Form ATF Form 5400.13/5 ATF Form 5400.13/5 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)

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

2. Trade Name or Business Name, if any

4. Name of County in Which
Business is Located

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. 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
9. Is or will your business and/or operations be: (Check appropriate box)
Individually Owned

A Partnership

10. Method of Payment (Check one)
Cashier’s Check or
Check (Enclosed)
Money Order (Enclosed)
Credit/Debit Card Number (No dashes)
Address:
Credit/Debit Card
Billing Address: City:

A Corporation
Visa

Other (Specify)

American
Express
Name as Printed on Your Credit/Debit Card
Mastercard

State:

Please Complete to Ensure Payment is Credited to the Correct Application:
I am Paying the Application Fee for the Following Person, Corporation, or Partnership:

Discover

Diners Club

Expiration Date (Month & year)

Zip Code:

Total Application Fees:
$

I Authorize ATF to Charge my Credit/Debit Card the Above Amount.

Signature of Cardholder

Date

Your credit/debit card will be charged the above stated amount upon receipt of your application. The charge will be reflected on your credit/debit card
statement. In the event a license/permit is NOT issued, the above amount will be credited to the credit/debit card noted above.

ATF Form 5400.13/5400.16
Revised ( )

Responsible Person(s) List
11. 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 U.S.-issued alien
number or admission number.)
a

Position at
Business
b

Social Security
Number
(Voluntarywill help prevent
misidentification)
c

Home Address and
E-mail Address
(Include ZIP Code)
d

Telephone
Numbers
(Home/Work)
e

Race
Date of Birth Place of Birth Country/ Sex Ethnicity
g
(Mark all that apply)
j
(Month/day/
Countries i
k
of
year)
(XX/XX/XXXX)
Citizenship
f
h
Are you
Hispanic
or
Latino?
Yes
No

American Indian or
Alaska Native
Asian
Black or African
American
Native Hawaiian or
Other Pacific Islander
White

Are you
Hispanic
or
Latino?
Yes
No

American Indian or
Alaska Native
Asian
Black or African
American
Native Hawaiian or
Other Pacific Islander
White

Are you
Hispanic
or
Latino?
Yes
No

American Indian or
Alaska Native
Asian
Black or African
American
Native Hawaiian or
Other Pacific Islander
White

Are you
Hispanic
or
Latino?
Yes
No

American Indian or
Alaska Native
Asian
Black or African
American
Native Hawaiian or
Other Pacific Islander
White

Are you
Hispanic
or
Latino?
Yes
No

American Indian or
Alaska Native
Asian
Black or African
American
Native Hawaiian or
Other Pacific Islander
White

ATF Form 5400.13/5400.16
Revised ( )

12. Application is made for an explosives license or permit under 18 U.S.C., Chapter 40, as an: (See definitions 5 through 9)
Explosives License

Fee

Renewal
Fee

Dynamite
Cast Boosters
$200
Detonators
Fireworks
Other (Specify)
Blasting Agents
Black Powder
Importer (Check the types of explosives you plan to import:)
Cast Boosters
Fireworks
Other (Specify)

$200

$100

$100

Dealer (Check the types of explosives you plan to deal in:)
Dynamite
Detonators
Blasting Agents
Black Powder

Cast Boosters
Fireworks
Other (Specify)

Fee Renewal
Fee

User of Explosives (Check the types of explosives you
plan to use:)

Manufacturer (Check the types of explosives you plan to
manufacture:)

Dynamite
Detonators
Blasting Agents
Black Powder

Explosives Permit

Dynamite
Detonators
Blasting Agents
Black Powder

Cast Boosters
Fireworks
Other (Specify)

$100

User (Limited) of Explosives (Check the types of
explosives you plan to use:)
Cast Boosters
Dynamite
Detonators
Fireworks
Other (Specify)
Blasting Agents
Black Powder

$50

$ 75

Limited Permit (Intrastate Only) (Check the types of
explosives you plan to use:)
$200

$100

Dynamite
Detonators
Blasting Agents
Black Powder

Cast Boosters
Fireworks
Other (Specify)

$ 12

$ 25

Total Fees $
13. Is a State or local license or permit required for explosives business and/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
14. Is the applicant or any person named in item 11: (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.)
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.

Yes

No

Yes

No

If the individual is an alien, provide the U.S.-issued alien number or admission number in item 11.
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 11 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
Sunday
Monday
Tuesday
Open
Close
17. Applicant’s Business and/or Operation is Located in:
A Commercial Building

Wednesday

Thursday

A Residence

Other (Specify)

Leased/Rented*

Other (Specify)

Friday

Saturday

18. Applicant’s Business and/or Operations Premises are:
Owned

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)
N/A
No
Yes
No
Yes
N/A

ATF Form 5400.13/5400.16
Revised ( )

21. Do You Deal in Black Powder? 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. Are all of the applicant’s storage facilities 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 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 ( )

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

For ATF Use Only

Global Positioning System (GPS)
Coordinates

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
Closest highway:

Unbarricaded
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): Three-point Lock
3. If Padlocks: Shackle Diameter:

Mortise Locks
No. of Tumblers:

Padlocks
Steel Hoods: Yes

No

Case-hardened: Yes

No

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

Length:

Width:

I. 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 ( )

1.

2.

All Applications are to be Submitted with Fees to:
Bureau of Alcohol, Tobacco, Firearms, and Explosives
P.O. Box 409567
Atlanta, GA 30384-9567
Instructions
letter or statement from someone having approved storage facilities
allowing the applicant use of his facilities should the need arise.
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 incom11. The certification in item 23 must be signed (executed) by the owner, a
plete or otherwise improperly prepared. This application should be
partner, or in the case of a corporation, association, etc., by an officer
submitted at least 90 days prior to the time the license or permit is required.
duly authorized to sign for the applicant.
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 to acquire,
use, or transport explosives.

12. If you have any questions relating to this application, please contact
the ATF Federal Explosives Licensing Center, 244 Needy Road,
Martinsburg, WV 25405, (877) 283-3352, or review information
online at www.atf.gov.
13. If the application is approved, the ATF Federal Explosives Licensing
Center (FELC) will forward an explosives license or permit to you. If
the application is denied, you will be advised in writing of the reason(s)
for the denial. If the application is abandoned, denied, or withdrawn,
your application fee will be refunded. However, in order to refund the
fee, a social security number or employer identification number is
REQUIRED.
14. Additional forms can be downloaded from ATF’s website in Adobe PDF
format at www.atf.gov/forms/download/atf-f-5400-13.pdf. The form
can be ordered using ATF’s Online Distribution Center Order Form at
www.atf.gov/dcof or by calling ATF’s Distribution Center at
(202) 648-6420.
Definitions

6.

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

1.

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

7.

It is not necessary for a licensed manufacturer or licensed importer (for
purposes of sale or distribution) to also obtain a dealer’s license in order
to engage in business on his or her licensed premises as a dealer in
explosives materials. In the case of a licensed manufacturer, a separate
license is not required with respect to onsite manufacturing.

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).

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.

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
o r transportation of explosive materials in interstate or foreign commerce.

8.

A photograph of each responsible person listed in item 11 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.-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
receipt. For example, a sufficient “contingency plan” would include a

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 ( )

7.

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

8.

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

9.

Dealer. Any person engaged in the business of distributing explosive
materials at wholesale or retail.

10. High Explosives. Explosive materials which can be caused to detonate
by means of a blasting cap when unconfined (for example, dynamite).
11. Low Explosives. Explosive materials which can be caused to deflagrate
when confined (for example, black powder).
12. 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).
Note: There are now six broad categories of explosives licenses and
permits that shall determine the type of business each licensee or permittee is engaged in: Manufacturer of Explosives, Dealer of Explosives,
Importer of Explosives, User of Explosives, User (Limited) of Explosives,
and Limited Permit (Interstate Only).

3. Routine uses. The information will be used by ATF to make a determi
nation 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.
Paperwork Reduction Act Notice
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).

Exceptions
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.

The estimated average burden associated with this collection is 1 hour and 30
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 Section, 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.

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 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.
premises;
license or
tions; and

To identify the applicant; to identify the location of the
to determine the eligibility of the applicant to obtain such
permit; to determine the ownership of the business or operato identify responsible persons in the business or operations.

ATF Form 5400.13/5400.16
Revised ( )