Application for License to Carry a Concealed Handgun ...(E) Presents evidence of equivalent...
Transcript of Application for License to Carry a Concealed Handgun ...(E) Presents evidence of equivalent...
UCSO CHL APP (08-2017) Previous Versions are Obsolete
Pag
e1
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
You must apply in person. Appointments are REQUIRED. Schedule online at www.co.umatilla.or.us/Sheriff/Civil/CHL or Call 541-966-3680.
Full Legal Name: First _________________________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 Photo and Government issued) PHOTO ID # 1 Type ____________________________ Number: ________________________ Exp_________ ID #2 Type ___________________________________________________ HANDGUN COMPETENCY CITIZENSHIP DOCUMENTATION
□ CHL (Renewal) □ Military □ Other □ Birth Cert □ Passport □ Other
APPLICATION TYPE: □NEW $65 □TRANSFER ONLY $30 □NAME CHANGE $30 □ADDRESS CHANGE $15
□RENEWAL $50 □TRANSFER & RENEWAL $65 □REINSTATEMENT $15 □DUPLICATE $15
UCSO CHL APP (08-2017) Previous Versions are Obsolete
Pag
e2
□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 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.
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.
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.
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 specific court restraining or stalking orders, 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
UCSO CHL APP (08-2017) Previous Versions are Obsolete
Pag
e3
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 5 for more details).
I understand that I will be photographed (all applicants) and fingerprinted (new applicants and transfers).
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).
I am a naturalized citizen of the United Sates and I have documentation of naturalization. (Must provide
documentation at the time of the appointment).
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 _________________________.
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 am applying as an out of state applicant and I currently live in a contiguous state. I have included a compelling
statement letter that demonstrates a reason SPECIFIC to Umatilla County.
UCSO CHL APP (08-2017) Previous Versions are Obsolete
Pag
e4
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.
Additional Background Questions:
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? Yes No
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 No
5) Have you ever been convicted of an offense involving controlled substance or participated in a court-supervised
drug diversion program? Controlled substance is defined under 475.005(6). Examples include but are not limited
to marijuana, ecstasy, heroin, cocaine, LSD, peyote, or methamphetamine- does not include alcohol.
Yes No
5a. If you answered Yes, what state and year? ______________-_______________
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
I am subject to prosecution and automatic denial or revocation. All payments are non-refundable.
Please DO NOT SIGN application until you are in our office. We will check ID and then have you sign in front of us.
Signature of Applicant: ______________________________________________ Date Signed: _______________
NEW applicants continue to next page….
UCSO CHL APP (08-2017) Previous Versions are Obsolete
Pag
e5
NEW APPLICANTS ONLY – Reference Information required: List two character references
1. Name, complete mailing address and phone number.
________________________________________________________________________________
2. Name, complete mailing address and phone number.
________________________________________________________________________________
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.
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.
UCSO CHL APP (11-2017) Previous Versions are Obsolete
Pag
e1
Residency Waiver Request Form for CHL
Umatilla County Sheriff’s Office ● Terry L. Rowan
Civil Division • 4700 NW Pioneer Place • Pendleton, OR 97801
IF you are applying for an Oregon Concealed Handgun License as an OUT OF STATE applicant, you MUST include this form WITH your application. DO NOT send this form in ahead of time.
Full Legal Name: First _________________________Middle _______________________Last ______________________________ Current RESIDENTIAL Street Address: ______________________________________________________________
Do you currently OWN or LEASE real property located in Umatilla County? Yes No If you answered Yes, STOP you can qualify to apply as an Oregon Resident and do not need this form. See Residency Requirement Section of Application
If you answered No, proceed with the form.
Qualifications: Submitting this form with your Umatilla County Sheriff’s Office Concealed Handgun License Application indicates you are requesting a “waiver of
residency requirements” from the Sheriff of Umatilla County for an Oregon Concealed Handgun License (CHL). By submitting this form you
understand issuance of a CHL to a non-resident applicant is at the discretion of the Sheriff. You MUST demonstrate a compelling business interest
or other legitimate demonstrated need that is specific to Umatilla County. The Sheriff is under no obligation to grant a residency waiver request
and reserves the right to deny the request to any out of state applicant.
1. Do you currently live in a state that borders Oregon? Yes No
If you answered No; STOP. You will not qualify under Oregon Law.
If you answered Yes, PROCEED with the form (make sure your Driver’s License shows your resident address)
2. Can you demonstrate a compelling business interest? Yes No
If you answered No, PROCEED to question #3.
If you answered Yes; EXPLAIN in DETAIL below (Attach additional documents if more space is needed)
Explanation examples: You are employed in Umatilla County or Your business requires you to visit Umatilla County. List the specific work and
employer information please.
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
3. Can you demonstrate a legitimate need by listing activities performed in Umatilla County? Yes No
If you answered No, PROCEED to NOTE section below.
If you answered Yes, EXPLAIN in DETAIL below (Attach additional documents if more space is needed)
Explanation examples: You visit relatives living in Umatilla County or Frequently Recreate – list specific locations.
Note: “I visit Pendleton Round-up” will not be accepted.
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
NOTE: If you answered NO to ALL 3 questions above, you will NOT be considered for a residency waiver. If you
have been convicted of a drug crime or a crime involving domestic violence you will NOT be considered for a
residency waiver. Negatives entries on your criminal history background could also result in a denial of residency waiver
request, even if you would otherwise qualify as an Oregon resident. If denied, application fee is non-refundable.
Signature of Applicant: ______________________________________________ Date Signed: _______________
NEW APPLICANTS: Applications are taken by APPOINTMENT ONLY. Schedule an appointment online at www.co.umatilla.or.us/Sheriff/Civil/CHL or 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. See page 5 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. A hospital “birth certificate” is not 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. Please call our office if you have questions or check out our website.
OUT OF STATE NEW APPLICANTS (also known as NON-RESIDENT): Applications are taken by
APPOINTMENT ONLY. Schedule an appointment online at www.co.umatilla.or.us/Sheriff/Civil/CHL or 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 an ADDITIONAL ITEM that are required AT THE TIME of your APPOINTMENT:
1. A Residency Waiver Request Form must also be filled out and attached to your application.
Under Oregon Law; Issuance of a license to a non-resident applicant is at the discretion of the
Sheriff. Do NOT send the form in ahead of time. Bring it with you to your appointment.
**ATTENTION to CHANGE** If you are applying as an out of state applicant, The Residency Waiver Request
Form MUST be used every time. If you are renewing, PLEASE refer to RENEWING APPLICANTS Section.
Concealed Handgun License (CHL) Application Instructions UMATILLA COUNTY SHERIFF’S OFFICE
Sheriff Terry L. Rowan ● CHL Unit 4700 NW Pioneer Place ● Pendleton, OR 97801 ● www.co.umatilla.or.us/Sheriff/Civil/CH
11-2017 Previous versions obsolete
Applications taken by Appointment ONLY
RENEWING APPLICANTS: Applications are taken by APPOINTMENT ONLY. Schedule an appointment online at www.co.umatilla.or.us/Sheriff/Civil/CHL or 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) 2. 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). 5. Out of State Applicants **ATTENTION to CHANGE** If you are applying as an out of state applicant, The Residency Waiver Request Form MUST be filled out and attached to your application. 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. Armed Forces members who are out of the area on active duty can renew by mail. Submit your application with proof of your military orders, payment and a copy of your military identification. 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. Bring in your expired CHL). 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. Appointments can be
schedule online or by phone.
CAUTION: A Oregon 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, federal post office
Airports, in secured areas of airports, and on airplanes
National forests or wilderness in which a specific local order prohibits 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. In Umatilla County, contact the Tribal
Police for more information 541-278-0550.
Court Facility – A courthouse or portion of any building occupied by a Circuit Court, the Court of Appeals, the
Supreme Court or Oregon Tax Court. The entire facility, not just areas adjacent to the courtrooms.
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.
WEAPONS POSSESSION: Possession of an Oregon Concealed Handgun License does not give you the right to possess a
firearm. There may be cases where you are prohibited by law from possessing a firearm or ammunition, yet qualify for an
Oregon CHL. If you are subject to certain restraining orders, have a conviction of a misdemeanor crime of domestic
violence, are addicted to drugs, or renounced you citizenship, you cannot lawfully possess a firearm or ammunition under
federal law. (18 USC 922)