Fill Out Your Pdcs 4406M Form
Applying for a pistol license in Suffolk County requires careful attention to detail and an understanding of the application process. One of the key documents in this process is the PDCS 4406M form, also known as the Pistol License Applicant Questionnaire. This comprehensive form gathers essential information about the applicant, ranging from personal identification to detailed questions about their background. The questions include basic details like name, date of birth, and citizenship, as well as inquiries about prior arrests, mental health history, and character references. Applicants must also detail any handguns in their possession and provide information on their current and previous employment. Such extensive questioning serves a critical purpose: ensuring that only individuals who meet the necessary qualifications and have the appropriate background are granted a pistol license. Submission of this form is an important step towards responsible gun ownership, and accuracy is paramount as any discrepancies can lead to complications down the road. Understanding the form's requirements is essential for a smooth application process and ultimately fosters a safer community.
Pdcs 4406M Example
POLICE DEPARTMENT COUNTY OF SUFFOLK
ACCREDITED LAW ENFORCEMENT AGENCY
PISTOL LICENSE APPLICANT QUESTIONNAIRE
PDCS 4406m
PAGE 1 of 2
1. |
Last Name: |
7. |
Date of Birth |
Male |
Female |
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First Name: |
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City of Birth |
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Middle Name: |
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State of Birth |
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4. |
Suffix: |
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Citizenship (Country): |
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5. |
Social Security #: |
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Marital Status: |
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6. |
Alien Registration # (If Applicable): |
12. |
Type of License You Are Applying For: (See Instructions Page 1) |
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PHYSICAL DESCRIPTIVE DATA: |
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13. |
HEIGHT (FEET/INCHES) |
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14. |
WEIGHT (POUNDS) |
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15. RACE |
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16. |
HAIR COLOR |
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17. |
EYE COLOR |
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18. |
Have you ever been arrested, summoned, charged or indicted anywhere for any offense, including DWI (except traffic infractions)? |
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YES |
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NO |
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If yes, furnish the following information: |
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DATE |
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POLICE AGENCY |
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CHARGE |
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DISPOSITION |
COURT & DATE |
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19. List all handguns in your possession (if none, so indicate)
MANUFACTURER |
PISTOL |
CALIBER |
SERIAL # |
MODEL |
PROPERTY OF |
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OR REV |
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20.Current Employer
21.Employer Address
22.Occupation
23. Nature of Employment |
24. Business Phone |
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25.List all prior places of employment (include business name, address, nature of business and phone #)
26.PRESENT ADDRESS: include House #, City, Village, Town, State (if other than New York), Zip Code, and Telephone # (include mailing address if different)
Address_____________________________________________ |
City________________________ State: New York |
Zip Code______________ |
Home Telephone #_________________________________ |
Alternate/ Cell Telephone#___________________________________ |
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Mailing Address_____________________________________________________________________________________________________________
POLICE DEPARTMENT COUNTY OF SUFFOLK
PISTOL LICENSE APPLICANT QUESTIONNAIRE (CONTINUED)
27. List all prior places of residence (include street address, city, state, and zip code) |
PAGE 2 OF 2 |
27.LIST ALL PRIOR PLACES OF RESIDENCE (INCLUDE STREET ADDRESS, CITY, STATE, AND ZIP CODE)
28. Spouse/ Domestic Partner Name:
D.O.B.:
Telephone #: Cell Phone #:
29. If Female, Your Maiden Name and all Previous Married Names:
30. If Married, Your Spouse’s Maiden Name:
31. Mother’s Maiden Name (Last, First):
32.Father’s Name (Last, First):
33.Nicknames or Aliases (Applicant):
34.Next of Kin (include person’s Name, Address, Phone# and relation to applicant):
35.Name and address of person who will safeguard pistol (s) and notify the Pistol Licensing Bureau in case of Applicant’s death or disability. (should be a Suffolk County resident, but does not need to possess a pistol license)
Name: |
Telephone: |
Address: |
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36.Give four (4) character references who, by their signature, attest to your good moral character – list references alphabetically and print clearly. Each reference must personally sign form. (see qualifications in instructions)
LAST, FIRST, MI
D.O.B.
STREET ADDRESS
CITY, TOWN
TELEPHONE
SIGNATURE
37. |
A license is required for the following reason: (see instructions, page 1) |
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38. |
Have you ever been terminated/discharged from any employment or the armed forces for cause? |
YES |
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NO |
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39. |
Have you ever undergone treatment for alcoholism or drug use? |
YES |
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NO |
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40. |
Have you ever suffered any mental illness, or been confined to any hospital, public or private institution, for mental illness? |
YES |
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NO |
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41. |
Have you ever had a pistol license, dealer’s license, gunsmith license, or any application for such a license disapproved , or had |
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such license revoked or cancelled? |
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YES |
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NO |
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42. |
Do you have any physical condition which could interfere with the safe and proper use of a handgun? |
YES |
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NO |
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43. |
Have you ever been charged, petitioned against, a respondent or otherwise been a subject of a proceeding in Family Court? |
YES |
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NO |
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44. |
Has anyone in your household been arrested for a felony or serious offense? |
YES |
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NO |
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45. |
Have you or any member of your household ever been evaluated or treated as a result of any mental health issues including, |
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but not limited to depression? |
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NO |
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Have you or any member of your household ever been admitted to any mental institution or hospital, public or private? |
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46. |
Do you now or have you ever tried, used, possessed or sold marijuana or its derivatives, narcotics, controlled substances, |
YES |
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NO |
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tranquilizers, or |
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If any of these substances were prescribed by a doctor, provide doctor’s name, address, and phone number. |
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47. |
Have you ever been denied appointment to a civil service position; federal, state, or local? |
YES |
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48. |
Have you ever served in the military? YES NO |
If yes, have you ever been the subject of military discipline? |
YES |
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NO |
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49. |
Have you ever had any license, including, but not limited to, a driver’s license, pistol license, or liquor license issued by |
YES |
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NO |
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any agency denied, revoked, cancelled or suspended? |
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50. |
Have you received a traffic summons, or been arrested or convicted for any traffic infraction in the last five (5) years? |
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If yes, list the date(s), charge(s), police agency, court, and disposition. |
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51.If you have answered ‘yes’ to any of the above (questions 38 through 50) and require additional space, submit a separate detailed, notarized explanation on 8½” x 11” sized paper.
STATE OF NEW YORK
COUNTY OF SUFFOLK I ________________________________________________________________ being duly sworn, depose and say that I am the above
named person and I have signed the foregoing statement.
I have personally read and answered all questions therein and I do solemnly swear that every answer is full, true, and correct in every respect.
Sworn to before me this _________________________ Day of _________________________, _____________
_________________________________________________________ |
_________________________________________________________ |
NOTARY STAMP |
SIGNATURE OF APPLICANT |
SIGNATURE OF NOTARY/WITNESS |
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POLICE DEPARTMENT COUNTY OF SUFFOLK |
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CONTINUATION PAGE - IF ADDITIONAL SPACE IS REQUIRED |
STATE OF NEW YORK
COUNTY OF SUFFOLK I ________________________________________________________________ being duly sworn, depose and say that I am the above
named person and I have signed the foregoing statement.
I have personally read and answered all questions therein and I do solemnly swear that every answer is full, true, and correct in every respect.
Sworn to before me this _________________________ Day of _________________________, _____________
_________________________________________________________ |
_________________________________________________________ |
NOTARY STAMP |
SIGNATURE OF APPLICANT |
SIGNATURE OF NOTARY/WITNESS |
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Form Characteristics
| Fact Name | Description |
|---|---|
| Form Title | The PDCS 4406M form is titled the "Pistol License Applicant Questionnaire." It is used by individuals applying for a pistol license in Suffolk County, New York. |
| Governing Law | This form is governed by New York State law, specifically the relevant sections governing firearms licensing and regulations. |
| Application Information | The form requires personal information such as the applicant's full name, date of birth, and details regarding citizenship and marital status. |
| Criminal History Disclosure | Applicants must disclose any arrests or offenses, including DWI, by listing details such as the dates, police agency involved, and the disposition of the charges. |
| Character References | The form requires applicants to provide four character references who must attest to the applicant's good moral character through their signatures. |
| Health and Substance Use | Questions pertaining to mental health, substance abuse, and any history of treatment for alcoholism or drug use are included to assess the applicant’s suitability. |
| Affidavit Requirement | Applicants must sign an affidavit affirming that all answers are true and accurate. This signature must be notarized to validate the application. |
Guidelines on Utilizing Pdcs 4406M
Completing the PDCS 4406M form is an essential step in the pistol licensing process. This form collects personal information and details about the applicant, as well as any background that may be relevant to the application for a pistol license. Follow these steps to ensure the form is filled out accurately.
- Start by entering your Last Name at the top of the form.
- Next, fill in your First Name.
- Include your Middle Name, if applicable.
- If you have a suffix (like Jr. or Sr.), enter it in the Suffix field.
- Provide your Social Security Number.
- If you are not a U.S. citizen, include your Alien Registration Number, if applicable.
- Enter your Date of Birth and select your gender.
- Fill in your City of Birth and State of Birth.
- State your Citizenship by entering the country.
- Indicate your Marital Status.
- Select the Type of License you are applying for, as directed in the form.
- Provide your Height and Weight.
- Specify your Race, Hair Color, and Eye Color.
- Answer the questions about any prior arrests, including details about the incident.
- List all handguns in your possession, including make, model, caliber, and serial number.
- Complete the employment section with your Current Employer, including the address and your job title.
- List prior employment details, including business names and contact information.
- Fill in your Present Address, including relevant contact numbers.
- List all previous addresses for residency history.
- Enter your spouse’s or domestic partner’s name, date of birth, and contact information.
- If applicable, provide your maiden name and any previous married names.
- Complete the inquiries about family, including parents’ names and any nicknames or aliases.
- Provide contact information for a person who will safeguard your pistol and notify authorities if needed.
- List four character references, ensuring they sign the form and meet the requirements specified.
- Answer questions regarding past employment terminations, treatment for substance use, mental health history, and any issues with previous licenses.
- If necessary, provide further explanations on a separate sheet, ensuring they are notarized.
- Finally, sign the form and have a notary public witness your signature.
Once the form is complete, it should be submitted to the appropriate authorities as part of the application process for a pistol license. Make sure to keep a copy for your records.
What You Should Know About This Form
What is the purpose of the PDCS 4406M form?
The PDCS 4406M form is a Pistol License Applicant Questionnaire used by the Suffolk County Police Department. It collects information from individuals who are applying for a pistol license. The information provided is used to assess the applicant's eligibility based on various criteria, including personal history and character references.
Who needs to complete the PDCS 4406M form?
Anyone who wishes to apply for a pistol license in Suffolk County must complete the PDCS 4406M form. This includes both residents of the county and those seeking to obtain a license while living in or moving to the area.
What information is required on the form?
The form requires detailed personal information, including the applicant’s name, date of birth, address, employment history, and criminal background. Additionally, it asks for specifics regarding any handguns in possession and character references, among other data necessary to evaluate the request for a license.
What happens if I answer 'yes' to the criminal history questions?
Should you answer 'yes' to any questions regarding past arrests, charges, or substance use, you are required to provide additional details. This includes specific information about the charge, date, police agency involved, and the outcome. Any necessary explanations should be submitted on separate notarized paper.
Can I apply if I have a mental health history?
Individuals with a history of mental health issues can still apply for a pistol license. However, they must disclose relevant information related to their mental health history on the form, including any treatments or hospitalizations. This information will be considered during the application evaluation process.
Is there a requirement for character references?
Yes, the form requires four character references who will attest to the applicant’s good moral character. Each reference must provide their name, address, and signature on the form. It is recommended that references be individuals who know the applicant well and are willing to vouch for their character.
What should I do if I need more space for my answers?
If additional space is needed to complete your answers, the form includes a continuation page for extra information. You may also provide separate, detailed responses on standard-sized paper, which must be notarized and submitted with your application.
What is the next step after completing the PDCS 4406M form?
Once the PDCS 4406M form is completed and signed, it should be submitted to the Pistol Licensing Bureau along with any required supporting documents. It is advisable to keep a copy of the completed form for your records. The application will then be reviewed, and further instructions or notifications will be provided by the licensing authority.
Common mistakes
Completing the PDCS 4406M form is an essential step for those seeking a pistol license in Suffolk County. However, applicants often make critical errors that can lead to delays or denials. Awareness of these common mistakes can aid in the smooth processing of the application.
One frequent mistake involves incomplete personal information. Applicants often fail to provide their full names as they appear on official documents. Omitting middle names or suffixes can cause confusion and lead to a rejection of the application. Ensuring that every field, especially names and social security numbers, is filled out completely and accurately is crucial.
Another error occurs in the section detailing employment history. Some individuals neglect to list all prior job titles or names of employers, which can be perceived as withholding information. Inconsistencies in employment history can raise concerns during the review process.
Additionally, applicants sometimes misinterpret the criminal history questions. Failing to disclose a past arrest, even if it seems minor, can lead to significant repercussions. The law requires full disclosure of any arrests or charges, and inaccuracies can be considered as attempts to mislead or withhold crucial information.
Further complicating matters, many people overlook the need for accurate contact information. An incorrect phone number can hinder communication between the licensing authority and the applicant. Consequently, this makes it essential to double-check the accuracy of the provided contact details.
Another common oversight involves the character reference section. Applicants may forget to obtain signatures from all four required references or fail to print their names clearly. This omission can result in delays in the application process, as the licensing authority will not be able to contact references efficiently.
Miscommunication about marital status can also create legal complications. Individuals might fail to disclose a prior marriage or provide a maiden name. Such inconsistencies can lead to questions regarding the validity of the applicant’s identity and background.
Furthermore, some applicants do not thoroughly read instructions regarding prior convictions or mental health history. This lack of attention can lead to incomplete answers or omissions that are crucial for the review board's assessment. Understanding the specific requirements and questions asked is vital for accurate completion.
Lastly, procrastination becomes an issue for some applicants. Delaying the submission can lead to rushed entries filled out in haste. Lack of preparation often results in missing information and unnecessary stress, jeopardizing the success of the application.
By learning from these mistakes, applicants can ensure that their PDCS 4406M forms are filled out accurately and completely, enhancing their chances of obtaining the necessary pistol license in a timely manner.
Documents used along the form
When applying for a pistol license in Suffolk County, there are several forms and documents that may accompany the PDCS 4406M form. Each document serves a specific purpose and helps ensure that the application process is thorough and compliant with local regulations. Here’s a brief overview of these related documents:
- PDCS 4406M Continuation Page: This page is used when more space is required to provide additional information that could not fit within the main questionnaire.
- Character Reference Form: Applicants must provide personal references who can attest to their good moral character. This form includes space for details about each reference.
- Employment Verification Form: This document confirms the applicant’s current and past employment, ensuring that their work history is accurately represented.
- Mental Health Disclosure Form: Applicants may need to disclose any mental health issues they have faced. This form helps the licensing authorities make informed decisions.
- Firearms Safety Training Certification: Proof of completion of a recognized firearms safety course is often required. This certification demonstrates the applicant's knowledge of safe firearm handling.
- Application for a Permit to Carry: If the applicant is seeking a carry permit in addition to a pistol license, this separate application must be completed and submitted.
- Notarized Affidavit: Some applicants may need to submit a notarized statement affirming the accuracy of their application and supporting documents.
- Police Background Check Authorization: This form allows the police department to conduct a background check on the applicant to ensure they meet eligibility requirements.
- Tax Information Disclosure Form: This is used to verify the applicant's tax status and ensure compliance with local financial regulations.
- Additional Personal Identification: Often, applicants will need to provide copies of personal identification documents, such as a driver's license or passport, to verify their identity.
Each of these documents plays an important role in the application process for a pistol license. Providing complete and accurate information across all forms helps ensure that the application is processed smoothly and efficiently. Applicants should carefully review all requirements to avoid any delays or complications in their licensing procedure.
Similar forms
- Pistol License Application (PDCS 4406): This form gathers similar personal information regarding the applicant’s identity, background, and criminal history. Like the Pdcs 4406M form, it helps law enforcement assess eligibility for a pistol license.
- Firearm Purchase Application: This document is used when someone wishes to purchase a firearm. It requires personal details, including the buyer's identification, residency, and legal eligibility to own a firearm, mirroring the data collection seen in the Pdcs 4406M form.
- Permit for Concealed Carry (CCW Application): This application requires detailed personal information, including mental health history and criminal background. Similar to the Pdcs 4406M form, it emphasizes the importance of assessing an applicant’s suitability for carrying a concealed weapon.
- Background Check Request Form: Often utilized during the hiring process or for firearm purchases, this form collects personal information to verify the background of the individual. Its structure parallels the Pdcs 4406M in that both aim to ensure public safety by confirming the applicant's history and character.
Dos and Don'ts
When filling out the Pdcs 4406M form, it is important to ensure that your application is complete and accurate. Here are some things you should and shouldn't do:
- Double-check all your personal information for accuracy.
- Use clear and legible handwriting when filling out the form.
- Provide all required information, including previous addresses and employment history.
- Be truthful in your responses, especially regarding any past legal issues.
- Make sure to sign the form and have it notarized if required.
- Do not leave any required fields blank.
- Avoid using nicknames that are not part of your legal name.
- Do not submit the form without reviewing it for errors.
- Avoid providing vague or incomplete information about your character references.
Following these guidelines can help ensure your application proceeds smoothly.
Misconceptions
When it comes to the PDCS 4406M form, there are several common misconceptions that applicants should be aware of. Understanding these inaccuracies can help clarify the application process for a pistol license in Suffolk County.
- Misconception 1: The PDCS 4406M is just a generic application form.
- Misconception 2: Providing accurate information is not essential.
- Misconception 3: Criminal history does not matter if it was minor.
- Misconception 4: The licensing process is quick and automatic.
- Misconception 5: Only the applicant is considered during the review process.
The PDCS 4406M is specifically designed for individuals seeking a pistol license in Suffolk County. It includes unique questions related to the applicant's background and eligibility, making it more than just a standard application.
Accurate and truthful information is crucial when filling out the PDCS 4406M. Any inconsistencies or dishonesty can lead to delays or even disqualification from obtaining the license.
All criminal history, regardless of severity, must be disclosed on the form. Even a minor arrest can impact an applicant's eligibility. It's critical to provide a complete history as requested.
The process can take time due to thorough background checks and evaluations. Applicants should be prepared for potential delays and understand that each submission is carefully reviewed.
The review process may also take into account the applicant's household members. Information regarding any criminal history, mental health evaluations, or relevant background of household members must be included.
Key takeaways
When filling out the Pdcs 4406M form, it is crucial to ensure accuracy and completeness. Here are seven key takeaways that can guide applicants through the process:
- Collect Personal Information: Before beginning, gather all necessary personal details including your full name, address, and date of birth, as this information is required throughout the form.
- Disclose Employment History: Be prepared to provide a comprehensive history of your current and past employment, including addresses and contact numbers for verification purposes.
- Character References: Choose four individuals who can vouch for your good character. Ensure that each reference is willing to sign the form and that their information is accurately listed.
- Be Honest About Legal History: If applicable, disclose any arrests or charges truthfully. Failure to do so could result in disqualification.
- Review Mental Health Questions Thoroughly: Consider the questions related to mental health seriously and answer them carefully, as they carry significance in the licensing process.
- Signature Requirement: The form must be signed and dated in the presence of a notary public to validate your application. This step cannot be overlooked.
- Follow Submission Guidelines: After completing the form, adhere to any specific instructions for submission. Ensure that you send it to the appropriate law enforcement agency and retain a copy for your records.
By keeping these takeaways in mind, applicants can confidently navigate the Pdcs 4406M form process while ensuring their application is processed smoothly.
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