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STATE OF CALIFORNIA DEPARTMENT OF JUSTICE FIREARMS QUALIFICATION APPLICANT DCA USE ONLY Agency File Number(s) New Applicant File Number CII Number DOJ USE ONLY CII Number Agency File Number(s) Please
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THE INFORMATION IS PROVIDED WITH NO WARRANTY OF ANY KIND. You have not applied to any of the following agencies... FBI, FBI-NJ, FBI/Newark Division, FBI/Reno-Tahoe (Reno) Division, FBI/San Diego (San Diego) Division, FBI/Nassau (Nassau) Division, FBI/Miami (Miami), Division, FBI/Denver (Denver), Division, FBI/San Diego (San Diego), Division, FBI/Reno Division, FBI/San Diego (San Diego), Division, FBI/Boston (Boston), Division, FBI/Boston (Boston) Division, FBI/Baltimore, Maryland, Division, FBI/Chicago, Illinois, Division, FBI/Baltimore, Maryland, Division. Use of this form does NOT create an attorney- client relationship between you and the Bureau. However, under the Fair Credit Reporting Act, we are required to share certain information regarding your application through the State Information Access Clearinghouse. The information, if any, that we share with the State Information Access Clearinghouse is for the sole purpose of ensuring that you are not misclassified as a criminal, violent, or mentally defective. We will not use the information you provide any other purpose. If at any time you feel that the information has been used or misused, please contact the State Information Clearinghouse, c/o the FBI, Attn: (202) 307, e-mail: or call toll-free in the US: and press 3 for the FBI. The FBI will have no responsibility to respond to your inquiry. If your application is rejected, your application fee will be fully refunded. Please review instructions regarding refunds carefully. Application fee and Federal and State identification requirements may need to be verified at the time of application. NOTE: The FBI will give a 30-day written notice and the Federal National Mortgage Association (Fannie Mae) or the Federal Home Loan Mortgage Corporation (Freddie Mac) will issue a 30-day non-pending written notice. You cannot register with any other organization until 30 days has passed from the mailing date of your original application.

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