Do I need a notary for the Firearms License Public Records Exemption Request?

No. The form provides a signature and date line, but no notary block. The signer just signs and dates the request.

Who can use this request?

The form is for a firearms license applicant or someone currently licensed to possess a firearm. It asks the signer to identify their status and explain the grounds for keeping information from public record.

What information does the form ask for?

It asks for your name, date of birth, address, and, if applicable, firearms license number, issue date, and licensing authority or county of issuance or application. It also asks you to select grounds and provide supporting information.

Wayne County, NY · Wayne County

No notary required

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 public record.

At a glance

Issued by: City of Wayne County · Wayne County, Wayne County, New York
Notarization: Not required: file this form without a notary.
Official source: waynecountyny.gov
Blank form: Download the PDF
Catalogued: Oct 5, 2026
Machine-readable: JSON record · about the forms index

What this form is

Use this form to request that information about your firearms license application or license not be a public record. It asks whether you are an applicant or current license holder, for identifying and license details, and which listed grounds support your request. The form also provides space for additional supporting information and warns that knowingly making false statements may result in criminal penalties.

Who needs it

Firearms license applicants or current license holders who want to request that information about their application or license not be public record 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 without a notary; the signer just signs and dates the request.

How to submit this form

1
Download the Request
Download the Firearms License Public Records Exemption Request.
2
Complete the Form
Mark whether you are an applicant or current license holder, provide the requested details, and check any applicable grounds.
3
Add Supporting Information
Use the space provided to explain any additional grounds or include supporting information.
4
Sign and Submit
Sign and date the request, then submit it to the county office named on the form.

Frequently asked questions

Do I need a notary for the Firearms License Public Records Exemption Request?: No. The form provides a signature and date line, but no notary block. The signer just signs and dates the request.
Who can use this request?: The form is for a firearms license applicant or someone currently licensed to possess a firearm. It asks the signer to identify their status and explain the grounds for keeping information from public record.
What information does the form ask for?: It asks for your name, date of birth, address, and, if applicable, firearms license number, issue date, and licensing authority or county of issuance or application. It also asks you to select grounds and provide supporting information.
How do I submit the request?: Submit it to the county office named on the form; check the county website for current contact details.

Need something notarized?

This Firearms License Public Records Exemption Request doesn’t need a notary, but if you have another Wayne County form that does, a commissioned online notary can help.