Use this questionnaire to respond to a firearm permit appeal reviewed by the Board of Firearms Permit Examiners (BFPE).
How to complete this questionnaire
This questionnaire is not available as an editable PDF. Copy it into a Word document or another editable document and enter your responses there. Use the questionnaire below as your guide and include all required information.
If the appeal is for a revocation rather than a denial, you may skip questions 1, 2, 3, 5, 6, and 7. However, you must explain the reasons for revoking the appellant's permit.
Board information
Board of Firearms Permit Examiners
165 Capitol Ave., Suite 1070
Hartford, CT 06106
Issuing Authority Questionnaire
To be completed by the State Issuing Authority
The Commissioner of the Department of Emergency Services and Public Protection, or the local issuing authority (Chief of Police or First Selectman).
This questionnaire must be mailed to the appellant, for information only, at least 10 days before the hearing. It is used in connection with an appeal reviewed by the Board under Section 29-32b(c) of the Connecticut General Statutes, as amended.
Appellant Information
Name: __________________________
Date of Birth: __________________________
Questionnaire
- Date the appellant requested a permit under Section 29-28 or 53-206:
- What application form did you require from the appellant?
- What investigation did you complete to determine the appellant’s suitability?
- What criminal record does the appellant have?
-
Were fingerprints sent to:
- (a) FBI — Date: __________
- (b) State Police — Date: __________
- Has the FBI reported a criminal record for the appellant?
- Has the State Police reported a criminal record for the appellant?
-
Provide the reasons for one of the following:
- Refusal or failure to provide an application
- Refusal or failure to issue the permit
- Revocation of the permit
Be specific. Simply stating the appellant is “not suitable” is not enough.
- Include any additional information you think the Board should consider.
For example, explain clearly if you know anything that may be a valid reason to deny the permit.
Additional details
Date of denial or revocation: __________________________
Name and title of issuing authority completing this questionnaire: __________________________
Signature of issuing authority: __________________________
Submission instructions
After completing this questionnaire, mail it along with:
- The permit application
- Any supporting documents
Mail the Issuing Authority Questionnaire and supporting documents to the Board of Firearms Permit Examiners. Send a copy to the appellant or their attorney at least 10 days before the hearing, as required by Section 29-32b(c).
Mail to:
Board of Firearms Permit Examiners
165 Capitol Ave., Suite 1070
Hartford, CT 06106