Form FIST-1 2013 Firearm Inquiry Statistics (FIST)

Firearms Inquiry Statistics (FIST) Program

Attachment III 2013 FIST survey

Firearm Inquiry Statistics (FIST) Program

OMB: 1121-0314

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Attachment III. Proposed 2013 FIST Survey
• Survey form for local agencies in North Carolina
• Survey form for local agencies in New York
• Survey form for state agency reporters

Attachment III. Proposed FIST survey for local agencies in North Carolina
OMB NO. 1121-0314 Approval Expires XX/XX/XXXX

FORM FIST-1

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

2013 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] in the
appropriate box below.
Did your agency issue, keep track of applications for, or conduct background checks for firearm transfer permits at any
time between January 1, 2013, and December 31, 2013?
Yes
If applicable, please list any other agencies for whom you conduct these activities:
(Agency Name(s))

No  The authorized permit issuing, processing, tracking, or checking agency for your jurisdiction is :
(Agency Name(s))

If your response to the above question is “No” or if the following condition (FOR LAW ENFORCEMENT AGENCIES
ONLY) applies, 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://survey6.spss-asp.com/REJIS,
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.

•
•
•
•
•
•
•

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) 2013. 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 III to describe how the estimates were calculated.
Please do not leave any items blank unless otherwise directed.
Section I –AGENCY CHARACTERISTICS

1. Does your agency issue, process, track, or conduct
background checks for Purchase Permits?
A purchase permit is a document that a prospective
purchaser must present to a seller to receive a
firearm.
Yes
No
Don’t know
2. Does your agency issue, process, track, or conduct
background checks for exempt Carry Permits?
An exempt carry permit (may be concealed), for the
purposes of this survey, is a state firearm carry 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

Section II –APPLICATIONS AND DENIALS
4. Between January 1, 2013, and December 31, 2013,
how many applications for firearm transfers or
permits were received or tracked by your agency?
Mark ‘x’ if
estimate

a. Purchase permits
(if applicable)

____________

b. Carry permits
(if applicable)

____________

c. Other transfer or
permit type
(if applicable)

____________

5. Between January 1, 2013, and December 31, 2013,
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

No
Don’t know
3. Does your agency issue, process, track, or conduct
background checks for any other firearm transfer
or permit type?
Yes Please describe the type of permit
(If more space is needed, please use the
space provided in Section III):

No
Don’t know

a. Purchase permits
(if applicable)

____________

b. Carry permits
(if applicable)

____________

c. Other transfer or
permit type
(if applicable)

____________

Does your agency track the reason(s) why an
application was denied? (If your agency had zero
denials in 2013, please still indicate whether or not you
would track the reasons for denial if one were issued.)

All reasons for denial are tracked (skip to
question 10)
Only one reason for the denial is tracked
Don’t know (skip to question 10)

Yes
No (skip to question number 10)
7.

For denials issued in 2013, 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.
Purchase
Permit

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

Carry
Permit

Mark ‘x’ if
estimate

If MULTIPLE reasons are for a denial, how are
found reasons tracked?

If ONLY ONE reason for a denial is tracked, how is
that reason tracked?
The first reason found during the background
check is tracked
The most serious charge listed on the criminal
history is tracked
Other method of tracking (Please explain. If more
space is needed, please use the space provided in
Section III)
Don’t know

10. Do any of the counts you provided for any of the
items throughout the survey cover only part of
the year?
Yes (please specify in Section III which counts
cover only part of the year and the months that
are covered)
No
Section III - COMMENTS
Please include any comments that would better explain
how your agency collects information for firearm
transfers and permits. If the reported totals are
estimates please provide a brief explanation to describe
how the estimates were calculated. (Use back of page if
more space is needed.)

Attachment III. Proposed FIST survey for local agencies in New York

FORM FIST-1

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

2013 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] in the
appropriate box below.
Did your agency issue, keep track of applications for, or conduct background checks for firearm permits at any time
between January 1, 2013, and December 31, 2013?
Yes
If applicable, Please list any other agencies that you conduct these activities for:
(Agency Name(s))

No  The authorized permit issuing, processing, tracking, or checking agency for your jurisdiction is :
(Agency Name(s))

If your response to the above question is “No” or if following condition (FOR LAW ENFORCEMENT AGENCIES
ONLY) applies, 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://survey6.spss-asp.com/REJIS,
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.

•
•
•
•
•
•
•

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) 2013. 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 unless otherwise directed.
Section I –AGENCY CHARACTERISTICS

Section II –APPLICATIONS AND DENIALS

1. Does your agency issue or track or conduct
background checks for Pistol Permits? A
pistol/revolver permit is a document that a prospective
purchaser must present to a seller to receive and
possess a firearm. May also be referred to as a pistol
license. Applies to all permit/license types (Carry
Concealed, Possess on Premises, and Possess/Carry
During Employment).

3. Between January 1, 2013, and December 31, 2013,
how many applications for Pistol Permits were
received or tracked by your agency? (Include any
license amendment applications to acquire a firearm
that required another background check. These may
also be referred to as purchase coupons.)
Mark ‘x’ if
estimate

Yes
No
Don’t know
2. Does your agency issue or track or conduct
background checks for any other firearm transfer
or permit type?
Yes Please describe the type of permit
(If more space is needed, please use the
space provided in Section III):
No
Don’t know

Pistol Permits (and
license amendments)

b. Other transfer or
permit type
(if applicable)

____________

4. Between January 1, 2013, and December 31, 2013,
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

Pistol permits
(and license
amendments)

____________

b. Other transfer or
permit type
(if applicable)

____________

5. Does your agency track the reason(s) why an
application was denied? (If your agency had zero
denials in 2013, please still indicate whether or not you
would track the reasons for denial if one were issued.)
Yes
No (skip to question number 9)

6. For denials issued in 2013, why was an 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.
Pistol Permits Mark ‘x’ if
estimate

a. Felony indictment or charge...
b.Felony conviction........................
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).............
7. If MULTIPLE reasons are found for a denial, how
are reasons tracked?
All reasons for denial are tracked (skip to
question 9)
Only one reason for the denial is tracked
Don’t know (skip to question 9)

8. If ONLY ONE reason for the denial is tracked, how
is that reason tracked?
The first reason found during the background
check is tracked
The most serious charge listed on the criminal
history record is tracked
Other method of tracking (Please explain. If more
space is needed, please use the space provided in
Section III)

Don’t know
9. Do any of the counts you provided for any of the
items throughout the survey cover only part of the
year?
Yes (please specify in Section III which counts cover
only part of the year and the months that are
covered)
No
Section III - 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.

Attachment III. Proposed FIST survey for state agency reporters

FORM FIST-1

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

2013 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
RETURN INSTRUCTIONS
Please submit your completed form by using the web reporting option at https://survey6.spss-asp.com/REJIS,
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.
•

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) 2013. 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 III to describe how the estimates were calculated.
Please do not leave any items blank unless otherwise directed.

Attachment III. Proposed FIST survey for state agency reporters

Section I –APPLICATIONS AND DENIALS
1. Between January 1, 2013, and December 31, 2013,
how many applications for firearm transfers were
received or tracked by your agency? 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.
Mark ‘x’ if
estimate

Applications

____________

Mark ‘x’ if
estimate

____________

3. Does your agency track the reason(s) why an
application was denied? (If your agency had zero
denials in 2013, please still indicate whether or not you
would track the reasons for denial if one were issued.)
Yes
No (skip to question number 7)

Transfer
Check

Mark ‘x’ if
estimate

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

2. Between January 1, 2013, and December 31, 2013,
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.
Denials

4. For denials issued in 2013, 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)...............
5. If MULTIPLE reasons are found for a denial, how
are reasons tracked?
All reasons for denial are tracked (skip to
question 7)
Only one reason for the denial is tracked
Don’t know (skip to question 7)

10. How many denied persons appealed to your
agency, requesting that your agency reconsider its
initial denial decision between January 1, 2013,
and December 31, 2013?
Mark ‘x’ if
estimate

Appeals to agency

____________

11. In 2013, did your agency track reversals by your
agency of initial denial decisions?
Yes
No (skip to question number 13)

Don’t know

12. Between January 1, 2013, and December 31, 2013,
how many initial denial decisions were reversed by
your agency?

Section II –ARRESTS AND APPEALS
7.

In 2013, did your agency track arrests that
occurred as a result of a denied application?
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 agency or another agency that is
notified.
Yes

Mark ‘x’ if
estimate

____________

13. In 2013, did your agency track appeals to a court
of any denial decision?

No (skip to question number 19)

Between January 1, 2013, and December 31, 2013,
how many arrests occurred as a result of a denied
application?
Arrests

Reversals by agency

Yes

No (skip to question number 9)
8.

Mark ‘x’ if
estimate

____________

In 2013, 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.

14. How many denials were appealed to a court
between January 1, 2013, and December 31, 2013?
Mark ‘x’ if
estimate

Appeals to a court

____________

15. In 2013, did your agency track reversals by a court
of initial denial decisions?
Yes
No (skip to question 17)

Yes
No (skip to question number 11)

16. Between January 1, 2013, and December 31, 2013,
how many denials were reversed after being
appealed to a court?
Mark ‘x’ if
estimate

Reversals by a court

____________

Section III – PARTIAL YEAR COUNTS
17. Do any of the counts you provided for any of the
items throughout the survey cover only part of
the year?
Yes (please specify in Section III which counts
cover only part of the year and the months that
are covered)
No
Section IV - COMMENTS
Please include any comments that would better explain
how your agency collects information on firearm transfers
and permits. If the reported totals are estimates please
provide a brief explanation to describe how the estimates
were calculated. (Use back of page if more space is needed.)

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File Type	application/pdf
Author	Allina Boutilier
File Modified	2014-02-04
File Created	2013-12-20