Form ATF F 5400.13 ATF F 5400.13 Application For Explosives License or Permit

OMB No. 1140-0070

U.S. Department of Justice
Bureau of Alcohol, Tobacco, Firearms and Explosives

Application for Explosives License or Permit
FOR ATF USE ONLY

Section A (Must be completed by all applicants.) Please print all information in block letters.
1.

Name of Applicant (If partnership, include name of each partner)

2.

Trade Name or Business Name, if any

4.

Name of County in Which
Business is Located

3.

Employer Identification Number (EIN) or Social
Security Number (SSN) (Voluntary-see Privacy Act
Information)

5a. Premises Address (No., Street, City, State, Zip Code)
Attach 2” x 2” Photograph Here
(See Instruction 8)

5b. Mailing Address (If different from address in item 5a.)
NOTE: A completed FD-258 (Fingerprint
Identification Card) must accompany this
application. (See Instruction 8)

6.

Location (If no street address listed in Item 5a, provide directions and
distance from nearest post office or city limits)

7.

Telephone Number (Include Area Code)
Business

(

)

Residence (

)

Emergency (

)

Fax

)

(

E-Mail Address
8.

9.

Are you presently engaged in a business and/or operations for which a license or permit is required under 18 U.S.C., Chapter 40, Explosives?
(If yes, provide date business began.)
Yes/Date:
No
Is or will your business and/or operations be: (Check appropriate box)
Individually Owned

A Partnership

A Corporation

Other (Specify)

10. Application is made for an explosives license or permit under 18 U.S.C., Chapter 40, as an: (See definitions and circle the appropriate type code)
Explosives License

Type
Code

Fee

23
24
25
51

Manufacturer of Theatrical Flash Powder
$200
Manufacturer of High Explosives
$200
Manufacturer of Low Explosives
$200
Manufacturer of Blasting Agents
$200
Manufacturer of Fireworks (Consumer, display, and $200
components)
Importer of High Explosives
$200
Importer of Low Explosives
$200
Importer of Blasting Agents
$200
Importer of Fireworks (Display)
$200

26
27
28
53

Dealer
Dealer
Dealer
Dealer

29

Dealer of Black Powder

19
20
21
22
50

of
of
of
of

High Explosives
Low Explosives
Blasting Agents
Fireworks (Display)

Renewal Type
Fee
Code
$100
33 User
$100
34 User
$100
35 User
$100
54 User
$100
36 User
$100
$100
$100
$100

$200
$200
$200
$200

$100
$100
$100
$100

$200

$100

37
38
55
60

Explosives Permit
of High Explosives
of Low Explosives
of Blasting Agents
of Fireworks (Display)

(Limited) of High Explosives
User (Limited) of Low Explosives
User (Limited) of Blasting Agents
User (Limited) of Display Fireworks
(Use ATF F 5400.21)
Limited Permit (Intrastate Only)

Please Make

Check

Renewal
Fee
$50
$50
$50
$50

Fee
$100
$100
$100
$100
$ 75
$ 75
$ 75

$ 25

$ 12

Money Order payable to the

“Bureau of Alcohol, Tobacco, Firearms, and Explosives”
Check/Money Order No.:

TOTAL
AMOUNT

$

11. List the types of explosive materials you intend to manufacture,
12. Is State or local license or permit required for explosives business and/
import, deal, or use (e.g., Dynamite, TNT, black powder, fireworks, etc.).
or operations? (If yes, provide license/permit numbers; if applied for
license/permit but not yet obtained, provide date of application.)
Yes/Numbers or Date
No

ATF Form 5400.13/5400.16
Revised February 2003

Responsible Person(s) List
13. Provide information for each individual owner, partner, and all other responsible persons (See Definition 3) in the trade or business operations identified in section A, block 2. List all names used by
each responsible person (i.e., nicknames, maiden name, name from previous marriage, etc.) (If additional space is needed use a separate sheet.)
Full Name
(If the individual is an alien, also provide
his/her INS-issued alien number or
admission number.)
a

Position at
Business
b

Social Security
Number
(Voluntary- will
help prevent
misidentification)
c

Home Address
(Include ZIP Code)
d

Date of Birth
Telephone Numbers (Month/Day/Year)
(Home/Work)
(XX/XX/XXXX)
e
f

Place of Birth
g

Country/
Countries of
Citizenship
h

Sex/
Race
i

ATF Form 5400.13/5400.16
Revised February 2003

14. Is the applicant or any person named in item 13: (ALL questions must be answered by checking the “YES” or “NO” box.) (Give full details on a
separate sheet for all “yes” answers in item 14.)

Yes

No

Yes

No

a. A fugitive from justice?
b. An unlawful user of, or addicted to, marijuana or any depressant, stimulant, or narcotic drug, or any other controlled substance?
c. Under indictment or information in any court for a felony, or any crime, for which the judge could imprison that person for more
than one year? (An information is a formal accusation of a crime by a prosecutor.) (See Definition 1.)
d. An alien in the United States? (If “yes,” attach an explanatory statement showing that the person is a lawful permanent resident
or a lawful nonimmigrant or refugee/asylee.) (See Definition 2 and Exception 2.)
Statement attached.
If the individual is an alien, provide the U.S. Immigration and Naturalization Service (INS)-issued alien number or admission
number in item 13.
e. Presently appealing a conviction of a crime punishable by imprisonment for a term exceeding one year? (If “yes,” attach an
explanatory statement showing date of conviction, court in which convicted, and court in which appeal is pending.)
Statement attached.
15. Has the applicant or any person named in item 13 EVER: (Give full details on a separate sheet for all “yes” answers in item 15.)
a. Been convicted in any court of a felony, or any other crime, for which the judge could have imprisoned that person for more
than one year, even if he or she received a shorter sentence, including probation? (See Definition 1 and Exception 1.)
b. Been adjudicated mentally defective (which includes having been adjudicated incompetent to manage his or her own affairs) or
been committed to a mental institution?
c. Been discharged from the Armed Forces under dishonorable conditions?
d. Renounced his or her United States citizenship?
Section B (Must be completed)
16. Hours of Operation of Applicant’s Business and/or Operations:
Time
Open

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Close
17. Applicant’s Business and/or Operation is Located in:
A Commercial Building
A Residence
18. Applicant’s Business and/or Operations Premises are:
Owned

Leased/Rented*

Other (Specify)
Other (Specify)

* If rented or leased, please provide the name, address and telephone number of the owner of the property.

19. Does User Permit Applicant Intend to Transport Explosive Materials in 20. Does User Permit Applicant Intend to Purchase Explosive Materials in
Interstate or Foreign Commerce? (If “yes,” state where)
Interstate or Foreign Commerce? (If “yes,” state where)
No
Yes
No
Yes
21. Type 29, Dealer of Black Powder License Applicant: Do You Have a Federal Firearms License? (If “yes,” provide the Federal firearms license number)
No

Yes

Federal Firearms License #:

Storage Facility Data
Section 842(j), 18 U.S.C., provides “It shall be unlawful for any person to store any explosive material in a manner not in conformity with regulations
promulgated by the Attorney General.” Before applying for a license or permit, the applicant must read and be familiar with the requirements as set forth
in 27 CFR, Part 555, Subpart K - STORAGE. An application for a license will be denied if upon an investigation it is found that storage
facilities are inadequate.
22a. All of the applicant’s storage facilities are listed on the attached Explosives Storage Magazine Description Worksheet(s) and meet the minimum
requirements as set forth in 27 CFR, Part 555, Subpart K - Storage. If “no” (i.e., storage facilities do not meet minimum requirements) explain on
separate sheet. (See Instruction 10.)
Yes
No
22b.

Please indicate the total number of explosives storage magazine(s).

22c.

If the applicant has no storage facilities, provide contingency plan for unexpected surplus explosive materials by completing Explosives Storage
Magazine Description Worksheet Item J. (See Instruction 10.)
Section C - Certification (Must be completed by all applicants)
23. Under the penalties imposed by 18 U.S.C. 844, I certify that the answers are true, correct, and complete. I also certify that I am familiar with all
published State laws and local ordinances relating to explosive materials for the location in which I intend to do business. In addition, if the application is for a Type 60, Limited Permit, I certify that I will not receive explosive materials on more than 6 separate occasions during the 12-month
period for which my limited permit is valid.
Applicant’s Signature
Title
Date

For Bureau of Alcohol, Tobacco, Firearms, and Explosives Use Only
24. Application is
Reason for Disapproval/Termination
Approved
Withdrawn*
Disapproved* *(Fee will be refunded)
Signature of Licensing Official

Date

ATF Form 5400.13/5400.16
Revised February 2003

Explosives Storage Magazine Description Worksheet
(Submit one for each magazine; you may photocopy for additional magazines)

For ATF Use Only

Global Positioning System (GPS)
Coordinates

Applicant name:
Magazine ID. no.:
State/local explosives magazine certificate number, if any:
Storage magazine address:

A. Type of magazine (e.g., permanent, mobile/portable, indoor/outdoor, building, igloo, tunnel, dugout, box, trailer, semitrailer, or other mobile magazine):

ATF Type: (Check one)

I

II

III

IV

V

B. Location of magazine and distance from licensed place of business and other magazines:

C. Distance to nearest storage magazine, regardless of ownership:
D. Describe terrain features, roads, structures, buildings, utilities, etc., that could be damaged if the contents of the magazine exploded:

E. Distance(s) between the magazine and the feature(s):
Indicate if magazine is:
Show distance in feet to:

Barricaded

Unbarricaded

Closest highway:

Closest inhabited bldg.:

Closest passenger railway:

F.

Materials, including thicknesses, used in construction of magazine:
Roof:

Top:

Doors:

Floor:

Walls:

Bottom:

G.
1.

Security, physical safeguards, safety equipment, and anti-theft measures:

2.

Locks (Check all that apply):

3.

If Padlocks: Shackle Diameter:

Three-point Lock

Mortise Locks

No. of Tumblers:

Steel Hoods: Yes

Padlocks
No

Case-hardened: Yes

No

H. Dimensions and capacity of magazine:
Capacity:
(In pounds or number of detonators)
I.

Height:

Length:

Width:

Explosives to be stored: Quantity or Weight
Class:

High

Low

Blasting Agents

Detonators

J.
1. Magazine is (Check one):

Owned

Borrowed

Leased

Rented

Contingency
Plan

2. Owner of magazine if borrowed, leased, rented, or on contingency:
3. Address and phone number of owner:
K. Names and telephone numbers of persons who can open magazine for inspection:

L. Special conditions, such as difficulty accessing in winter, etc.:

M. A plat plan must be be furnished, not necessarily to scale, which will indicate, at a minimum, (1) all buildings on the premises, and (2) all magazines identified, with
distances between the magazines, as well as the distances between magazines and inhabited buildings, public highways, and passenger railways.

Prepared by:

Date:
(Name and Title)
ATF Form 5400.13/5400.16
Revised February 2003

All Applications are to be Submitted with Fees to:
Bureau of Alcohol, Tobacco, Firearms, and Explosives
P.O. Box 845219
Dallas, Texas 75284-5219
Instructions
1.

2.

Issuance of your license or permit under 18 U.S.C., Chapter 40, will be delayed
if the fee is omitted or incorrect, or if the application is incomplete or otherwise
improperly prepared. This application should be submitted at least 90 days prior
to the time the license or permit is required.
Submit the original of this form (either typewritten or printed legibly) and total
fees payable to the Bureau of Alcohol, Tobacco, Firearms, and Explosives to the
post office box listed above. (CAUTION: Submission of this application does
NOT authorize you to engage in any of the activities covered by the requested
license or permit. The license or permit must be received before operations
commence.) Include your social security or employer identification number on
your check or money order.

3.

If separate sheets are needed to respond to the questions, they must be identified with your name and address at the top of the page and reference the
question number being explained.

4.

A separate or additional license is not required for storage facilities operated by
the applicant as an integral part of one business premises, or to cover a location used by the applicant solely for maintaining required records.

5.

One PERMIT is required for an individual or business entity.

6.

A separate application and LICENSE fee are required for each premises on which
explosive materials are, or will be, manufactured, imported, or distributed.

7.

In the case of a licensed manufacturer, a separate license is not required with
respect to onsite manufacturing.

8.

A photograph of each responsible person listed in item 13 MUST accompany this
application. The photograph must be 2 x 2 inches in size, clearly showing a full
frontal view of the features of the responsible person with head bare, with the
distance from the top of the head to the point of the chin approximately 1 1/4
inches, and which shall have been taken within the last 6 months prior to the
date of application.
A completed FD-258 (Fingerprint Identification Card) for each responsible person,
including sole proprietors, MUST also accompany this application. The fingerprints must be clear for accurate classification and must be taken at a local law
enforcement agency. In addition, if you are an alien, you must place your U.S.
Immigration and Naturalization Service (INS)-issued alien number or admission
number in the miscellaneous block of the FD-258.

9.

This application must include the names and identifying information of EACH
employee authorized to possess explosive materials in the course of his/her
employment with the applicant. This information MUST be submitted on
ATF F 5400.28, Employee Possessor Questionnaire, and included with the submission of this application.

10. For item 22 use the attached Explosives Storage Magazine Description Worksheet to describe each storage facility (magazine). You may photocopy the
worksheet if you have more than one magazine. For the purpose of this
worksheet, “barricade” is defined as the effective screening of a magazine
containing explosive materials from another magazine, a building, a railway, or a
highway, either by a natural barricade or by an artificial barricade. To be properly
barricaded, a straight line from the top of any sidewall of the magazine containing explosive materials to the eave line of any other magazine or building, or
to a point 12 feet above the center of a railway or highway, will pass through the
natural or artificial barricade. A “contingency plan” is required in the event the
explosive materials cannot be used within the same day of purchase. For
example, a sufficient “contingency plan” would include a letter or statement from
someone having approved storage facilities allowing the applicant use of his
facilities should the need arise.
11. The certification in item 23 must be signed (executed) by the owner, a partner, or
in the case of a corporation, association, etc., by an officer duly authorized to
sign for the applicant.
12. If you have any questions relating to this application, please contact the
ATF Federal Explosives Licensing Center, 2600 Century Parkway NE, Suite
400, Atlanta, GA 30345, (404) 417-2750, or review information online at
www.atf.gov.

14. Additional forms can be downloaded from ATF’s website in Adobe PDF format at
www.atf.gov/forms/index.htm. The form can be ordered using ATF’s Online
Distribution Center Order Form at www.atf.gov/dcof/index.htm, or by calling
ATF’s Distribution Center at (703)455-7801.
Definitions
1.

Under Indictment or Information or Convicted in Any Court. An indictment,
information, or conviction in any Federal, State, local, or foreign court.

2.

Alien. An alien in the United States means any person who is not a citizen or
national of the United States.

3.

Responsible Person. An individual who has the power to direct the management
and policies of the applicant pertaining to explosive materials. For example,
responsible persons generally include sole proprietors and explosives facility site
managers. In the case of a corporation, association, or similar organization,
responsible persons generally include corporate directors and officers, as well as
stockholders who have the power to direct management and policies.

4.

Employee Possessor. An employee possessor is an individual who has actual
or constructive possession of explosive materials during the course of his
employment. Actual possession exists when a person is in immediate possession or control of explosive materials (e.g., an employee who physically handles
explosive materials as part of the production process; an employee who
handles explosive materials in order to ship, transport, or sell them; or an
employee, such as a blaster, who actually uses explosive materials).
Constructive possession exists when an employee lacks direct physical control
over explosive materials, but knowingly has the power and intention to exercise
dominion and control over the explosive materials, either directly or indirectly
through others (e.g., an employee at a construction site who keeps keys for
magazines in which explosive materials are stored, or who directs the use of
explosive materials by other employees; or an employee transporting explosive materials from a licensee to a purchaser).

5.

A User Permit. A User Permit authorizes the holder, on a continuing basis, to
acquire for his own use and not for resale, explosive materials from an explosives
licensee in interstate or foreign commerce, and to transport explosive materials so
acquired in interstate or foreign commerce. A User Permit is issued for 3 years
and is renewable.

6.

A User-Limited Permit. A User-Limited Permit is the same as a User Permit but is
valid only for a single purchase transaction, a new permit being required for a
subsequent purchase transaction. A User-Limited Permit (Display Fireworks, Type
55) is advantageous to civic and veteran’s organizations who wish to conduct a
Fourth of July fireworks display or similar activity. User-Limited Permit Display
Fireworks applicants MUST use ATF F 5400.21.

7.

Limited Permit. A limited permit authorizes the holder to receive for his use
explosive materials from a licensee or permittee in his State of residence on
no more than 6 occasions during the 12-month period in which the permit is
valid. A limited permit does not authorize the receipt or transportation of explosive materials in interstate or foreign commerce.

8.

Manufacturer. Any person engaged in the business of manufacturing explosive
materials for purposes of sale or distribution or for his own use.

9.

Importer. Any person engaged in the business of importing or bringing explosive materials into the United States for purposes of sale or distribution.

10. Dealer. Any person engaged in the business of distributing explosive materials
at wholesale or retail.
11. High Explosives. Explosive materials which can be caused to detonate by
means of a blasting cap when unconfined (for example, dynamite).
12. Low Explosives. Explosive materials which can be caused to deflagrate when
confined (for example, black powder).
13. Blasting Agents. Any material or mixture, consisting of fuel and oxidizer,
intended for blasting, not otherwise defined as an explosive: Provided that the
finished product, as mixed for use or shipment, cannot be detonated by means
of a numbered eight test blasting cap when unconfined (for example, ammonium
nitrate fuel oil).

13. If the application is approved, the ATF Federal Explosives Licensing Center will
forward an explosives license or permit to you. If the application is denied, you
will be advised in writing of the reasons for the denial, and your application fee
will be refunded.

You Must Immediately Contact ATF To Report Lost Or Stolen Explosives!
Call Toll Free: 1-888-ATF-BOMB

ATF Form 5400.13/5400.16
Revised February 2003

Exceptions

Paperwork Reduction Act Notice

1. A person who has been convicted of a felony, or any other crime, for which the
judge could have imprisoned the person for more than one year, is not prohibited from shipping, transporting, possessing, or receiving explosives if: (1)
the conviction was properly invalidated by a court on the basis that the conviction was unconstitutional; (2) in the case of a Federal conviction, the person
received a Presidential pardon; or (3) ATF granted relief from Federal explosives disabilities under 18 U.S.C. 845(b), 27 CFR 555.142.

This request is in accordance with the Paperwork Reduction Act of 1995. The
information collection is used to determine the eligibility of the applicant to engage in
certain operations, to determine the location and extent of operations, and to determine
whether the operations will be in conformity with Federal laws and regulations. The
information requested is required to obtain or retain a benefit and is mandatory by
statute (18 U.S.C. 843).

2. For purposes of this form, aliens can be responsible persons if they are lawful
permanent residents or lawful nonimmigrants (or refugees/asylees). 18 U.S.C.
842(d)(7); (i)(5).

Privacy Act Information

The estimated average burden associated with this collection is 1 hour and 9 minutes
per respondent or recordkeeper, depending on individual circumstances. Comments
concerning the accuracy of this burden estimate and suggestions for reducing this
burden should be directed to Reports Management Officer, Document Services Branch,
Bureau of Alcohol, Tobacco, Firearms, and Explosives, Washington, DC 20226.
An agency may not conduct or sponsor, and a person is not required to respond to, a
collection of information unless it displays a currently valid OMB control number.

The following information is provided pursuant to Sections 3 and 7(b) of the Privacy
Act of 1974 (5 U.S.C. 552a(e)(3));
1. Authority. Solicitation of this information is made pursuant to 18 U.S.C. 843(a).
Disclosure of this information by the applicant is mandatory if the applicant
wishes to obtain a Federal explosives license or permit.
2. Purpose. To identify the applicant; to identify the location of the premises; to
determine the eligibility of the applicant to obtain such license or permit; to determine the ownership of the business or operations; and to identify responsible
persons in the business or operations.
3. Routine uses. The information will be used by ATF to make a determination as
set forth in paragraph 2. In addition, information may be directly disclosed to
other Federal, State, foreign and local law enforcement and regulatory agency
personnel to verify information on the application and to aid in the performance
of their duties with respect to the regulation of explosives unless such disclosure
is prohibited by law. Finally, the information may be disclosed to members of
the public in order to verify the information on the application where such
disclosure is not prohibited by law.
4. Effects of not supplying the requested information. Failure to supply complete information will delay processing and may cause denial of the application.
5. Disclosure of social security number. Disclosure of the individual’s social
security number is voluntary. Under 18 U.S.C. 842(f), 843, and Executive Order
9397, November 22, 1943, ATF has the authority to solicit an individual’s social
security number. The number may be used to verify the individual’s identity.

ATF Form 5400.13/5400.16
Revised February 2003