Form FIST-1 Annual Survey of Background Checks for Firearm Transfers

Attachment VI. Revised survey

OMB NO. 1121-0314: Approval Expires 02/28/2014

FORM FIST-1

U.S DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
(REJIS ACTING AS DATA COLLECTION AGENT)

2012 FIREARMS INQUIRY STATISTICS (FIST)
Annual Survey of Background Checks for Firearm Transfers and Permits
Please correct any errors in the name and address information that is printed below.

OFFICIAL AGENCY NAME (If different from above)
9-DIGIT NCIC-ORI NUMBER
PERSON COMPLETING THE FORM
NAME

TITLE

TELEPHONE

FAX

E-MAIL ADDRESS
IMPORTANT – Please answer the following questions before proceeding with the questionnaire. Mark [X] the
appropriate box below.
Did your agency conduct background checks for firearm transfers or permits at any time between
January 1, 2012 and December 31, 2012?
Yes
No
If no, the authorized checking agency for
your jurisdiction is :

(Agency Name)

If your response to the above question is “No” or if any of the following conditions apply, you do not need to
complete the questionnaire. Mark an [X] in the appropriate box below and return the survey using the
instructions below.
Agency no longer in existence
Agency employed only part-time officers AND the total combined hours of work for these officers averaged less
than 35 hours per week
RETURN INSTRUCTIONS
 Please submit your completed form by using the web reporting option at https://websurvey.rejis.org/FIST2012,
mailing it to the Regional Justice Information Service (REJIS) in the enclosed postage paid envelope, or faxing each
page to 1-314-535-1729.
 If you have any questions, comments, or feedback about the survey, please call the FIST project manager toll free
at 1-800-531-2150, or send an e-mail to [email protected].
 Please retain a copy of your completed survey for 1 year.
Burden Statement
Federal agencies may not conduct or sponsor an information collection, and a person is not required to respond to a collection of information, unless it displays a
currently valid OMB Control Number. Public reporting burden for this collection of information is estimated to average 25 minutes per response, including time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send
comments regarding this burden estimate, or any other aspects of this collection of information, including suggestions for reducing this burden, to the Director, Bureau of
Justice Statistics, 810 Seventh Street, NW, Washington, DC 20531. The Omnibus Crime Control and Safe Streets Act of 1968, as amended (42 USC 3732), authorizes this
information collection.

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INSTRUCTIONS FOR COMPLETING THE FORM
Please mark ‘X’ in the appropriate boxes.
If possible, please answer all questions for the entire calendar year (January through December) 2012. If data are
available for only part of the year, please supply any available information in the spaces provided.
If the answer to a question is “not available” or “unknown,” write “DK” in the space provided.
If the answer to a question is “not applicable,” write “NA” in the space provided.
If the answer to a question is “none” or “zero,” write “0” in the space provided. Please respond with zero only when
the actual total reported count is zero, as opposed to when the data are not known or unavailable.
When an exact numeric response is not available, provide an estimate and mark the estimate box next to the
number field. Please provide a brief explanation in Section V to describe how the estimates were calculated.
Please do not leave any items blank in unless otherwise directed.
Section I –AGENCY CHARACTERISTICS

1. Did your agency conduct background checks for
firearm transfers or permits for the entire calendar
year 2012, January 1, 2012, through December 31,
2012?

2. Does your agency conduct Point of Transfer
background checks? This is a check that occurs after a
seller transmits a prospective purchaser’s application
data to a checking agency by telephone, computer,
mail, or other means.

Yes

Yes

No  a. Did your agency start or
discontinue being the designated
checking agency for your jurisdiction
in 2012?

No

Started
Discontinued
b. When did your agency start or
discontinue conducting background
checks?
______ /______ /___________
mm/ dd/ yyyy

c. Name of old/new designated
checking agency:

Agency Name

Don’t know
3. Does your agency conduct background checks for
Purchase Permits? A purchase permit is a document
(referred to as a permit, license, identification card, or
other name) that a prospective purchaser must present
to a seller to receive a firearm.
Yes
No
Don’t know
4. Does your agency conduct background checks for
exempt Concealed Carry Permits? An exempt
concealed carry permit, for the purposes of this survey,
is a state concealed firearm permit (issued after a
background check) that exempts the holder from a
check at the time of a firearm purchase under a Bureau
of Alcohol, Tobacco, Firearms, and Explosives (ATF)
regulation or state law.
Yes
No
Don’t know

Section II –APPLICATIONS AND DENIALS
5. Between January 1, 2012, and December 31, 2012,
how many applications were received by your
agency?
Mark ‘x’ if
estimate

a. Point of transfer checks
(if applicable)

____________

b. Purchase permits
(if applicable)

____________

c. Concealed carry permits
(if applicable)

____________

Concealed
Point of Purchase
carry
Transfer Permit
Permit

a. Felony indictment
or charge......................
b.Felony conviction.......

6. Between January 1, 2012, and December 31, 2012,
how many applications were denied? A denial
occurs when an applicant is prohibited from receiving
a firearm or permit that can be used to obtain a
firearm because a disqualifying factor was found
during a background check.
Mark ‘x’ if
estimate

a. Point of transfer checks
(if applicable)

____________

b. Purchase permits
(if applicable)

____________

c. Concealed carry permits
(if applicable)

____________

7. In 2012, did your agency track the reason(s) why an
application was denied?
Yes
No (skip to question number 11)

8. For denials issued in 2012, why was the application
denied? List total counts (including zeros, where
applicable) for each reason for a denial (please include
all federal, state, and local law reasons for denial within
the most appropriate category). Mark ‘x’ in the
checkbox provided for any estimated counts.

c. Felony arrest with
no disposition.............
d.Fugitive or
outstanding
warrant..........................
e. Domestic violence
misdemeanor…...........
f. Domestic violence,
protective or
restraining order........
g.Addicted to or
unlawful user of a
controlled
substance.....................
h. Mental health
commitment or
adjudication....…......…
i. Illegal or unlawful
alien………................…...
j. State law prohibitor
(if not included in
above categories)….....
k. Local law prohibitor
(if not included in
above categories)….....
l. Other reasons not
included above
(including juveniles
and dishonorable
discharge).....................

9. If multiple reasons are found for a denial, what is
recorded and reported?
All reasons for denial are recorded and reported
(skip to question 11)
Only one reason for the denial is recorded and
reported
Don’t know (skip to question 11)

a. Point of transfer checks
(if applicable)

____________

b. Purchase permits
(if applicable)

____________

c. Concealed carry permits
(if applicable)

____________

13. In 2012, did your agency track appeals made to
your agency for reconsideration of denial? An
appeal, for the purposes of this survey, is an objection
to a denial decision and includes reconsiderations,
challenges, and other informal procedures.
Yes
No (skip to question number 15)

10. If only one reason for the denial is recorded or
reported, what reason is reported?
The first reason found during the background
check
The most serious charge listed on the criminal
history record
Other method (Please explain. If more space is
needed, please use the space provided in
Section V)

14. How many denied persons appealed to your
agency, requesting that your agency reconsider its
initial denial decision between January 1, 2012, and
December 31, 2012?
Mark ‘x’ if
estimate

a. Point of transfer checks
(if applicable)

____________

b. Purchase permits
(if applicable)

____________

c. Concealed carry permits
(if applicable)

Don’t know

____________

15. In 2012, did your agency track reversals by your
agency of initial denial decisions?

Section III –ARRESTS AND APPEALS

Yes
11. In 2012, did your agency track arrests that occurred
as a result of a denied application?
No (skip to question number 17)
An arrest, for the purposes of this survey, occurs when
a denied person who submitted a false application or
has an outstanding warrant is arrested by the checking 16. Between January 1, 2012, and December 31, 2012,
how many initial denial decisions were reversed by
agency or another agency that is notified.
your agency?
Yes
Mark ‘x’ if
estimate

No (skip to question number 13)
12. Between January 1, 2012, and December 31, 2012,
how many arrests occurred as a result of a denied
application?
Mark ‘x’ if
estimate

a. Point
.
of transfer checks
(if applicable)

____________

b. Purchase permits
(if applicable)

____________

c. Concealed carry permits

____________

(if applicable)
17. In 2012, did your agency track appeals to a court of
any denial decision?

Yes (please specify in Section IV which counts
cover only part of the year and the months that
are covered)
No

Yes
No (skip to question number 19)

18. How many denials were appealed to a court
between January 1, 2012, and December 31, 2012?
Mark ‘x’ if
estimate

a. Point of transfer checks
(if applicable)

____________

b. Purchase permits
(if applicable)

____________

c. Concealed carry permits
(if applicable)

____________

19. In 2012, did your agency track reversals by a court
of initial denial decisions?
Yes
No (skip to question 21)
20. Between January 1, 2012, and December 31, 2012,
how many denials were reversed after being
appealed to a court?
Mark ‘x’ if
estimate

a. Point
.
of transfer checks
(if applicable)

____________

b. Purchase permits
(if applicable)

____________

c. Concealed carry permits
(if applicable)

____________

Section IV – Partial Year Counts
21. Do any of the counts you provided for any of the
items throughout the survey cover only part of the
year?

Section V - COMMENTS
Please include any comments that would better explain
how your agency collects information on background
checks. If the reported totals are estimates please provide
a brief explanation to describe how the estimates were
calculated.

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