STATE OF CALIFORNIA DEPARTMENT OF JUSTICE
BOF 116 (Rev. 05/2019) PAGE 1 of 4
CALIFORNIA DEPARTMENT OF JUSTICE
BUREAU OF FIREARMS
Personal Firearm Eligibility Check Application
Penal Code Section 30105
This application must be notarized by a licensed California Notary Public.
See reverse for instructions and fees.
Last Name Suffix First Name Middle Name
Alias Last Name (if any)
Suffix
Alias First Name Alias Middle Name
Date of Birth (mm/dd/yyyy)
Sex
California Driver License or ID No.
(copy must accompany application)
U.S.
Citizen?
Yes
No
If no, enter Alien Registration No. or I-94 No.
Height
Weight Eye Color Hair Color Race Telephone Number
Residence Street Address City State Zip Code
Mailing Address (if different) City State Zip Code
No person or agency may require or request another person to obtain a firearms eligibility check or notification of firearms eligibility check
pursuant to Penal Code section 30105, subdivision (h). A violation of this subdivision is a misdemeanor.
If the applicant for a firearms eligibility check purchases, transfers, or receives a firearm through a licensed dealer as required by law, a
waiting period and background check are both required.
CERTIFICATE OF ACKNOWLEDGEMENT
A notary public or other officer completing this certificate verifies only the identity of the individual who
signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of
that document.
State of California
County of ________________________________
On __________________________ before me, __________________________________________,personally
appeared__________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the
within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity
(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the
person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true
and correct.
WITNESS my hand and official seal.
Signature (Seal)
Applicant
Right
Thumbprint
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. I expressly authorize the
Department of Justice to perform firearms eligibility checks of all relevant state and federal databases as permitted under the law. I also
understand that if I currently possess/own firearms and the results of this check reveal that I am ineligible to lawfully either possess or
purchase firearms, I must relinquish any and all firearms, ammunition, and firearm magazines in my possession.
Signature (must be notarized above) Date
FOR DOJ USE ONLY
Date Received:
Date Paid:
Complete Submission:
________
________
________
PFEC No.:
Date Processed:
Processed by:
________
________
________
Eligible:
Ineligible:
Determination could not be made:
________
________
________
STATE OF CALIFORNIA DEPARTMENT OF JUSTICE
BOF 116 (Rev. 05/2019) PAGE 2 of 4
CALIFORNIA DEPARTMENT OF JUSTICE
BUREAU OF FIREARMS
Personal Firearm Eligibility Check Application
Penal Code Section 30105
Application Instructions
Personal Firearm Eligibility Check Application Submission Requirements:
Please type or print clearly in blue or black ink. The application must be completed in full.
The applicant's right thumbprint impression must be provided on the application and must be of fingerprint
identification quality.
You must submit a copy of your California driver license or identification card. (Cal. Code Reg., tit. 11, § 4045.1)
If your California driver license or identification card has “FEDERAL LIMITS APPLY” on the front, you shall also
submit proof of lawful presence in the United States, in the form of one of the following documents:
(1) Valid, unexpired U.S. passport or passport card.
(2) Certified copy of U.S. birth certificate.
(3) Certification of Birth Abroad (FS-545), Certification of Report of Birth (DS-1350) or Consular Report of
Birth Abroad of a Citizen of the United States of America (FS-240), issued by the U.S. Department of State.
(4) Valid, unexpired foreign passport with valid U.S. immigrant visa and approved Record of Arrival/Departure
(I-94) form.
(5) Certified copy of birth certificate from a U.S. Territory.
(6) Certificate of Naturalization or U.S. Citizenship.
(7) Valid, unexpired Permanent Resident Card. (Cal. Code Reg., tit. 11, § 4045.1)
If your name, as it appears on the “FEDERAL LIMITS APPLY” California driver license or identification card, differs
from the name on the document(s) above, you shall also submit one of the following certified documents:
(1) An adoption document that contains your legal name as a result of the adoption.
(2) A name change document that contains your legal name both before and, as a result of, the name change.
(3) A marriage certificate.
(4) A dissolution of marriage document that contains your legal name as a result of the court action.
(5) A certificate, declaration or registration document verifying the formation of a domestic partnership.
(6) A dissolution of domestic partnership document that contains your legal name as a result of the court action.
(Cal. Code Reg., tit. 11, § 4045.1)
STATE OF CALIFORNIA DEPARTMENT OF JUSTICE
BOF 116 (Rev. 05/2019) PAGE 3 of 4
CALIFORNIA DEPARTMENT OF JUSTICE
BUREAU OF FIREARMS
Personal Firearm Eligibility Check Application
Personal Firearm Eligibility Check Application Submission Requirements (Continued):
The Personal Firearm Eligibility Check (PFEC) fee is $20. Please submit a check or money order payable to the
Department of Justice. DO NOT SEND CASH.
The application must be notarized by a licensed California Notary Public. To find a Notary Public in your area,
please consult your telephone directory. Also, many website search engines provide area searches for notaries
public.
Please be advised that federal law does not authorize a check of the National Instant Criminal History Background
Check System (NICS) as part of a Personal Firearm Eligibility Check (PFEC). Therefore, the results of a PFEC might
indicate that you are eligible to possess and purchase firearms but you could still be prohibited based on information
in a federal database that the California Department of Justice was not authorized to check.
The Department of Justice will make every effort to process PFECs within 30 days, however, please allow 90 to 120 days for
the processing of your application. You will be notified by U.S. mail.
Mail completed application package and fee to the following address:
DEPARTMENT OF JUSTICE
BUREAU OF FIREARMS - PFEC
P.O. BOX 820200
SACRAMENTO, CA 94203-0200
STATE OF CALIFORNIA DEPARTMENT OF JUSTICE
BOF 116 (Rev. 05/2019) PAGE 4 of 4
CALIFORNIA DEPARTMENT OF JUSTICE
BUREAU OF FIREARMS
Personal Firearm Eligibility Check Application
Privacy Notice
As Required by Civil Code § 1798.17
Collection and Use of Personal Information: The Division of Law Enforcement, Bureau of Firearms in
the Department of Justice collects the information on this application pursuant to Penal Code section
30105, subdivision (c). The Bureau of Firearms uses this information to conduct a personal firearm
eligibility check. In addition, any personal information collected by state agencies is subject to the
limitations in the Information Practices Act and state policy. The Department of Justice's general privacy
policy is available at http://oag.ca.gov/privacy-policy.
Providing Personal Information: All personal information on this application is mandatory. Failure to
provide the mandatory personal information will result in your application not being processed.
Access to Your Information: You may review the records maintained by the Division of Law
Enforcement, Bureau of Firearms in the Department of Justice that contain your personal information, as
permitted by the Information Practices Act. See below for contact information.
Possible Disclosure of Personal Information: In order to conduct a personal firearm eligibility check,
we may need to share the information you provide us with any Bureau of Firearms representative or any
other person designated by the Attorney General upon request. The information you provide may also
be disclosed in the following circumstances:
With other persons or agencies when necessary to perform their legal duties, and their use of
your information is compatible and complies with state law, such as for investigations, licensing,
certification, or regulatory purposes;
To another government agency as required by state or federal law.
Contact Information: For questions about this notice or access to your records, you may contact the
Staff Services Analyst in the Customer Support Center at (916) 227-7527, via email at
firearms.bureau@doj.ca.gov, or by mail at P.O. Box 820200 Sacramento, CA 94203-0200.
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