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  1. [code]
  2.  
  3.  
  4. [divbox=white][center][img]https://i.imgur.com/wg4RsRM.png[/img]
  5. [size=150][b]Firearm License Application[/b][/size]
  6. [size=130]Personal History Questionnaire[/size][/center]
  7. [color=#FFFFFF]BREAK[/color]
  8. [hr]
  9. [color=#FFFFFF]BREAK[/color]
  10. [border][i]This application is a permanent record. All information must be typed or neatly printed by the applicant. Illegible or incomplete applications will not be accepted. Failure to fully explain your answers, intentionally making a false statement on any material fact or practices or attempting any deception or fraud may disqualify you from the selection process immediately.[/i][/border]
  11. [color=#FFFFFF]BREAK[/color]
  12. [hr]
  13. [color=#FFFFFF]BREAK[/color]
  14. [legend=Personal Information]Legal Name
  15. [color=#FFFFFF]BREAK[/color]Last:
  16. [color=#FFFFFF]BREAK[/color]First:
  17. [color=#FFFFFF]BREAK[/color]Middle:
  18.  
  19. Sex:
  20.  
  21. Height:
  22.  
  23. Weight:
  24.  
  25. Hair:
  26.  
  27. Eyes:
  28.  
  29. Citizenship Status (Remove Inapplicable)
  30. [color=#FFFFFF]BREAK[/color]US Citizen
  31. [color=#FFFFFF]BREAK[/color]Naturalized Citizen
  32. [color=#FFFFFF]BREAK[/color]Legal Alien
  33.  
  34. Date of Birth:
  35.  
  36. Place of Birth (city, county, state and country):
  37.  
  38. Present Address
  39. [color=#FFFFFF]BREAK[/color]Number, street and apt. no:
  40. [color=#FFFFFF]BREAK[/color]City:
  41. [color=#FFFFFF]BREAK[/color]State:
  42. [color=#FFFFFF]BREAK[/color]Name of Country:
  43.  
  44. Contact
  45. [color=#FFFFFF]BREAK[/color]Phone no.:
  46. [color=#FFFFFF]BREAK[/color]E-mail address:
  47.  
  48. Marital Status (Remove Inapplicable)
  49. [color=#FFFFFF]BREAK[/color]Single
  50. [color=#FFFFFF]BREAK[/color]Married
  51. [color=#FFFFFF]BREAK[/color]Widowed
  52. [color=#FFFFFF]BREAK[/color]Separated
  53. [color=#FFFFFF]BREAK[/color]Annulled
  54. [color=#FFFFFF]BREAK[/color]Divorced
  55. [/legend]
  56.  
  57. [legend=Experience and Employment]
  58. - Ex-Police Officers Only -
  59.  
  60. Have you ever applied to the Los Santos Police Department before (for any position)?: Yes/No
  61. [color=#FFFFFF]BREAK[/color]Submitted application only
  62. [color=#FFFFFF]BREAK[/color]Oral interview taken
  63. [color=#FFFFFF]BREAK[/color]Oral interview failed
  64. [color=#FFFFFF]BREAK[/color]Background investigation conducted
  65. [color=#FFFFFF]BREAK[/color]Background pending
  66. [color=#FFFFFF]BREAK[/color]Disqualified
  67. [color=#FFFFFF]BREAK[/color]Was not selected
  68. [color=#FFFFFF]BREAK[/color]Hired or job offer made
  69. [color=#FFFFFF]BREAK[/color]Withdrew application or denied
  70. [color=#FFFFFF]BREAK[/color]Other
  71. [/legend]
  72.  
  73. [legend=Education]
  74. Please indicate your current education status. (Remove Inapplicable)
  75. [color=#FFFFFF]BREAK[/color]I possess a high school diploma from a US institution
  76. [color=#FFFFFF]BREAK[/color]I possess a two-year college degree from an accredited college.
  77. [color=#FFFFFF]BREAK[/color]I possess a four-year degree from an accredited college or university.
  78. [color=#FFFFFF]BREAK[/color]I passed the GED test meeting the required scores.
  79. [color=#FFFFFF]BREAK[/color]I passed the San Andreas High School Proficiency Examination.
  80.  
  81. Academia Details
  82. [color=#FFFFFF]BREAK[/color]Name of US High School Attended:
  83. [color=#FFFFFF]BREAK[/color]Address of US High School Attended:
  84. [color=#FFFFFF]BREAK[/color]From: MONTH YEAR
  85. [color=#FFFFFF]BREAK[/color]To: MONTH YEAR
  86. [color=#FFFFFF]BREAK[/color]Did you graduate?: Yes/No
  87.  
  88. [color=#FFFFFF]BREAK[/color]Name of College or University:
  89. [color=#FFFFFF]BREAK[/color]Address of College or University:
  90. [color=#FFFFFF]BREAK[/color]Degree Type:
  91. [color=#FFFFFF]BREAK[/color]From: MONTH YEAR
  92. [color=#FFFFFF]BREAK[/color]To: MONTH YEAR
  93. [/legend]
  94.  
  95. [legend=Legal]
  96. Either as an adult or a juvenile, have you ever been arrested or charged with a criminal act?: Yes/No
  97. [color=#FFFFFF]BREAK[/color]If yes
  98. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Date:
  99. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Charges:
  100. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Police Agency:
  101. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Results:
  102. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Explain Circumstances:
  103.  
  104. Either as an adult or a juvenile, have you ever been detained for a criminal investigation, or named as a suspect in a police report, or held on suspicion, or questioned, or fingerprinted by any law enforcement agency or military authority, even as a victim or witness?: Yes/No
  105. [color=#FFFFFF]BREAK[/color]If yes
  106. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Date:
  107. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Charges or Reason for Investigation:
  108. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Police Agency:
  109.  
  110. Have you ever received a misdemeanor citation in lieu of going to jail?: Yes/No
  111. [color=#FFFFFF]BREAK[/color]If yes
  112. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Date:
  113. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Police Agency:
  114. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Explain Circumstances:
  115.  
  116. Have you ever been placed on court probation?: Yes/No
  117. [color=#FFFFFF]BREAK[/color]If yes
  118. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Date:
  119. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Explain Circumstances:
  120.  
  121. Are you currently on probation?: Yes/No
  122.  
  123. Have you ever had a warrant issued for your arrest or have you ever failed to appear in court on a criminal matter?: Yes/No
  124. [color=#FFFFFF]BREAK[/color]If yes
  125. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Explain Circumstances:
  126.  
  127. Have you ever been reported to a law enforcement agency as a missing person or runaway?: Yes/No
  128. [color=#FFFFFF]BREAK[/color]If yes
  129. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Explain Circumstances:
  130.  
  131. Have you ever applied in the past for a permit to carry a concealed weapon?: Yes/No
  132. [color=#FFFFFF]BREAK[/color]If yes
  133. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Date Applied:
  134. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Was permit granted?:
  135. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Weapon:
  136.  
  137. Have you ever participated in an unlawful demonstration?: Yes/No
  138. [color=#FFFFFF]BREAK[/color]If yes
  139. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Explain Circumstances:
  140.  
  141. Have you ever engaged in civil disobedience?: Yes/No
  142. [color=#FFFFFF]BREAK[/color]If yes
  143. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Explain Circumstances:
  144.  
  145. [/legend]
  146.  
  147. [color=#FFFFFF]BREAK[/color]
  148. [hr]
  149. [color=#FFFFFF]BREAK[/color]
  150. [border][i]I hereby certify that all statements made in this questionnaire are true and complete. I understand that any discrepancies, misstatements, omissions, and/or falsifications will be cause for disqualification, for my name to be removed from the eligibility list, or for immediate termination if an appointment has been made.[/i]
  151.  
  152. [color=#FFFFFF]BREAK[/color]Applicant's Signature:
  153. [color=#FFFFFF]BREAK[/color]Date:
  154. [/border]
  155. [/divbox]
  156. [/code]
  157.  
  158. [divbox=white][center][img]https://i.imgur.com/wg4RsRM.png[/img]
  159. [size=150][b]Firearm License Application[/b][/size]
  160. [size=130]Personal History Questionnaire[/size][/center]
  161. [color=#FFFFFF]BREAK[/color]
  162. [hr]
  163. [color=#FFFFFF]BREAK[/color]
  164. [border][i]This application is a permanent record. All information must be typed or neatly printed by the applicant. Illegible or incomplete applications will not be accepted. Failure to fully explain your answers, intentionally making a false statement on any material fact or practices or attempting any deception or fraud may disqualify you from the selection process immediately.[/i][/border]
  165. [color=#FFFFFF]BREAK[/color]
  166. [hr]
  167. [color=#FFFFFF]BREAK[/color]
  168. [legend=Personal Information]Legal Name
  169. [color=#FFFFFF]BREAK[/color]Last:
  170. [color=#FFFFFF]BREAK[/color]First:
  171. [color=#FFFFFF]BREAK[/color]Middle:
  172.  
  173. Sex:
  174.  
  175. Height:
  176.  
  177. Weight:
  178.  
  179. Hair:
  180.  
  181. Eyes:
  182.  
  183. Citizenship Status (Remove Inapplicable)
  184. [color=#FFFFFF]BREAK[/color]US Citizen
  185. [color=#FFFFFF]BREAK[/color]Naturalized Citizen
  186. [color=#FFFFFF]BREAK[/color]Legal Alien
  187.  
  188. Date of Birth:
  189.  
  190. Place of Birth (city, county, state and country):
  191.  
  192. Present Address
  193. [color=#FFFFFF]BREAK[/color]Number, street and apt. no:
  194. [color=#FFFFFF]BREAK[/color]City:
  195. [color=#FFFFFF]BREAK[/color]State:
  196. [color=#FFFFFF]BREAK[/color]Name of Country:
  197.  
  198. Contact
  199. [color=#FFFFFF]BREAK[/color]Phone no.:
  200. [color=#FFFFFF]BREAK[/color]E-mail address:
  201.  
  202. Marital Status (Remove Inapplicable)
  203. [color=#FFFFFF]BREAK[/color]Single
  204. [color=#FFFFFF]BREAK[/color]Married
  205. [color=#FFFFFF]BREAK[/color]Widowed
  206. [color=#FFFFFF]BREAK[/color]Separated
  207. [color=#FFFFFF]BREAK[/color]Annulled
  208. [color=#FFFFFF]BREAK[/color]Divorced
  209. [/legend]
  210.  
  211. [legend=Experience and Employment]
  212. - Ex-Police Officers Only -
  213.  
  214. Have you ever applied to the Los Santos Police Department before (for any position)?: Yes/No
  215. [color=#FFFFFF]BREAK[/color]Submitted application only
  216. [color=#FFFFFF]BREAK[/color]Oral interview taken
  217. [color=#FFFFFF]BREAK[/color]Oral interview failed
  218. [color=#FFFFFF]BREAK[/color]Background investigation conducted
  219. [color=#FFFFFF]BREAK[/color]Background pending
  220. [color=#FFFFFF]BREAK[/color]Disqualified
  221. [color=#FFFFFF]BREAK[/color]Was not selected
  222. [color=#FFFFFF]BREAK[/color]Hired or job offer made
  223. [color=#FFFFFF]BREAK[/color]Withdrew application or denied
  224. [color=#FFFFFF]BREAK[/color]Other
  225. [/legend]
  226.  
  227. [legend=Education]
  228. Please indicate your current education status. (Remove Inapplicable)
  229. [color=#FFFFFF]BREAK[/color]I possess a high school diploma from a US institution
  230. [color=#FFFFFF]BREAK[/color]I possess a two-year college degree from an accredited college.
  231. [color=#FFFFFF]BREAK[/color]I possess a four-year degree from an accredited college or university.
  232. [color=#FFFFFF]BREAK[/color]I passed the GED test meeting the required scores.
  233. [color=#FFFFFF]BREAK[/color]I passed the San Andreas High School Proficiency Examination.
  234.  
  235. Academia Details
  236. [color=#FFFFFF]BREAK[/color]Name of US High School Attended:
  237. [color=#FFFFFF]BREAK[/color]Address of US High School Attended:
  238. [color=#FFFFFF]BREAK[/color]From: MONTH YEAR
  239. [color=#FFFFFF]BREAK[/color]To: MONTH YEAR
  240. [color=#FFFFFF]BREAK[/color]Did you graduate?: Yes/No
  241.  
  242. [color=#FFFFFF]BREAK[/color]Name of College or University:
  243. [color=#FFFFFF]BREAK[/color]Address of College or University:
  244. [color=#FFFFFF]BREAK[/color]Degree Type:
  245. [color=#FFFFFF]BREAK[/color]From: MONTH YEAR
  246. [color=#FFFFFF]BREAK[/color]To: MONTH YEAR
  247. [/legend]
  248.  
  249. [legend=Legal]
  250. Either as an adult or a juvenile, have you ever been arrested or charged with a criminal act?: Yes/No
  251. [color=#FFFFFF]BREAK[/color]If yes
  252. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Date:
  253. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Charges:
  254. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Police Agency:
  255. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Results:
  256. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Explain Circumstances:
  257.  
  258. Either as an adult or a juvenile, have you ever been detained for a criminal investigation, or named as a suspect in a police report, or held on suspicion, or questioned, or fingerprinted by any law enforcement agency or military authority, even as a victim or witness?: Yes/No
  259. [color=#FFFFFF]BREAK[/color]If yes
  260. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Date:
  261. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Charges or Reason for Investigation:
  262. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Police Agency:
  263.  
  264. Have you ever received a misdemeanor citation in lieu of going to jail?: Yes/No
  265. [color=#FFFFFF]BREAK[/color]If yes
  266. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Date:
  267. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Police Agency:
  268. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Explain Circumstances:
  269.  
  270. Have you ever been placed on court probation?: Yes/No
  271. [color=#FFFFFF]BREAK[/color]If yes
  272. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Date:
  273. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Explain Circumstances:
  274.  
  275. Are you currently on probation?: Yes/No
  276.  
  277. Have you ever had a warrant issued for your arrest or have you ever failed to appear in court on a criminal matter?: Yes/No
  278. [color=#FFFFFF]BREAK[/color]If yes
  279. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Explain Circumstances:
  280.  
  281. Have you ever been reported to a law enforcement agency as a missing person or runaway?: Yes/No
  282. [color=#FFFFFF]BREAK[/color]If yes
  283. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Explain Circumstances:
  284.  
  285. Have you ever applied in the past for a permit to carry a concealed weapon?: Yes/No
  286. [color=#FFFFFF]BREAK[/color]If yes
  287. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Date Applied:
  288. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Was permit granted?:
  289. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Weapon:
  290.  
  291. Have you ever participated in an unlawful demonstration?: Yes/No
  292. [color=#FFFFFF]BREAK[/color]If yes
  293. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Explain Circumstances:
  294.  
  295. Have you ever engaged in civil disobedience?: Yes/No
  296. [color=#FFFFFF]BREAK[/color]If yes
  297. [color=#FFFFFF]BREAK[/color][color=#FFFFFF]BREAK[/color]Explain Circumstances:
  298.  
  299. [/legend]
  300.  
  301. [color=#FFFFFF]BREAK[/color]
  302. [hr]
  303. [color=#FFFFFF]BREAK[/color]
  304. [border][i]I hereby certify that all statements made in this questionnaire are true and complete. I understand that any discrepancies, misstatements, omissions, and/or falsifications will be cause for disqualification, for my name to be removed from the eligibility list, or for immediate termination if an appointment has been made.[/i]
  305.  
  306. [color=#FFFFFF]BREAK[/color]Applicant's Signature:
  307. [color=#FFFFFF]BREAK[/color]Date:
  308. [/border]
  309. [/divbox]
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