Rockland County, NY · Rockland County
NYS Firearms License Request for Public Records Exemption
This form lets firearms license applicants or current license holders request that information about their application or license not be made public.
At a glance
- Issued by
- City of Rockland County · Rockland County, Rockland County, New York
- Notarization
- Not required: file this form without a notary.
- Official source
- rocklandcountyny.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Applicants for a firearms license 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 also acknowledges the consequences of knowingly providing false information.
Who needs it
Firearms license applicants or current license holders who seek to keep information about their application or license from public disclosure can complete this request.
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 request is signed and dated without a notary; the form does not identify any attachment or related step requiring notarization or a sworn statement.
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 details, select the applicable grounds, and explain any additional supporting information.
- 3
Sign and Date
Sign and date the completed request.
- 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 exemption request?
- No. The form asks the signer to sign and date it and does not identify 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 in New York State.
- What information does the form ask for?
- It requests identifying and license details, the grounds for keeping the information from public disclosure, and any supporting explanation.
- How do I submit the request?
- Submit it to the county office named on the form; check the county website for current contact details.