• Federal Firearm Rights Restoration Case Evaluation Questionnaire

    Complete this questionnaire to provide our attorneys with information needed to conduct an initial evaluation of your potential federal firearm rights restoration application matter. Information submitted herein is confidential but submission of this form is to allow attorneys to evaluate the facts of each case and does not create an attorney-client relationship.
  • Are you an individual federally prohibited from possessing or otherwise handling firearms for one or more of the following reasons, pursuant to 18 U.S.C. 922(g)?Which of the following, if any, apply to your eligibility history?*
  • Are you currently: • awaiting sentencing for any crime • incarcerated or serving any part of a sentence • in a program that diverts conviction or is in place of conviction • a fugitive from justice • an unlawful user or addict of controlled substances, as defined in 27 CFR 478.11, except for people whose only unlawful use or addiction is marijuana • an alien in the United States illegally or under a nonimmigrant visa • under a court-issued restraining order for harassment, stalking, or threatening of an intimate partner or intimate partner’s child • required to register as a sex offender for an offense that prohibits you from owning a firearm • subject to a mental health-related disability set forth in 18 U.S.C. 922(g)(4), where the state, territory, department, or agency that imposed the disability maintains a relief-from-disability program, and: — you are eligible to apply to the program, and you have not applied or your application is pending; or — you were eligible to apply to the program, and your application was denied.*
  • Have you ever been convicted of committing, attempting, soliciting, or conspiring to commit, or aiding or abetting the commission of, a felony that involves the following conduct: • the death of another person • rape, sexual abuse, or sexual assault • human trafficking • kidnapping • intimate partner or domestic violence • burglary • robbery • extortion • carjacking • arson • racketeering (if at least one of the predicate racketeering acts is violent) • gang-related offenses • maiming, assault, or battery • stalking • escape or rescue of a person in custody • terrorism • witness tampering • brandishing or discharging a firearm or using an explosive • acts that are the same as or similar to the conduct identified above*
  • Within the last 10 years have you been convicted of or served any part of a sentence for: • a felony that involves the following conduct: drug trafficking, including conduct such as manufacturing, selling, distributing, importing, or exporting; threats of violence; manufacturing, possessing, transferring, or using explosives; certain firearm- or ammunition-related conduct; possessing or discharging a firearm or other weapon on school property; or animal abuse • a misdemeanor crime of domestic violence*
  • At any time within the 10 years following a conviction for or service of any part of a sentence for a misdemeanor crime of domestic violence, have you incurred: • any other disability set forth in 18 U.S.C. 922(g) • an arrest for a felony • a misdemeanor crime of domestic violence • any other offense that involves the commission or attempt of acts or threats of violence, brandishing or discharging a firearm, or using an explosive*
  • An application submitted requires a statement from you as the applicant under penalty of perjury attesting that you: • Have not committed a crime (other than traffic or parking infractions, or petty offenses not involving force or violence to persons or property) within the past five years; • Are not an unlawful user of or addicted to any controlled substance, as defined in § 107.1, regardless of whether the controlled substance has been legalized or decriminalized for medicinal or recreational purposes in the State where the applicant resides (marijuana is excluded); • Do not regularly abuse alcohol or other intoxicants, including prescription drugs; • Are not currently suffering from a mental health condition that would impair the applicant's judgment or behavior; • Are a person of good character and has a good reputation in the community; • Have not threatened to use unlawful violence, or attempted to do so toward any person or threatened or attempted suicide regardless of whether the authorities were notified, within the past five years; • Would not pose a danger to public safety or to himself/herself, family members, or intimate partners if permitted to possess a firearm; • Have not been a member of, or associated with, a group of three or more persons who acted together in the United States or elsewhere with the aim of committing any crime within the last 10 years; • Have provided, to the extent possible, all information relevant to the applicant's eligibility under this paragraph (g) and that all information provided in the application is true and correct. Can you attest to such a statement?*
  • At any time within the past 5 years, were you convicted of or served any part of a sentence for any other: • felony not included above • misdemeanor assault, battery, stalking, or threatened act of violence*
  • Have you completed all court-ordered conditions, probation, or supervision related to the offense or matter affecting your eligibility?*
  • Have all fines, restitution, fees, and other financial obligations related to the offense or matter affecting your eligibility been paid or otherwise resolved?*

  • Required Information

  • Format: (000) 000-0000.
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year

  • Factors to Be Considered

  • Should be Empty: