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[center][size=130]LOS SANTOS POLICE DEPARTMENT
FIREARMS LICENSING DIVISION
ADMINISTRATIVE SERVICES BUREAU | OFFICE OF ADMINISTRATIVE SERVICES[/size]

[img]http://i1143.photobucket.com/albums/n635/GeorgeForan/Los%20Santos%20Police%20Department/Office%20and%20Divisional%20Images/Personnel%20and%20Training%20Bureau/FLDsmall.png[/img]

[size=130][b]STANDARD APPLICATION
for
LICENSE TO CARRY A CONCEALED WEAPON (CCW)[/b][/size][/center]
[hr][/hr]

[u][size=120][b]PUBLIC DISCLOSURE ADMONITION[/b][/size][/u]

[list]I understand that I am obligated to be complete and truthful in providing information on this application. I understand that all of the information disclosed by me in this application may be subject to public disclosure.

SIGNATURE OF APPLICANT: [color=#E0218A][img]http://i.imgur.com/AwBGdIc.png[/img][/color]

PRINT NAME OF APPLICANT: MICHAEL NAPOLI

DATE: 19/06/2016


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[u][size=120][b]SECTION 1 - APPLICANT PERSONAL INFORMATION[/b][/size][/u]

[list][b][u]01.[/u][/b] Surame: Napoli
[b][u]02.[/u][/b] Forename: Michael

[b][u]03.[/u][/b] City and County of Residence: Fort Carson, Bone County
[b][u]04.[/u][/b] Country of Citizenship: United States of America
[b][u]05.[/u][/b] Date of Birth: 08/10/1970

[b][u]06.[/u][/b] [color=#2E5894][b][IF US][/b][/color] City, County, State of Birth: Fort Carson, Bone County, San Andreas
[b][u]07.[/u][/b] [color=#2E5894][b][IF NON-US][/b][/color] City, Country of Birth: N/A

[b][u]08.[/u][/b] Height: 5' 7"
[b][u]09.[/u][/b] Weight: 180 lbs.
[b][u]10.[/u][/b] Eye Color: Brown
[b][u]11.[/u][/b] Hair Color: Brown
[b][u]12.[/u][/b] Gender (tick): Male [cbf][/cbf] Female [cb][/cb]
[b][u]13.[/u][/b] Race (tick): White [cbf][/cbf] Black [cb][/cb] Hispanic [cb][/cb] Asian [cb][/cb] Other [cb][/cb]

[b][u]14.[/u][/b] Residence Address: 4012 5th Avenue
[b][u]15.[/u][/b] Contact Number: 267882
[b][u]16.[/u][/b] Occupation: Truck Driver
[b][u]17.[/u][/b] Business/Employer Name: Freelance

[b][u]18.[/u][/b] Link to Accepted PF Application: [url=http://pd.lsgov.us/forum/viewtopic.php?t=194354]ACCESS[/url]

[b][u]19.[/u][/b] Link to Accepted Guard Card Application (if applicable): N/A
[/list]

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[u][size=120][b]SECTION 2 - APPLICANT CLEARANCE QUESTIONS[/b][/size][/u]

[list][b][u]01.[/u][/b]  Do you now have, or have you ever had a license to carry a concealed weapon (CCW)?
No [cbf][/cbf] Yes [cb][/cb] (If yes, please detail below):

Issuing Agency: N/A
Date: N/A
If Revoked: Reason: N/A

[b][u]02.[/u][/b] Have you ever applied for and been denied a license to carry a concealed weapon?
No [cbf][/cbf] Yes [cb][/cb] (If yes, please detail below):

Agency: N/A
Date: N/A
Reason for Denial: N/A

[b][u]03.[/u][/b]If you served with the Armed Forces, were you ever convicted of any charges or was your discharge other than honorable?
No [cbf][/cbf] Yes [cb][/cb] (If yes, explain):

Component: N/A
Date of Discharge: N/A
Reason For Discharge: N/A

[b][u]04.[/u][/b] Are you now, or have you been a party to a lawsuit in the last five years?
No [cbf][/cbf] Yes [cb][/cb] (If yes, detail below):

Category: Civil [cb][/cb] Criminal [cb][/cb] Appellate [cb][/cb]
Handling Court: Superior [cb][/cb] Supreme: [cb][/cb]

In progress: Yes [cb][/cb] No [cbf][/cbf]

Was the outcome in your favour: Yes [cb][/cb] No [cb][/cb] N/A [cbf][/cbf]


[b][u]05.[/u][/b] Are you now, or have you been, under a restraining order(s) from any court?
No [cbf][/cbf] Yes [cb][/cb] (If yes, please detail below):

Details: N/A

[b][u]06.[/u][/b] Are you on probation or parole from any state for conviction of any offense including traffic?
No [cbf][/cbf] Yes [cb][/cb] (If yes, please detail below):

Details: N/A

[b][u]07.[/u][/b] Have you ever been convicted for any criminal offense (civilian or military) in the U.S. or any other country?
No [cbf][/cbf] Yes [cb][/cb] (If yes, explain including date, agency, and charges):

Date of offence: N/A
Charging Agency: N/A
Charge: N/A


[b][u]08.[/u][/b] Have you ever been in a mental institution, treated for mental illness, or been found not-guilty by reason of insanity?
No [cbf][/cbf] Yes [cb][/cb] (If yes, please detail below):

Details: N/A

[b][u]09.[/u][/b] Are you now, or have you ever been, addicted to a controlled substance or alcohol, or have you ever utilized an illegal controlled substance, or have you ever reported to a detoxification or drug treatment program?
No [cbf][/cbf] Yes [cb][/cb] (If yes, please detail below):

Details: N/A

[b][u]10.[/u][/b] Have you ever been involved in an incident involving firearms?
No [cb][/cb] Yes [cbf][/cbf] (If yes, please detail below):

Details: Involved in many. One case of this I was driving with my work colleague along his truck route, and while unloading at the docks we were hit over the head with bats. They held guns on us and stole our wallets and truck and stole the rest of our shipment.

[b][u]11.[/u][/b] Have you been involved in a domestic violence incident?
No [cbf][/cbf] Yes [cb][/cb] (If yes, please detail below):

Details: N/A

[b][u]12.[/u][/b] Is there any information not applicable to the above fields that you should declare?
No [cbf][/cbf] Yes [cb][/cb] (If yes, please detail below):

Details: N/A
[/list]

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[u][size=120][b]SECTION 3 - DESCRIPTION OF WEAPONS[/b][/size][/u]

[list]List below the weapons you desire to carry if granted a CCW. You may carry concealed only the weapon(s) which you list and describe herein, and only for the purpose indicated. Any misuse will cause an automatic revocation and possible arrest. (Use additional pages if necessary.)

[b][u]1.[/u][/b] Glock 22, .40 S&W
[/list]

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[u][size=120][b]SECTION 4 - CCW LICENSE RESTRICTION AND CONDITIONS[/b][/size][/u]

[list]The licensee is responsible for all liability for, injury to, or death of any person, or damage to any property which may result through any act or omission of either the licensee or the agency that issued the license. In the event any claim, suit, or action is brought against the agency that issued the license, its chief officer or any of its employees, by reason of, or in connection with any such act or omission, the licensee shall defend, indemnify, and hold harmless the agency that issued the license, its chief officer or any of its employees from such claim, suit, or action.

The licensee authorizes the licensing agency to investigate, as they deem necessary, the licensee’s record and character to ascertain any and all information which may concern his/her qualifications and justification to be issued a license to carry a concealed weapon and release said agency of any and all liability arising out of such investigation.

While exercising the privileges granted to the licensee under the terms of this license, the licensee shall not, when carrying a concealed weapon:

[list]• Violate any of the license usage or prohibition criteria guidelines
• Consume any alcoholic beverage.
• Be in a place having a primary purpose of dispensing alcoholic beverages for on-site consumption.
• Be under the influence of any medication or drug, whether prescribed or not.
• Refuse to show the license or surrender the concealed weapon to any peace officer upon demand.
• Impede any peace officer in the performance of his/her duties.
• Present himself/herself as a peace officer to any person unless he/she is, in fact, a peace officer as defined by San Andreas law.
• Unjustifiably display a concealed weapon.
• Carry a concealed weapon not listed on the permit.
• Carry a concealed weapon at times or circumstances other than those specified in the permit.[/list]

Pursuant to U.S. Government Code – Title 49, Chapter 26, Section 1472(1) and Federal Aviation Regulation 121.583, a license to carry a concealed weapon does not authorize a person to carry a firearm or any dangerous weapon aboard commercial airlines. Further, a person must declare that he/she is carrying such firearm or dangerous weapon BEFORE entering the boarding area of an air terminal where the security checks are made. Such violation can result in arrest by law enforcement.

Any violation of these restrictions or conditions may invalidate the CCW license and may void any further use of the license until reinstated by the licensing authority. Any arrest for a felony or serious misdemeanor, including driving under the influence of alcohol and/or drugs, is cause for invalidating the license.[/list]

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[u][size=120][b]SECTION 5 - AGREEMENT TO RESTRICTIONS AND TO HOLD HARMLESS [/b][/size][/u]

[list]I, Casey Malone, accept and assume all responsibility and liability for, injury to, or death of any person, or damage to any property which may result through any act or omission of either the licensee or the agency that  issued the license. In the event any claim, suit or action is brought against the agency that issued the license, its chief officer or any of its employees, by reason of, or in connection with any such act or omission, the licensee shall defend, indemnify, and hold harmless the agency that issued the license, its chief officer or any of its employees from such claim, suit, or action.

I understand that the acceptance of my application by the licensing authority does not guarantee the issuance of a license and that fees and costs are not refundable if denied. I further understand that if my application is approved and I am issued a license to carry a concealed weapon, that the license is subject to restrictions placed upon it and that misuse of the license will cause an automatic revocation and possible arrest and that the license may also be suspended or revoked at the discretion of the licensing authority at any time. I am aware that any use of a firearm may bring criminal action or civil liability against me.

I have read, understand, and agree to the CCW license liability clauses, conditions, and restrictions stated in this Application and Agreement to Restrictions and to Hold Harmless.

Signature of Applicant: [color=#E0218A][img]http://i.imgur.com/AwBGdIc.png[/img][/color]

Print Name of Applicant: MICHAEL NAPOLI

Date: 19/06/2016

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[u][size=120][b]SECTION 6 - REASON FOR LICENSE[/b][/size][/u]

[list]If the CCW license is desired for self-protection, the protection of others, or for the protection of large sums of money or valuable property, you are required to explain and provide good cause for issuance of the license. For example, has your life or property been threatened or jeopardized? Explain incidents and include dates, times, locations, and names of police agencies to which these incidents were reported.

[u]Details of Reason for Applicant desiring a CCW License:[/u]

Police Agencies: LSPD
Date & Time: 05/12/2012 at around 11:30 pm
Details: I was walking with my girlfriend to a late night movie. After the movie we started to get followed by a group of young black teens. We were in a pretty bad neighborhood so I didn't think much of it, just some kids hanging out at night. We turned a corner and were confronted by a handgun pointed at us. The other teens came from behind, and started searching my pockets, pulling out my wallet and taking it. After grabbing money from my girlfriend's purse they fled the area leaving us. We called the LSPD and gave them a description of the group but never heard back from the Police. I called the bank and had my bank cards deactivated, along with my girlfriends.


Police Agencies: SASD
Date & Time: 20/02/2013 at 11:00 pm
Details: Being a freelance trucker I deal with a lot of cash. Sometimes late at night or very early in the mornings I have to drop my money of at the bank. One night I was pulling into the bank at Las Barrancas before heading home to Fort Carson. I pulled waited in front of the bank counting my money for a few minutes before exiting the vehicle. Two men in masks ran from an alley and held shotguns out telling me to empty my pockets. I quickly tossed my wallet, keys and cellphone on the road next to me. One of the men grabbed all the contents of my pockets that were on the road and they both got into my truck. They took off down the road leaving me without a way to contact anyone. While walking down the road I was picked up by an old woman who drove me home. I called the Sheriff's Department and they came to my house, taking my statement. My truck was returned to me the following week but they didn't find my cellphone or wallet.


Police Agencies: SASD
Date & Time: 19/11/2015 at 4:00 am
Details: Driving long shifts is pretty normal for me, so I often have to pull over at rest stops to sleep. After a long haul from San Fierro to Las Venturas, I was extremely tired. Shortly after leaving Las Venturas I pulled over in a rest stop along the highway. I'm used to doing this often but I was about to be in for a surprise. I heard something clanging outside of my truck and I jolted up. Examining my side mirrors I saw lights coming from the back of my truck. I got dressed and hopped out of the truck, then cautiously approached the back. The doors to the van slammed shut and took off down the road. As I approached the back, the trailer doors were open and a bunch of cargo was gone. The Sheriff's Department approached from behind and I was inspecting my cargo asking if everything was okay. I explained the situation and they responded saying the same vehicle was involved in many overnight truck robberies. The load was insured by the company so it wasn't a big loss.


[/list]

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[u][size=120][b]SECTION 7 - CERTIFICATION AND RELEASE OF INFORMATION[/b][/size][/u]

[list]I hereby give permission to the agency to which this application is made to conduct a background investigation of me and to contact any person or agency who may add to or aid in this investigation. I further authorize persons, firms, agencies and institutions listed on this application to release or confirm information about me and statements I have made as contained in this application.

Notwithstanding any other provision of law and pursuant to the Public Records Act (Government Code section 6250 et seq.), I understand that information contained in this application may be a matter of public record and shall be made available upon request or court order.

I hereby certify under penalties of perjury that the answers I have given are true and correct to the best of my knowledge and belief, and that I understand and agree to the provisions, conditions, and restrictions herein or otherwise imposed.

Signature of Applicant: [color=#E0218A][img]http://i.imgur.com/AwBGdIc.png[/img][/color]

Print Name of Applicant: MICHAEL NAPOLI

Date: 19/06/2016

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[u][size=120][b](( SECTION 8 - OUT OF CHARACTER))[/b][/size][/u]

[list][b][u]01.[/u][/b] Screenshot of Character Level: [url=http://i.imgur.com/mzHKtgZ.jpg]ACCESS[/url][/list][/list][/list][/list][/divbox]