Form 7110.15 Forensic Firearm Training Request for Non-ATF Employees

OMB No. 1140-xxxx (xx/xx/xxxx)

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

Forensic Firearm Training Request for
Non-ATF Employees

Course of Interest
Course ID

Course Title

Participant Information
Name (Last, first, middle initial)

Social Security Number (last 4 digits)

Department/Agency Name

Sex

Male

Rank/Title

Female

Agency Type (Please check one)
Federal

Local

State

Military

International Law Enforcement

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

Office Telephone Number (Including area code)

Supervisor’s Signature

Length of Time in Public Service

Supervisor’s E-mail Address

AF
T

Supervisor’s Name

Participant’s E-mail Address

Telephone Number (Including area code)

Briefly Describe your Area of Responsibility and Duties. Include your Experience Level with the Course Title you are Requesting.

R

For Serial Number Restoration or Toolmark Identification and Comparison Training e-mail this form to:
[email protected] OR to the individual e-mail listed on the course website.

For further information contact: (202) 648-6061. For Students interested in the National Firearms Examiner Academy, use ATF E-Form 6330.1

D

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. Section 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, program information, and program evaluation.
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
inidividual to ATF or other government officials is on a need to know basis.
4. Effects 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 suggestons for reducing this burden should be direted to the 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.
ATF Form 7110.15
Revised ( )