Form ATF Form 6310.1 ATF Form 6310.1 Arson and Explosives Training Request for Non-ATF Employ

OMB No. 1140-0106 (XX/XX/XXXX)

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

Course of Interest
Course ID
Participant Information
Name (Last, first, middle initial)

Arson and Explosives Training Request for
Non-ATF Employees
Course Title

Social Security Number (last 4 digits) Sex

Rank/Title
Male

Department/Agency Name

Female

Agency Type (Please check one)

Hazardous Device School Basic Class Number

HDS Certification Expiration Date:

Federal

Local

State

Military

Advanced Explosives Disposal Techniques Graduation Date:

Department/Agency Address (Number, street, city, State, and zip code)

Office Telephone Number (Including area code)
Supervisor’s Name

Work E-mail Address

Fax Telephone Number (Including area code)

Supervisor’s Signature

International Law Enforcement

Supervisor’s E-Mail Address

Length of Time in Public Service
Telephone Number (Including area code)

Briefly Describe Your Area of Responsibility and Duties

For Arson and Explosives Training
E-mail this form to [email protected]
Or the individual course e-mail as listed on the
course website
Contact Number: (256) 261-7500
For Students Interested in the National Firearms Examiner Academy, Please Use ATF E-Form 6330.1.
Privacy Act Information
This information is provided pursuant to Public Law 93-579 (Privacy Act of 1974) December 31, 1974, relative to the collection of information from prospective students to
attend the ATF Training.
1. Authority. Sections 1302 3301, 3304, and 7201 of Title 5, United States Code, 42 U.S.C. 4222; 5 U.S.C. 301; and 46 F.R. 16586.
2. Purpose. To obtain information from Federal, State and local, military and international law enforcement personnel making application for training conducted by ATF for
the purpose of student registration and program information.
3. Routine Uses. Disclosure upon request to the individual, to the individual’s parent agency, or to any other individual or agency at the request of the individual to ATF or
other government officials is on a need to know basis.
4. Efeects of Nondisclosure. Disclosure of your social security number, which is solicited under the authority of Executive Order 9367, is also voluntary and no right, benefit
or privilege by law will be denied as a result to disclose it. Not providing all or any part of the requested information may result in the applicant not being registered for
the requested program.
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
attend ATF training.
The estimated average burden associated with this collection is 6 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 the Reports Management
Officer, Document Services, 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
ATF Form 6310.1
Revised January 2015