2.Upon paying all applicable fees and filing the application, the applicant must have classifiable fingerprints taken by the county clerk, state police, sheriff’s office, local police agency, or other entity that provides fingerprinting services.

3.The entity providing fingerprinting services shall issue a receipt when fingerprints are taken so long as the applicant has provided an application receipt. The fingerprinting receipt must contain:

Name of the applicant.

Date and time the receipt is issued.

The amount paid.

The name of the entity providing fingerprint services.

The applicant’s state issued driver’s license or personal identification card number.

The statement “This receipt was issued for the purpose of applying for a concealed pistol license. As provided in section 5b of 1927 PA 372, MCL 28.425(b), if a license or notice of statutory disqualification is not issued within 45 days after the date this

receipt was issued, this receipt shall serve as a concealed pistol license for the individual named in the receipt when carried with an official state issued driver’s license or personal identification card. The receipt is valid as a license until a license or

notice of statutory disqualification is issued by the county clerk. This receipt does not exempt the individual named in the receipt from complying with all applicable laws for the purchase of firearms.

Note: Possession of a valid receipt of application for a CPL does not exempt the holder from the requirement to obtain a license to purchase a pistol or exempt a firearms dealer from running a background check prior to the sale of a pistol.

4.The entity providing fingerprint services will fingerprint the applicant and immediately forward the fingerprints to the MSP for processing.

5.A completed application and all associated receipts expire one year from the date of application.

6.The county clerk shall issue a license or notice of statutory disqualification within 45 days after the date the applicant has classifiable fingerprints taken.

Pistol Safety Training Course

1.Those required to take a pistol safety training course include:

All new applicants.

Persons with a CPL that has been expired more than one year.

Note: The pistol safety training course requirement is waived for a new applicant who is a retired police officer or a retired law enforcement officer as defined in MCL 28.421(1)(o).

2.The pistol safety training course required under Michigan law must be a program certified by this state or a national or state firearms training organization. The training must provide at least eight hours of instruction, including at least three hours of instruction on a firing range, firing at least 30 rounds of ammunition, and at least five hours of instruction in, but not limited to all of the following:

The safe storage, use, and handling of a pistol including, but not limited to, safe storage, use, and handling to protect child safety.

Ammunition knowledge and the fundamentals of pistol shooting.

Pistol shooting positions.

Firearms and the law, including civil liability issues and the use of deadly force. This portion must be taught by an attorney or a person trained in the use of deadly force.

Avoiding criminal attack and controlling a violent confrontation.

All laws that apply to carrying a concealed pistol in Michigan.

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Note: The pistol safety training must have been provided within five years preceding the date of application.

a.The instructor must be certified by this state or a national organization to teach the eight-hour pistol safety training course required by Michigan law. The instructor must provide a certificate of completion containing the printed name and original handwritten signature of the course instructor to the applicant. The certificate of completion must state that the individual successfully completed the course and contain the statement: "This course complies with section 5j of 1927 PA 372."

b.The certificate must also contain, on its face or by attachment, the instructor’s telephone number and the name and telephone number of the state agency or the state or national firearm training organization that has certified the individual as an instructor, his or her instructor certification number, if any, and the expiration date of that certificate.

A person who either grants a certificate of completion to an individual knowing the individual did not satisfactorily complete the course or presents a certificate of completion to a county clerk knowing the individual did not satisfactorily complete the course is guilty of a felony punishable by up to four years imprisonment and/or a $2,500 fine.

CPL Renewal Information

1.An application to renew a CPL may be submitted to the county clerk, through the CPL renewal website at

www.michigan.gov/cplrenewal, or by first-class mail to the MSP, not more than six months before, nor one year after, the expiration of the current CPL. Please make check payable to State of Michigan.The mailing address is:

Michigan State Police

Attn: Concealed Pistol License Unit

P.O. Box 30634

Lansing, MI 48909

2.A CPL is valid until the applicant's date of birth that falls not less than four years or more than five years after the license is issued or renewed.

3.CPL holders will be notified that their license is approaching expiration by their county clerk between three to six months prior to the expiration of their current license.

4.Upon paying the renewal application and license fee of $115, the applicant will be issued a receipt. If renewed prior to expiration, this receipt, when carried with the expired license, shall serve as a valid CPL until the new license or notice of statutory disqualification is received. For the purposes of Michigan law, the receipt is considered to be part of the CPL until a renewal is issued or denied.

5.Possession of this receipt and expired CPL does not exempt the holder from the requirement to obtain a license to purchase a pistol or exempt a firearms dealer from running a background check prior to the sale of a pistol.

6.An application is considered a renewal if the applicant has previously received a CPL in compliance with the training requirements set forth in Michigan law effective July 1, 2001, and the previous license has not been expired more than one year.

7.An applicant applying for a renewal is not required to have fingerprints taken again if the applicant's fingerprints have been submitted to and are maintained by the MSP. Fingerprints have been maintained by the MSP since January 1, 2006.

8.The applicant shall sign the statement on the application certifying that he or she has completed at least three hours of review of the required training and has had at least one hour of firing range time in the six months immediately preceding the renewal application.

Emergency CPL

There are two instances when a county clerk may issue an Emergency CPL:

1.The individual has obtained a personal protection order issued under MCL 600.2950 or 600.2950a.

2.A county sheriff determines there is clear and convincing evidence to believe the safety of the applicant or the safety of a member of the applicant’s family or household is endangered by the applicant’s inability to immediately obtain a license to carry a concealed pistol.

An applicant for an Emergency license must meet the state and federal requirement listed previously in this guide.

An applicant for an Emergency license must complete a valid pistol training course and apply for a Standard CPL within ten business days after applying for the license.

An Emergency license is valid for 45 days or until the county clerk issues a license or a notice of statutory disqualification, whichever occurs first. If the Emergency license applicant does not complete a valid pistol safety training course under section 5j and apply for a Standard license under section 5b within ten business days, the Emergency license will be invalid ten business days from date of application.

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Denials

If the county clerk issues a notice of statutory disqualification, the county clerk must within five business days do all of the following:

3.Inform the applicant in writing of the reasons for the disqualification that includes a statement of each statutory disqualification identified, the source record for each statutory disqualification identified, and the contact information for the source of the record for each statutory disqualification identified.

4.Inform the applicant that he or she should contact the source of the record for any statutory disqualification to correct any errors in the record resulting in the statutory disqualification.

5.Inform the applicant in writing of his or her right to appeal the notice of statutory disqualification to the circuit court of jurisdiction.

Appeals

1.An applicant may appeal the notice of statutory disqualification, failure to issue a receipt, or failure to issue a license to the circuit court in the judicial circuit in which he or she resides. The appeal shall be determined by a review of the record for error.

2.If the circuit court determines the notice of statutory disqualification, failure to issue a receipt, or failure to issue a license was clearly erroneous, the court shall order the county clerk to issue a receipt or CPL as required by Michigan law.

3.If the court determines the decision to deny issuance of a receipt or CPL to an applicant was arbitrary and capricious, the court

shall order the county clerk, entity taking fingerprints, or the state, to pay the actual costs and actual attorney fees of the applicant in appealing the denial, according to each entity’s degree of responsibility.

4.If the court determines an applicant’s appeal was frivolous, the court shall order the applicant to pay the actual costs and actual attorney fees of the county clerk, entity taking fingerprints, or the state in responding to the appeal.

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CONCEALED PISTOL LICENSE APPLICATION

I. General Information: Type or clearly print in ink answers to all fields.

1. Full Legal Name (Include Suffix)

 

 

 

 

 

 

 

 

 

2. Date of Birth

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. Previous Names, Aliases, or Maiden Names (If Applicable)

 

 

 

 

 

4. Daytime Phone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

-

-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5a. Social Security Number (Voluntary)

 

 

 

 

5b. Email Address (Voluntary)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6a. Driver’s License Number or Personal Identification Number

6b. Driver’s License or Personal Identification State of Issuance

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7a. Primary Residence Address

 

 

 

 

 

7b. Primary Residence City

 

 

7c. Primary Residence ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8a. Mailing Address (If Different)

 

 

 

 

8b. Mailing City

 

 

 

8c. Mailing ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9a. Race

 

9b. Gender

 

 

9c. Height

9d. Hair Color

 

 

 

9e. Eye Color

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10.

County of Residence

 

 

 

 

 

11. Place of Birth (State or Country)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12.

Are you a U.S. citizen?

 

13a. Are you a Legal Immigrant Alien?

13b. Alien Registration Number

 

 

13c. Country of Citizenship

 

 

Yes

No

 

 

Yes

No

 

 

 

 

 

 

 

 

 

(If no, complete 13 a, b, and c)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14a. Are you lawfully registered to vote in Michigan?

 

 

 

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14b. Are you on active duty status with the United States Armed Forces, stationed

 

 

 

 

 

 

 

 

outside of Michigan, but your home of record is in Michigan?

 

 

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14c.

Are you on active duty status with the United States Armed Forces, permanently

Yes

No

 

 

 

 

 

stationed in Michigan, but your home of record is outside of Michigan?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

II. Type of License: Check the box next to the type of license that applies to this application.

 

 

 

Standard – Application for Standard License

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Emergency – Personal Protection Order Obtained

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Emergency – Sheriff

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Renewal – If renewing an existing Standard license, complete the renewal information and certification below.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1. Renewal Information

 

 

 

 

 

 

 

 

 

 

 

 

 

 

a. Expiration Date of Current CPL

 

b. County of Issuance

 

c. Name on Previous License

 

d. CPL Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. Renewal Certification

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I certify that I have completed at least three hours of review of the required training and have had at least one hour of firing range time in the

 

six months immediately preceding this application.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date

 

 

 

 

 

 

 

 

 

 

 

III. Survey: Answer "yes" or "no" to the following questions.

 

 

 

 

 

 

 

1.

Have you ever been convicted or adjudicated as a juvenile of a felony in this state or elsewhere?

 

 

 

 

No

Yes

2.Do you have a felony charge pending in this state or elsewhere?

No

Yes

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III. Survey (continued): Answer "yes" or "no" to the following questions.

3. Have you been convicted or adjudicated as a juvenile of a misdemeanor violation, or have a misdemeanor charge pending,

No

Yes

of any offense listed in Section A.9 of the CPL Guide in the eight years immediately preceding this application?

 

 

4.Have you been convicted or adjudicated as a juvenile of a misdemeanor violation, or have a misdemeanor charge

 

pending, of any offense listed in Section A.10 of the CPL Guide in the three years immediately preceding this

No

Yes

 

application?

 

 

5.

Do you have a personal protection order against you or have you been released by a judge or a district court

No

Yes

 

magistrate subject to protective conditions?

 

 

 

 

 

 

 

6.

Have you ever been found guilty but mentally ill of any crime or offered a plea of not guilty of, or been acquitted of,

No

Yes

 

any crime by reason of insanity?

 

 

 

 

 

 

 

7.

Are you now, or have you ever been, subject to an order of involuntary commitment in an inpatient or outpatient setting

No

Yes

 

due to a mental illness?

 

 

 

 

 

 

 

8.

Do you have a diagnosed mental illness that includes an assessment that you present a danger to yourself or another,

No

Yes

 

regardless of whether you are receiving treatment for that illness?

 

 

 

 

 

 

 

9.

Are you under a court order of legal incapacity in this state or elsewhere?

No

Yes

 

 

 

 

10.

Have you ever been dishonorably discharged from the United States Armed Forces?

No

Yes

 

 

 

 

11.

Have you completed the training required for a new CPL (documentation must be presented with the application),

 

 

 

OR have you certified above that you have completed the required review and firing range time for a renewal of your

No

Yes

 

license?

 

 

 

 

 

 

12.

Are you a retired police officer or retired law enforcement officer?

No

Yes

 

 

 

 

13.

Are you exempt from prohibited premises pursuant to MCL 28.425o? If yes, acceptable proof must be provided to the

No

Yes

 

county clerk pursuant to MCL 28.425b(22)(a).

 

 

 

V. Agreement and Certification

By signing below, you acknowledge the following statements are true:

I have read the information provided on carrying a concealed pistol and obtaining a Michigan CPL. I meet all the criteria for obtaining a CPL and I do not have a history of mental illness that would disqualify me from obtaining a CPL under the Firearms Act, 1927 PA 372, as amended.

I give authority to the MSP to access any record needed to perform its required verification through the Law Enforcement Information Network (LEIN) and the National Instant Criminal Background Check System (NICS).

I understand that my personal information, and biometric data being submitted by Livescan, will be used to search against identification records from both the MSP and FBI for the purpose of verifying my eligibility to obtain a CPL. I hereby authorize the release of my personal information for such purpose and release of any records found by the MSP.

During the processing of this application, and for as long as my fingerprints and associated information/biometrics are retained by the State and/or FBI, they may be disclosed without my consent as permitted by MCL 28.248 and the Privacy Act of 1974, 5 USC § 552a, for all applicable routine uses published by the FBI, including the Federal Register and for the routine uses for the FBI's Next Generation Identification. Routine use includes, but is not limited to, disclosure to: governmental or authorized nongovernmental agencies responsible for employment, contracting, licensing, security clearances, and other suitable determinations; local, state, tribal, or federal law enforcement agencies; criminal justice agencies; and agencies responsible for national security or public safety. I understand this new application is executed under oath and swear or affirm under penalty of law that the above answers are true and correct to the best of my knowledge.

I understand that intentionally making a false statement on this application is a felony punishable by imprisonment for not more than four years or a fine of not more than $2,500, or both.

I have been provided with a copy of the compilation of the Firearms Laws of Michigan created by the Legislative Services Bureau and forms to appeal any notice of statutory disqualification, or suspension or revocation of a license under this act.

Applicant's Name and Signature

If completing this form in person, do not sign until instructed by the county clerk or his or her representative. This does not apply to renewal applications if the completed form will be submitted by mail or electronically.

Witness’ Name, Title, and Signature

If completing this form in person, the witness will be the County Clerk or Representative. A witness signature is not necessary for renewal applications if the completed form will be submitted by mail or electronically.

Date

Date

When used as a new application, return the completed unsigned form and documentation of required training to the county clerk's office. A

passport quality photograph must be submitted if a digital photograph is not on file with the Michigan Secretary of State.

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michigan ri 012 form writing process clarified (step 1)

2. Right after this part is completed, go to type in the suitable details in all these: c Are you on active duty status, stationed in Michigan but your, Yes, II Type of License Check the box, Standard Application for Standard, Emergency Personal Protection, Emergency Sheriff, Renewal If renewing an existing, Renewal Information, a Expiration Date of Current CPL, b County of Issuance, c Name on Previous License, d CPL Number, Renewal Certification, and I certify that I have completed at.

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3. Within this stage, review III Survey continued Answer yes or, of any offense listed in Section A, Have you been convicted or, pending of any offense listed in, Do you have a personal protection, magistrate subject to protective, Have you ever been found guilty, any crime by reason of insanity, Are you now or have you ever been, due to a mental illness, Do you have a diagnosed mental, regardless of whether you are, Are you under a court order of, Have you ever been dishonorably, and Have you completed the training. Each one of these will have to be filled out with greatest accuracy.

How to prepare michigan ri 012 form step 3

4. To go onward, your next part requires completing several blanks. These comprise of Applicants Name and Signature If, Date, Witness Name Title and Signature, Date, When used as a new application, and passport quality photograph must, which you'll find integral to carrying on with this particular PDF.

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