Chemung County, NY · Chemung County
Firearms License Public Records Exemption Request
This request lets firearms license applicants and license holders ask that information about their application or license not be made public.
At a glance
- Issued by
- City of Chemung County · Chemung County, Chemung County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- chemungcountyny.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Firearms license applicants and current license holders use this form to request that information about their application or license not be a public record. It asks for identifying and license details, the grounds for withholding the information, and any supporting explanation. The signer certifies the statements and signs and dates the request.
Who needs it
A firearms license applicant or current license holder who wants to request that their license information not be publicly disclosed may use this form.
How to submit it
Submit it to the county office named on the form; check the county website for current contact details.
About notarization
This document is signed and dated without a notary; it requests a public-records exemption and lists no notarized attachment or sworn step.
How to submit this form
- 1
Download the Form
Download the Firearms License Public Records Exemption Request.
- 2
Complete the Request
Provide your identifying and license information, select the applicable grounds, and add supporting details as needed.
- 3
Sign and Date
Sign and date the request; the form does not call for notarization.
- 4
Submit to the County
Submit the form to the county office named on it; check the county website for current contact details.
Frequently asked questions
- Do I need a notary for the Firearms License Public Records Exemption Request?
- No. The form calls for a signature and date, not notarization. It does not list a notarized attachment or sworn step.
- Who can use this request?
- The form is for a firearms license applicant or someone currently licensed to possess a firearm who requests that license-related information not be a public record.
- What information does the form ask for?
- It asks for your name, date of birth, address, license details if applicable, licensing authority or county, grounds for the request, and any supporting information.
- How do I submit the request?
- The document does not specify a submission method. Submit it to the county office named on the form and check the county website for current contact details.