Fill a Valid Illinois Application Firearm Form
The Illinois Application Firearm form serves as a crucial document for individuals seeking a firearm control card, particularly those employed in security-related roles. This application outlines specific eligibility requirements, such as the applicant needing to be at least 21 years old and possessing a verifiable firearm training number. Additionally, it mandates the disclosure of a U.S. social security number, which is used for various identification purposes, including compliance with child support and tax obligations. Certain exemptions exist, notably for peace officers and armed security guards at regulated nuclear facilities, which allow them to bypass some registration requirements. The application also requires the submission of a non-refundable processing fee of $75, along with detailed personal information, including height, weight, and any prior criminal history. Moreover, it emphasizes the importance of returning the firearm control card upon termination of employment, ensuring that the card is properly managed throughout the employee's tenure. This comprehensive form is a key step in maintaining safety and regulatory compliance within the state of Illinois.
Example - Illinois Application Firearm Form
APPLICATION FOR FIREARM CONTROL CARD
FOR LICENSEE/LICENSED AGENCIES
INSTRUCTIONS
EXEMPTIONS: A peace officer as defined in the Private Detective, Private Alarm, Private Security, Fingerprint Vendor, and Locksmith Act is exempt from the requirements relating to the possession of a firearm control card. The employing agency shall remain responsible for any peace officer employed under this exemption.
A person employed as an armed security guard at a nuclear energy, storage, weapons, or development site or facility regulated by the Nuclear Regulatory Commission who has completed the background screening and training mandated by the rules and regulations of the Nuclear Regulatory Commission is exempt from registration for a firearm control card.
1.Please type or print.
2.Applicant must be at least 21 years of age to apply for a firearm control card.
3.Disclosure of your U.S. social security number, if you have one, is mandatory, in accordance with 5 Illinois Com- piled Statutes
identify persons who are more than 30 days delinquent in complying with a child support order, or to the Illinois
Department of Revenue to identify persons who have failed to file a tax return, pay tax, penalty or interest shown in a filed return, or to pay any final assessment or tax penalty or interest, as required by any tax Act administered by the Illinois Department of Revenue, or to other entities for verification of identification.
4.The name shown for the employee or licensee to whom the card will be issued must be as it appears on the per-
manent employee registration card or on the private detective, private security contractor, and/or private alarm contractor license that the applicant possesses. An application for a firearm control card may be completed by a licensed private detective, private security contractor, or private alarm contractor working on their own behalf.
5.Applicant must have a verifiable firearm training number (see item 6 of applicant section) to be eligible for firearm control card. The
6.A $75 processing fee, made payable to the Illinois Department of Financial and Professional Regulation, must accompany this application. There will be a $45 triennial fee required for renewal of this card. All fees are nonre- fundable.
7.The firearm control card shall be retained by the employee for the term of employment. Upon termination of em- ployment, the card shall be returned to the Department by the employer. The firearm control card will expire on date specified on face of the card.
8.Child support statement and state tax statement must be answered.
9. Send application and fee to: |
Department of Financial and Professional Regulation |
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Attn: Division of Professional Regulation |
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320 West Washington Street, 3rd Floor |
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Springfield, Illinois 62786 |
Packet Updated 4/30/19 |
APPLICATION FOR FIREARM CONTROL CARD
FOR LICENSEE/LICENSED AGENCIES
IMPORTANT NOTICE: Effective July 13, 2012, submit a
payable to IDFPR. Completion of this form is necessary for consideration for licensure under
225 of the Illinois Compiled Statutes 447/1et. seq. Disclosure of this information is REQUIRED. However, failure to comply may result in this form not being processed.
Agency / Licensee Number - This box to be completed by the Division of Professional Regula-
tion:
FOR OFFICIAL USE ONLY
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THIS SECTION TO BE COMPLETED BY APPLICANT/LICENSEE |
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1. |
NAME OF EMPLOYEE/LICENSEE TO WHICH CARD WILL BE ISSUE |
2. UNITED STATES SOCIAL SECURITY NUMBER |
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(Last, First, Middle Initial) |
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3. |
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4. |
INDIVIDUAL LICENSE |
NUMBER, IF APPLICABLE |
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Only use one prefix.) |
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5. |
PERC |
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6. FIREARM TRAINING NUMBER |
7. |
F.O.I. NUMBER (You must attach a legible photocopy of active F.O.I.D. |
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129- |
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230- |
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card.) |
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8. |
PERSONAL DATA (See reverse side for assistance in completing this |
9. I have been trained on the following weapon(s): |
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portion.) |
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Type: |
Last Qualification Date (M/D/Y) |
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A. Height: |
_________ |
E. Eye Color: _________ |
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Revolver |
_____ / _____ / ________ |
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B. Weight: |
_________ |
F. Race: |
_________ |
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C. Date of Birth: _________ |
G. Sex: |
_________ |
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_____ / _____ / ________ |
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D. Hair Color: |
_________ |
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Shotgun |
_____ / _____ / ________ |
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Rifle |
_____ / _____ / ________ |
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10.Have you ever had an Illinois license or registration disciplined based upon a violation of the Illinois Private
Detective, Private Alarm, Private Security, Fingerprint Vendor, and Locksmith Act or administrative rule? |
Yes |
No |
If yes, include a detailed explanation of the nature of the offense and the final disposition of the case. |
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11.Have you been convicted of or pled guilty or nolo contendere to any criminal offense in any state or in federal court? Please do not give details on minor traffic charges, but do include information relating to Driving While Intoxicated (DWI) charges. If yes, attach a personal statement describing the circumstances of the conviction and certified copies of court records of your conviction including the nature of the offense, date of discharge, and a statement from the probation or parole office. In general, a criminal conviction by
itself does not usually result in denial of licensure. |
Yes |
No |
12.Do you now have any disease or condition that presently limits your ability to perform the essential functions of your profession, including any disease or condition generally regarded as chronic by the medical community, i.e., (1) mental or emotional disease or condition; (2) alcohol or other substance abuse; (3) physical disease or condition? If yes, attach a detailed statement, including an explanation whether or not you are currently under treatment.
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Yes |
No |
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13. Have you ever been dishonorably discharged from the armed services or from a city, country, state of |
Yes |
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federal position? If yes, attach explanation. |
No |
14.In accordance with 5 Illinois Compiled Statutes
Are you more than 30 days delinquent in complying with a child support order? |
Yes |
No |
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(NOTE: If you are not subject to a child support order, answer "no.") |
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15.In accordance with 20 ILCS
Are you delinquent in the filing of state taxes? |
Yes |
No |
Signature of Employee/Licensee: |
Date: |
THE EMPLOYING AGENCY/LICENSEE MUST COMPLETE PAGE 2
(DE) |
Ap for Firearm Control Card for Licensed Agencies - Page 1 of 2 |
THIS SECTION TO BE COMPLETED BY EMPLOYING AGENCY/LICENSEE
1. NAME OF AGENCY/LICENSEE AS IT APPEARS ON LICENSE |
2. AGENCY/LICENSEE TELEPHONE NUMBER |
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( ___ ___ ___) ___ ___ |
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ADDRESS OF AGENCY/LICENSEE (Street, City, State, Zip Code) |
4. |
NAME OF LICENSEE IN CHARGE OF AGENCY/LICENSEE |
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5. |
AGENCY LICENSE NUMBER |
6. |
LICENSE NUMBER OF LICENSEE OR LICENSEE IN CHARGE |
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7. |
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Signature of Licensee or Licensee in Charge: |
Date: |
(Licensee or Licensee in Charge)
I UNDERSTAND THAT FEES ARE NOT REFUNDABLE. My signature above authorizes the Department of Financial and Professional
Regulation to reduce the amount of this check if the amount submitted is not correct. I understand this will be done only if the amount submitted is greater than the required fee hereunder, but in no event shall such reduction be made in an amount greater than $50.
INSTRUCTIONS FOR ABBREVIATIONS OF PERSONAL DATA
FOR BOX 8 ON PAGE 1 OF THE APPLICATION
NAME (Last, First, MI): |
A.HEIGHT
Express in feet and inches respectively. (Do not use fractions of an inch; round off to the nearest inch.
Example: 5'11": 511
6'0": 600
70": 510
B.WEIGHT
Express in pounds.
(Do not use fractions of a pound; round off to the nearest pound.)
Example: |
94 lbs: |
094 |
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186 lbs: |
186 |
C.DATE OF BIRTH
Month/Day/Year
D. HAIR |
COLOR |
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F. RACE |
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*Bald |
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BAL |
White |
W |
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Black |
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BLK |
Black |
B |
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Blond or Strawberry |
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BLN |
Asian/Pacific Islander |
A |
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Brown |
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BRO |
American Indian/Alaskan |
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Gray or Partially Gray |
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GRY |
Unknown |
U |
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Red or Auburn RED |
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Sandy |
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SDY |
G. SEX |
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White |
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WHI |
Male |
M |
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*Bald (BAL) is to be used when subject has |
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Female |
F |
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lost most of the hair on his head or is hair |
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less. |
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E. EYE COLOR |
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Black |
BLK |
Green |
GRN |
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Blue |
BLU |
Hazel |
HAZ |
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Brown |
BRO |
Maroon |
MAR |
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Gray |
GRY |
Pink |
PNK |
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SS#: |
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Profession: |
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___________________ |
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Ap for Firearm Control Card for Licensed Agencies - Page 2 of 2 |
IMPORTANT NOTICE: Completion of this form
is necessary to accomplish the requirements outlined in 225 ILCS 447/1 et. seq. (Illinois Compiled Statues). Disclosure of this information is REQUIRED. Failure to provide this information
could result in a penalty as outlined in said Act.
RETURN TO: |
STATE OF ILLINOIS |
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DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION |
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ATTN: DIVISION OF PROFESSIONAL REGULATION |
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320 West Washington Street, 3rd Floor |
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Springfield, Illinois 62786 |
CARD TERMINATION
Upon termination, for any reason, of the employment of the individual to whom card marked below has been issued, it is the respon- sibility of the
To return the card, Section I of this form must be completed, the card must be attached to the form and mailed to the Department at the address shown at the top of this form.
If the card cannot be obtained for return to the Department, Section II of this form MUST be completed and submitted to the De- partment within 72 hours of termination of the individual’s employment.
Failure to comply with these requirements is grounds for discipline of the license of the
Check the box below that pertains to the card being returned for the employee listed on the form: |
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CANINE HANDLER AUTHORIZATION CARD |
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FIREARM CONTROL CARD |
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CANINE TRAINER AUTHORIZATION CARD |
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SECTION |
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1. EMPLOYEE NAME (Last, First, Middle Initial) |
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2. SOCIAL SECURITY NUMBER |
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___ ___ ___ - ___ ___ - ___ ___ ___ ___ |
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3. |
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4. DATE OF EMPLOYEE’S TERMINATION |
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CANINE HANDLER AUTHORIZATION CARD NUMBER 267 |
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CANINE TRAINER AUTHORIZATION CARD NUMBER |
266 |
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FIREARM CONTROL CARD NUMBER |
229 |
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Month |
Day |
Year |
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I attest that the
Signature_____________________________________________ |
_________________________________________________ |
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Name of Agency or Proprietary Security Force |
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_____________________________________________ |
_________________________________________________ |
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License Number of |
License Number of Agency or Registration Number |
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(Not Applicable for Proprietary Security Force) |
of Proprietary Security Force |
SECTION |
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A. |
EMPLOYEE NAME (Last, First, Middle Initial) |
B. SOCIAL SECURITY NUMBER |
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___ ___ ___ - ___ ___ - ___ ___ ___ ___ |
C.CANINE HANDLER AUTHORIZATION CARD NUMBER 267 -
CANINE TRAINER AUTHORIZATION CARD NUMBER 266 - |
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FIREARM CONTROL CARD NUMBER |
229 - |
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D. EMPLOYEE FIREARM OWNER’S I.D. CARD NUMBER (For FCC only) |
E. |
EXPIRATION DATE OF FIREARM CONTROL CARD |
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F. DATE EMPLOYEE LEFT AGENCY |
G. THE CARD MARKED ABOVE IS NOT ATTACHED FOR THE FOLLOWING REASON(S): |
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Month |
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Year |
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I attest that the
Signature_____________________________________________ |
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Name of Agency or Proprietary Security Force |
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_________________________________________________ |
License Number of |
License Number of Agency or Registration Number |
(Not Applicable for Proprietary Security Force) |
of Proprietary Security Force |
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Document Breakdown
| Fact Name | Details |
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| Exemptions | Peace officers and armed security guards at regulated nuclear facilities are exempt from needing a firearm control card. |
| Age Requirement | Applicants must be at least 21 years old to apply for a firearm control card. |
| Social Security Disclosure | Providing a U.S. social security number is mandatory, as outlined in 5 Illinois Compiled Statutes 100/10-65. |
| Training Requirement | Applicants need a verifiable firearm training number and must have completed a 40-hour training course within the last two years. |
| Application Fee | A non-refundable processing fee of $75 is required, along with a $45 triennial renewal fee. |
| Renewal and Return Policy | The firearm control card must be returned to the Department upon termination of employment, and it will expire as indicated on the card. |
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