App Licationinstructions Nm Department Of Public Safety-Books Pdf

APP LICATIONINSTRUCTIONS NM Department of Public Safety
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New Mexico Department of Public Safety, CONCEALED HANDGUN LICENSE. FIREARMS SAFETY TRAINING, INSTRUCTOR APPROVAL APPLICATION. Read APPLICATION INSTRUCTIONS prior to completing this application TYPE or PRINT LEGIBLY. IN INK Your application WILL NOT be processed unless until all applicable questions have been. answered on page 2 and all required documents have been submitted. Be sure to include two 2 full sets of fingerprints two 2 release forms an original NOT A PHOTOCOPY of. your birth certificate a current training certificate a photocopy of New Mexico Driver s License or Identification. Card and payment in the form of a personal check cashier s check or money order for the appropriate amount. CASH WILL NOT BE ACCEPTED FEES ARE NON REFUNDABLE, New License Application Training Instructor Application Renewal Application. Current Law Enforcement Retired Law Enforcement, Social Security Number Date of Birth mm dd yyyy Sex Race. Last Name First Name Middle Name, County of Residence NM Driver s License or ID Number NM Driver s License Height Weight Eye Color Hair Color.
or ID Issue Date, Place City of Birth State of Birth Country of Birth other than USA. Mailing Address City State Zip Code, Physical Address if different than above City State Zip Code. How long have you lived at the above address, Home Phone Business Phone. Years Months EMAIL, FOR OFFICE USE ONLY, Form of Payment MONEY ORDER CASHIER S CHECK PERSONAL CHECK. The Department of Public Safety acknowledges that on the sum of. was received by, Signature of employee accepting application Printed Typed name of employee accepting application.
Instructions to Department Employee or approved person receiving the application Use the check list below to. mark off the required documents included in this packet prior to forwarding packet to the Concealed Carry Unit. 2 page Application Photocopy of NM DL or ID 2 Release Forms Letter from Agency. 100 00 Application Fee Birth Certificate Fingerprint Cards 2 complete signed. 75 00 Renewal Fee Training Certificate Law Enforcement Certification Number. ALL APPLICANTS CHECK YES or NO TO THE QUESTIONS BELOW YES NO. 1 Are you a citizen of the United States, 2 Are you a resident of New Mexico or a member of the armed forces whose permanent duty station is. located in New Mexico or a dependent of such a member. 3 Are you 21 years of age or older, 4 Have you satisfactorily completed a DPS Approved Firearms Safety Training Program or Renewal. Training Program, 5 Have you been convicted of a felony in New Mexico or any other state or pursuant to the laws of the. United States or any other jurisdiction, 6 Are you currently under indictment for a felony criminal offense in New Mexico or any other state or. pursuant to the laws of the United States or any other jurisdiction. 7 Are you otherwise prohibited by federal law or the law of any other jurisdiction from purchasing or. possessing a firearm, 8 Have you been adjudicated incompetent or committed to a mental institution.
9 Are you an unlawful user of or addicted to any controlled substances and or alcohol. 10 Have you received a conditional discharge a diversion or a deferment or been convicted of pled. guilty to or entered a plea of nolo contendre to a misdemeanor offense involving a crime of violence. within the last 10 years, 11 Have you within five years immediately preceding this application been convicted of a misdemeanor. offense involving driving while under the influence of intoxicating liquor or drugs. 12 Have you been convicted of a misdemeanor offense involving the possession or abuse of a controlled. substance within the last 10 years immediately preceding this application. 13 Have you been convicted of a misdemeanor offense involving assault battery or battery against a. household member, 14 Since the age of 18 have you been arrested for any reason If yes submit brief summary and. court disposition, 15 Are you a fugitive from justice. 16 Are you an alien who is residing in the United States illegally or a former citizen of the United States. who has renounced citizenship, 17 INSTRUCTOR APPLICANTS ONLY Do you meet ALL training instructor criteria required. under NMAC 10 8 2 22 If yes include all proper documentation. WARNING Submission of a false answer to any question or submission of a materially false document will result in the. denial of the application and may result in criminal prosecution for perjury NMSA 30 25 1 Tampering with public records. may result in criminal prosecution under NMSA 30 26 1. I HEREBY STATE UNDER PENALTY OF LAW THAT, 1 I have read the New Mexico Concealed Handgun Carry Act of 2003 and qualify to apply for a concealed handgun.
2 I have been furnished with a copy of the state laws relating to concealed handguns and have read and understand. 3 I want a permit to carry a concealed handgun for lawful purposes which may include self defense. 4 The information in this application and any documents submitted in this application is true correct and complete to. the best of my knowledge and belief and, 5 I understand a license eligibility investigation will be conducted as a part of the application process this may involve. but is not limited to computerized record searches criminal history searches and I authorize the investigation. Date Signature of Applicant, Applicant Full Name Print Clearly or Type. NEW MEXICO DEPARTMENT OF PUBLIC SAFETY, AUTHORIZATION TO OBTAIN HEALTH INFORMATION. This authorization allows the New Mexico Department of Public Safety DPS to obtain confidential. health information about you The authorization may be revoked by you It will remain in effect. indefinitely solely for purposes of obtaining information regarding your Concealed Handgun Carry. Act application or permit You are entitled to a copy of the completed authorization There may be. fees charged for any copying associated with this request If you are a person with a disability and. you require this authorization in an alternative format or require a special accommodation to complete. this form you may request assistance from staff at any DPS location. Applicant Name Printed First Middle Last, 1 I authorize the Department of Public Safety to obtain health information as described below. 2 I understand that any information disclosed by any provider of any kind may include. information about behavioral or mental health services and treatment for alcohol or. drug substance abuse and information obtained by the New Mexico Department of Public. Safety from any other provider specifically related to the statutory purposes set out in the. Concealed Handgun Carry Act at Section 29 19 1 to 29 19 13 NMSA 1978. 3 This authorization applies to any health information from any provider or any source relating. to the stated purposes, 4 The health information will specifically be related to a adjudication of mental incompetence.
or any commitment to a mental institution b any addiction to alcohol or controlled. substances, 5 This health information shall be utilized in order to assess compliance with the purposes of. the Concealed Handgun Carry Act, STATEMENT OF UNDERSTANDING. I understand that I have a right to revoke this authorization at any time I understand that if I revoke this authorization I must. do so in writing to the New Mexico Department of Public Safety I understand that the revocation will not apply to. information that has already been obtained pursuant to this authorization I understand that unless I revoke this authorization. as stated above this authorization will continue in full force and effect I understand that authorizing the disclosure of this. health information is voluntary I further understand that revoking this authorization may have consequences regarding my. application for a concealed handgun carry permit or my ability to continue carrying a concealed handgun if I have already. been issued a concealed handgun carry permit, SIGNATURES. Signature of Applicant Date, Signature of Witness Date. AUTHORIZATION FOR RELEASE OF INFORMATION, NAME MUST BE PRINTED LEGIBLY SOC DOB.
PURSUANT TO NMSA 1978 SECTION 29 10 6 A Repl Pamp 1990 OF THE NEW MEXICO ARREST RECORD. INFORMATION ACT HEREBY APPOINT, New Mexico Department of Public Safety. 6301 Indian School Road Suite 310, Albuquerque NM 87110. AS AN AUTHORIZED AGENT FOR ME FOR THE PURPOSE OF INSPECTING AND OR OBTAINING COPIES. ANY NEW MEXICO ARREST FINGERPRINT CARD SUPPORTED RECORD INFORMATION MAINTAINED BY. THE DEPARTMENT OF PUBLIC SAFETY AND NEW MEXICO LAW ENFORCEMENT AGENCIES INCLUDING. INFORMATION CONCERNING FELONY OR MISDEMEANOR ARRESTS. TO THE CUSTODIAN OF THE RECORDS IN QUESTION I HEREBY DIRECT YOU TO RELEASE SUCH. INFORMATION TO THE AUTHORIZED AGENT AS DESCRIBED ABOVE. I HEREBY RELEASE THE CUSTODIAN OR CUSTODIANS OF SUCH RECORDS AND THE DEPARTMENT OF. PUBLIC SAFETY INCLUDING ANY OF THEIR AGENTS EMPLOYEES OR REPRESENTATIVES IN ANY. CAPACITY FROM ANY AND ALL CLAIMS OF LIABILITY OR DAMAGE OF WHATEVER KIND OR NATURE. WHICH AT ANY TIME COULD RESULT TO ME MY HEIRS ASSIGNS ASSOCIATES PERSONAL. REPRESENTATIVE OR REPRESENTATIVES OF ANY NATURE BECAUSE OF COMPLIANCE BY SAID. CUSTODIAN OR CUSTODIANS WITH THIS AUTHORIZATION FOR RELEASE OF INFORMATION AND MY. REQUEST CONTAINED HEREIN FOR THIS RELEASE OR BECAUSE OF ANY USE OF THESE RECORDS THIS. RELEASE IS BINDING NOW AND IN THE FUTURE ON MY HEIRS ASSIGNS ASSOCIATES PERSONAL. REPRESENTATIVE OR REPRESENTATIVES OF ANY NATURE, ATTN NOTARY ENSURE DOCUMENT IS SIGNED IN YOUR PRESENCE AND NAME DOB SOC INFO IS. VERIFIED WITH A VALID ID, SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF 20. NOTARY PUBLIC, MY COMMISSION EXPIRES, auth for release of info form doc.
APP LICATIONINSTRUCTIONS For a complete outline of eligibility requirements refer to the New Mexico Concealed Handgun Carry Act of 2003 as amended in 2005 Section 29 19 1 thru 14 NMSA 1978 and NMAC 10 8 2 included in this packet Personal check cashier s check or money order should be made payable to New Mexico Department of Public Safety Cash will NOT be accepted If you are

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