Nassau County Police Department ‘oRUCE A LAKEMAN uhonka Mowark 11504 PATRICK 5 RYbER aoa rearem eis) 573-8800 oan ‘September 27, 2022 Dear Applicant: ‘The Pistol License Section is in receipt of your request for a concealed carry pistol Hieense, Please be advised that section 400.00(1) of the New York State Penal Law requires applicants for any type of Nassau County pistol. license to complete and submit. an application to the Ligense Section, All applications require an investigation by the Pistol License 5 determine that all statements in an opplication are true and that an applicant complies with each requirement for eligibility specified in Penal Law § 400.00(1). Such investigations include, among other things, a review of records accessible to the Division of State Police or Division of Caminal Justice Services pertaining to criminal convictions, mental health, and all other records necessary to determine an applicant’s ehipibility, as well as areview of other facts as may be required te show the good character, competency and integrity of the applicant. In furtherance of the investigation into your request for a concealed carry pistol lieense, please submit the following items in-person to the Pistol License Section: [21 A notarized statement detailing whether oF not you have ever been admitted to a hospital in any jurisdiction for assessment, observation, care, and/or treatment of a mental illness; 12 A notarized statement detailing whether or not you have ever becn admitted to a school in aay jurisdiction for care or treatment ofa developmental disability, 1 A notarized statement detailing whether or not you have been convicted within the last five (5) years of assault in the third degree as defined in section 120 of the Penal Law, menacing 2s defined in section 120.15 of the Pensl Law, or misdemeanor driving while intoxicated as defined in section 1192 of the Vehicle and Traffic Law, © A notarized statement detailing whether or not any minors are residing, full-time or part- time, with you; @@ The name and contact information of your current spouse or domestic partner and any adults residing with you, including adult children; of your former and current social media aecounts from the past three (3) years,‘ceitificate of complet BEGGING our toiciewynaconcael reese mos na te ae Sue et pes) And the Minimum Standards for New York State of a ae fearm Sal y Training promulgated by the New York State Division ee lable ate Ae te Divison of State Police. The Minimum Standards led carry firearms safety training course that ‘hitps://www. criminaljustice ny. gowFINAL"%20NYSP- icecny. e200 Wrirearm®420Safety%20Trainings208- mumae20, ‘Urine drug testing results from a 12-panel test conduct by a United States Department of Health and Human Services (HHS) certified laboratory. Such results shall be from a sample that was submitied to the HHS-certified laboratory no more than fifteen (15) days after the date of this correspondence Please be advised that a complete packet including each of the above-listed items must be submitted in- person to the Pistol License Section, Upon reporting to the Pistol License Section with each of the listed items, an interview will be conducted with a Pistol License Section investigator. ‘assau County Police Department Pistol License Section: (516) 573-7559