Application for License to Carry a Concealed

Transcription

Application for License to Carry a Concealed Handgun
Umatilla County Sheriff’s Office
Terry L. Rowan
Civil Division • 4700 NW Pioneer Place • Pendleton, OR 97801 • (541) 966-3680 • www.co.umatilla.or.us
You must apply in person. Appointments are REQUIRED. Call 541-966-3680.
First (Full Legal Name)
Full Middle
Last
Date of Birth: _______________________ Height:__________ Weight: __________ Eye Color: _______ Hair Color: ________
Driver’s License #: ________________________________________ State: _____ Age: _______ Sex: _______ Race: ________
Social Security No. (Voluntary) ___________________ Place of Birth ________________________________________________
Other and All Names Used (Maiden, Nickname, etc) ______________________________________________________________
Current RESIDENTIAL Street Address
MAILING ADDRESS
_______________________________________________
Numbers and Street Name
_____________________________________________
_______________________________________________
City
State
Zip Code
_____________________________________________
City
State Zip Code
Years at Address______
Home Phone # _________________________ Cell # ________________________________
List ALL states you have lived in as an ADULT: ____________________________________________________________
Email Address (optional): _________________________________________________________________________________
PRIOR ADDRESSES – List all resident addresses for the past three years: (use back of form if more room is needed):
Address: ____________________________________ City: ____________________ State: _________ Zip Code: __________
◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊For Sheriff’s Office Use Only◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊◊
PROOF OF IDENTIFICATION: ( 2 pieces of current I.D. are required, 1 must be Government issued with Photo)
PHOTO ID # 1 Type ____________________________ Number: ________________________ Exp_________
ID #2 Type ____________________________________ Number: ________________________ Exp ________
HANDGUN COMPETENCY
□ N/A Renewal □ Military □ Oregon CHL ______(County) □ Other Date of Training ______ (for new)
Instructor____________________________________ NRA#___________________________________
□NEW $65 □TRANSFER ONLY $30 □NAME CHANGE $30 □ADDRESS CHANGE $15
□TRANSFER & RENEWAL $65
□REINSTATEMENT $15 □DUPLICATE $15
UCSO CHL APP (01-2014) Previous Versions are Obsolete
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□RENEWAL $50
1
APPLICATION TYPE:
Terry L. Rowan
Oregon Law prohibits the issuance of a concealed handgun license to anyone with a felony conviction, a
misdemeanor conviction within the last four years or anyone on pretrial release. Oregon law allows for
the denial of a concealed handgun license if the Sheriff determines you are a danger based upon a past
pattern of unlawful violence or threats of unlawful violence. Oregon Law prohibits the issuance of a
concealed handgun license to anyone who is subject to a court restraining or stalking order, or to anyone
who is required to register as a sex offender in any state. Oregon Law also prohibits issuance of a
concealed handgun license to anyone that has been dishonorably discharged from the Armed Forces of
the United States. Federal Law under 18 USC 922 prohibits anyone who has been convicted in any court of
a misdemeanor crime of domestic violence from possessing a firearm or ammunition. Laws regarding
Oregon Concealed Handgun licensing can be found under Oregon Revised Statutes 166.291 – 166.295.
www.leg.state.or.us/ors
□
INITIAL to indicate that you have read and understand the ABOVE statement.
Qualifications:
You are required to answer the following questions to provide sufficient information to complete a full
background check. Failure to answer any question will result in your application being denied as incomplete.
Making a false statement in this application may result in prosecution for a misdemeanor and will result in an
automatic denial of your application.
Initial the box next to each statement below that is TRUE– Read Carefully. I hereby Declare:
I am now at least 21 years of age.
I have NOT been under the jurisdiction of the juvenile department in the last four years for committing an act
that if committed by an adult, would constitute a felony or a misdemeanor involving violence as defined in ORS
166.470.
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I have NOT been convicted of a misdemeanor within the last four years from the date of this application. This
includes being found guilty of a misdemeanor by reason of insanity under ORS 161.295 in the State of Oregon
or elsewhere.
2
I have NEVER been convicted of a felony. This includes being found guilty of a felony by reason of insanity
under ORS 161.295, in the State of Oregon or elsewhere.
Terry L. Rowan
Initial the box next to each statement below that is TRUE– Read Carefully. I hereby Declare:
There are no outstanding warrants for my arrest AND I am not free on any form of pretrial release including
diversion. (DUII)
I have NOT been committed to the Mental Health and Developmental Disabilities Services Division under ORS
426.130, nor have I been found mentally ill and been prohibited from possessing a firearm because of mental
illness. For those previous criminal or mental health conditions that do apply to me, I have been granted relief
from the disability under ORS 166.274 or 18 USC 925(c). Proof of relief must be attached to this application.
I meet the requirements of ORS 166.291 (f) (A) to (G) of competency with a handgun, and I know I must bring
documentation to my appointment or my application will not be approved. Renewal applicants automatically
meet the requirements. (New Applicants See Page 6 for more details).
I have NEVER been convicted of more than one offense involving a controlled substance.
I understand that I will be photographed (all applicants) and fingerprinted (new applicants and transfers).
I have NEVER been convicted in any court of a misdemeanor crime of domestic violence.
Citizenship Documentation: All new and renewal applicants must provide proof of citizenship.
Initial ONE box only
I am a citizen of the United States and I am providing the following documentation as proof of citizenship.
Check ONE box. □ US Birth Certificate □ US Passport □ FFS240 (Military Service Foreign Birth).
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I am a legal resident alien who can document continuous residency in Umatilla County for at least six months. I
have declared in writing to the Immigration and Naturalization Service my intention to become a citizen and I
can present proof of receipt (the N-300 or N-400 form) to the Sheriff at the time of this application. I will be
eligible to apply for citizenship on _________________________.
3
I am a naturalized citizen of the United Sates and I have documentation of naturalization. (Must provide
documentation at the time of the appointment).
Terry L. Rowan
Residency Requirements:
Initial ONE box only
I have a current Oregon driver’s license showing a residence address in the county.
I am registered to vote in Umatilla County and I have a precinct memorandum card showing a residence
address in Umatilla County.
I have documentation showing that I currently own or lease real property in the county.
I currently live in a contiguous state and am applying as an out of state applicant, I have included a compelling
statement letter demonstrates a reason SPECIFIC to Umatilla County.
Address Change Requirements:
Initial ALL to indicate that you have read and understand the following statements.
I understand that an Oregon Concealed Handgun License Holder is required to provide the Sheriff’s Office with
my current address. ORS166.291(3)(a).
I understand that the fee for a change of address is $15.00. ORS166.291(5)(C).
I understand that failure to update my address could be grounds for revocation of my Concealed Handgun
License.
Privacy Questions:
I am requesting that my concealed handgun license status remain confidential.
PRIVACY NOTICE: If you request confidentiality by selecting “YES”, your CHL status remains
confidential and may only be released by a public body if the disclosure is necessary for criminal
justice purposes, is made in response to a court order or is made with your written permission.
Page
YES NO
4
Initial the boxes to indicate your answers.
Terry L. Rowan
Please INITIAL the appropriate box to indicate your answer to EVERY question.
1) Have you ever been dishonorably discharged from the United States Armed Forces?
Yes
No
2) Have you ever renounced your United States citizenship?
Yes
No
3) Are you subject to any type of restraining or stalking order issued by any court?
Yes
No
3a. If you are subject to a restraining or stalking order, please provide information about the order: _________________________________________________________________________________.
4) Have you ever been required to register as a sex offender in any state?
4a. If you answered Yes, what state required you to register? _____________
4b. Is the requirement to register as a sex offender still in effect?
Yes
Yes
No
No
5) Have you ever been convicted of an offense (including a violation or infraction) involving controlled substances?
A controlled substance is defined under 475.005(6). Examples include but are not limited to marijuana, ecstasy,
heroin, cocaine, LSD, peyote, or methamphetamine. Alcohol is not a controlled substance.)
Yes
No
6) Have you ever been in a court-ordered diversion program related to controlled substance charge including
violations and infractions? If Yes, When and Where?
.
Yes
No
Initial
I have read the entire text of and understand this application, and the statements therein are correct and
true. I further understand that making false statements on this application is a MISDEMEANOR crime, and
that I am subject to prosecution and automatic denial or revocation. All payments are non-refundable.
Signature of Applicant: ______________________________________________ Date Signed: _______________
Please do NOT sign application until you are in our office. We will check ID and then have you sign in front of us.
Page
1. Name, complete mailing address and phone number.
________________________________________________________________________________
2. Name, complete mailing address and phone number.
________________________________________________________________________________
5
NEW APPLICANTS ONLY – Reference Information required:
List two character references
Terry L. Rowan
NEW APPLICANTS ONLY – Must be able to provide acceptable
documentation of compliance of ORS 166.291(f) (A) to (G) of competency with
a handgun. No Photocopies of training certificates will be accepted, originals
only.
ORS 166.291(f) (A) to (G) - bolding added for emphasis
(A) Completion of any hunter education or hunter safety course approved by the
State Department of Fish and Wildlife or a similar agency of another state if
handgun safety was a component of the course;
(B) Completion of any National Rifle Association firearms safety or training
course if handgun safety was a component of the course;
(C) Completion of any firearms safety or training course or class available to
the general public offered by law enforcement, community college, or private or
public institution or organization or firearms training school utilizing instructors
certified by the National Rifle Association or a law enforcement agency if
handgun safety was a component of the course;
(D) Completion of any law enforcement firearms safety or training course or
class offered for security guards, investigators, reserve law enforcement officers
or any other law enforcement officers if handgun safety was a component of
the course;
(E) Presents evidence of equivalent experience with a handgun through
participation in organized shooting competition or military service;
(F) Is licensed or has been licensed to carry a firearm in this state, unless the
license has been revoked; or
(G) Completion of any firearms training or safety course or class conducted
by a firearms instructor certified by a law enforcement agency or the
National Rifle Association if handgun safety was a component of the course;
Military Service Members: Documentation can be shown through your DD Form 214,
qualification records, Military Rank, certain MOS, NEC etc. Please call if you have
questions.
Page
6
Please contact our agency if you have additional questions regarding
competency requirements. We look forward to assisting you.
Umatilla County Sheriff’s Office Concealed Handgun Unit 541-966-3680.
UMATILLA COUNTY SHERIFF’S OFFICE
Sheriff Terry L. Rowan ● Civil Division and CHL Unit
4700 NW Pioneer Place ● Pendleton, OR 97801 ● www.co.umatilla.or.us/civil/htm
Concealed Handgun License (CHL) Application Instructions
Applications taken by Appointment ONLY - Call 541-966-3680
Applications will NOT be accepted without the required documentation
NEW APPLICANTS: Applications are taken by APPOINTMENT ONLY, please call 541-966-3680. Please
BRING the following with you AT THE TIME of your APPOINTMENT…..
1.
Your completed application. (Please wait to date and sign it in person at your appointment).
2.
Proof of handgun safety training which has been approved by the Sheriff in accordance with State
Law Requirements. No copies of certificates of handgun safety classes, originals only. See page 6 of
application for further explanation.
3.
2 Forms of acceptable ID (one must be government issued photo ID). Call if you have questions.
4.
Nonrefundable fee of $65.00. Acceptable forms of payment are either
CASH in EXACT CHANGE or a CHECK made out to Umatilla County Sheriff’s Office.
5.
Proof of Citizenship: US Birth Certificate, US Passport or FFS240 (Military Service Foreign Birth)
Copies will not be accepted.
6.
If NOT BORN in the United States- you must provide documentation of naturalization or proof of
intent to become a citizen (N-300 or N-400 form). See page 3 of application.
7.
Driver’s License or State ID Card (Make sure your CURRENT resident address shows on your driver’s
license or has been provided to DMV). .
8.
If NOT an OREGON RESIDENT- Umatilla County Sheriff will accept applications from individuals living
in states which border the State of Oregon. **See section below labeled OUT OF STATE APPLICANTS
for additional requirements.
At the time of your appointment your application will be reviewed and ID will be checked. Your photograph
will be taken and you will be fingerprinted. After your appointment we will run a complete background
investigation. Upon approval, your concealed handgun license will be mailed to you in approximately 45
days. Please call our office if you have questions.
OUT OF STATE NEW APPLICANTS (also known as NON-RESIDENT): Applications are taken by
APPOINTMENT ONLY, please call 541-966-3680. PLEASE refer to the NEW APPLICANTS ONLY Section above
to see a list of items needed to apply. The following is a list of ADDITIONAL ITEMS that are required AT THE
TIME of your APPOINTMENT:
1.
A written request addressed to the Sheriff requesting permission to apply as a nonresident applicant and providing a reason for the request that is specific to Umatilla
County, such as a business interest or other demonstrated need. Under Oregon Law;
Issuance of a license to a non-resident applicant is at the discretion of the Sheriff.
2.
Documentation from your State that you have NOT been committed to Mental Health
and Developmental Disability Services Division. This does NOT apply to Washington State
residents. Please call our office if you have questions.
UMATILLA COUNTY SHERIFF’S OFFICE
Sheriff Terry L. Rowan ● Civil Division and CHL Unit
4700 NW Pioneer Place ● Pendleton, OR 97801 ● www.co.umatilla.or.us/civil/htm
RENEWING APPLICANTS: Applications are taken by APPOINTMENT ONLY; please call 541-966-3680.
Please BRING the following with you AT THE TIME of your APPOINTMENT…..
1.
2 Forms of acceptable ID (most common used is Driver’s License & your current Concealed Handgun
License) and Proof of Citizenship (Birth Certificate, U.S. Passport, FFS240 etc.)
2.
Nonrefundable fee of $50.00. Acceptable forms of payment are either
CASH in EXACT CHANGE or a CHECK made out to Umatilla County Sheriff’s Office.
3.
Driver’s License or State ID Card (Make sure your CURRENT resident address shows on your driver’s
license or has been provided to DMV).
4.
Your completed application. (Please wait to date and sign it in person at your appointment).
At the time of your appointment your application will be reviewed and ID will be checked. Your photograph
will be taken. After your appointment we will run a complete background investigation. Upon approval,
your concealed handgun license will be mailed to you. Please call our office if you have questions.
Common Questions
What if my License has EXPIRED? - The renewal PROCESS and cost is the SAME regardless of whether you
apply before or after the expiration date. (If your license has EXPIRED, you do NOT need to retake a handgun
safety class to apply for renewal). If your license has expired, you are NOT covered to carry until you apply
for a renewal and receive the new license.
I applied for renewal BEFORE my license expired, but what if my License EXPIRES before I get my new
license? Am I still covered to Carry?
If you renewed BEFORE your current license expired, you are covered to carry concealed past the expiration
date (up to 45 days from the date you renew) until such time as you receive your new Concealed Handgun
License. You must carry the EXPIRED CHL and the RECEIPT showing you renewed.
Does your office MAIL out RENEWAL NOTICES? - Yes, as a courtesy our office does mail out renewal
notices. However, it is the responsibility of the individual license holder to be aware of the expiration date of
their license and schedule an appointment for renewal with the Sheriff’s Office.
CAUTION: A Concealed Handgun License (CHL) does not authorize you to carry a firearm everywhere. Oregon law
provides a few limits on where a person with a Concealed Handgun License can carry a firearm, and federal laws contain a
few more prohibitions. Be aware that even if you have a Concealed Handgun License, you cannot carry a firearm on any of
the following properties:

Federal facilities - federal courthouses, social security offices, in secured areas of airports, and on airplanes

National forests marked or posted by signs prohibiting all firearms

Tribal reservations or Tribal property - you may not carry a firearm concealed without the written permission of
the tribal council; this may also apply to certain casinos on Tribal lands. Contact the Tribal Police for more
information 541-278-0550.

Courts - in a courtroom, jury room, judge's chambers or adjacent areas that the presiding judge determines
should be free of firearms to ensure the safety of the litigants, court personnel, witnesses and others

Private property, business or facility where the owner prohibits firearms possession
If found with a handgun on these premises you may be subject to arrest under Oregon Laws, in which case your concealed
handgun license would be seized and/or revoked.
ATTENTION: You must carry your valid concealed handgun license with you whenever you carry a concealed handgun.
Failure to carry a CHL when carrying concealed is prima facie evidence that the person does not have such a license.

Application for License to Carry a Concealed

Transcription

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