2
Violation of any law regulating the use, possession, or sale of controlled substances as defined in Section 1
of MGL Chapter 94C
Commitment to any hospital or institution for mental illness
Currently the subject of a MGL 209A order
Currently the subject of an outstanding arrest warrant
Commitment for drug addiction or habitual drunkenness
Pursuant to MGL. Ch. 140 § 131, the licensing authority will make a determination of suitability on all LTC
applicants and active licensees. If the licensing authority determines an applicant or licensee could create a risk to
public safety, the licensing authority will deny the issuance of a new LTC or suspend / revoke an active LTC.
RESTRICTIONS:
Suitable applicants may be issued an LTC, subject to restrictions of the licensing authority. Two
common restrictions include:
Condition of Employment: Restricts possession to business owner engaged in business activities, or to
an employee while engaged in work related activities, and maintaining proficiency, where the employer
requires carrying of a firearm (i.e. armored car, security guard, etc.). Includes travel to and from activity
location. The license must be surrendered to the Licensing Unit when employment is terminated.
T
ar
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et / Hunting: Restricts possession to the purpose of lawful recreational shooting or competition; for
use in the lawful pursuit of game animals and birds; for personal protection in the home; and for the purpose
of collecting (other than machine guns). Includes travel to and from activity location.
Any violation of these restrictions may result in suspension or revocation of an LTC.
Change of address: Licensee shall notify, in writing, the issuing licensing authority, the Chief of Police into whose
jurisdiction the licensee moves and the Firearm Record Bureau of any change of address. Notification shall be
made within thirty days by certified mail. Failure to notify shall be cause for suspension or revocation.
Applicant Notification and Record Challenge:
Officials at the governmental institutions and other entities authorized to submit fingerprints and receive FBI identification records under this authority must
notify the individuals fingerprinted that the fingerprints will be used to check the criminal history records of the FBI. The officials making the determination of
suitability for licensing or employment shall provide the applicants the opportunity to complete, or challenge the accuracy of, the information contained in the
FBI identification record. These officials also must advise the applicants that procedures for obtaining a change, correction, or updating of an FBI
identification record are set forth in Title 28, C.F.R., 16.34. Officials making such determinations should not deny the license or employment based on
information in the record until the applicant has been afforded a reasonable time to correct or complete the record, or has declined to do so.
I have read and I understand all of the information listed above.
Signature of applicant: ________________________________
Date: __________________________________
Revised 10/10/16 JM