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Rev. 2015A
Please read the following restrictions carefully. They apply to the possession of firearms, to
purchase/transfer permits, and reports of transfer for handguns and semiautomatic military-style assault
weapons. Individuals with restrictions shall not be entitled to possess a pistol or any other firearm. The
legal basis for the restrictions may be found in federal law (18 United States Code § 922) or Minnesota law
(Minnesota Statutes, §§ 253B.02, 624.712, 624.713. 624.7131 or 624.714). I understand the following:
• I must be at least 21 years old to purchase a handgun or handgun ammunition from a federally licensed
dealer.
• I must be at least 18 years old to purchase a semi-automatic assault rifle.
• I have not been convicted, adjudicated delinquent, or convicted as an extended jurisdiction juvenile of a
crime of violence in Minnesota or elsewhere unless my civil rights have been restored, and I have not been
convicted of any other crime of violence during that time.
NOTE: This lifetime prohibition on possessing, receiving, shipping, or transporting firearms for
persons convicted or adjudicated delinquent of a crime of violence applies only to offenders who
are discharged from sentence or court supervision for a crime of violence on or after August 1, 1993.
• I have not been charged with a crime of violence either as an adult or a juvenile and placed in a pretrial
diversion program by the court before disposition, until I have completed the diversion program and the
charge of committing the crime of violence has been dismissed.
• I have not been convicted of fifth-degree assault as defined in Minnesota Statutes, § 609.224 or assault as
defined in Minnesota Statutes, § 609.2242 or a similar offense in another state where the victim was a family
or household member since August 1, 1992. As a further condition, I am not disqualified because three
years have elapsed from the conviction and I have not been convicted of any other violation of § 609.224,
subdivision 3 or 609.2242, subdivision 3 in Minnesota or a similar law in another state.
• I have not been convicted in any court of a misdemeanor crime of domestic violence as defined in 18 United
States Code section 922(g)(9). Federal law prohibits the possession of a firearm for anyone convicted in any
court of a qualified misdemeanor crime of domestic violence.
• I am not subject to a court order that
(1) was issued after a hearing of which I had actual notice and at which I had an opportunity to participate
(2) restrains me from harassing, stalking, or threatening an intimate partner, a child of an intimate partner,
or my own child, or engaging in other conduct that would place an intimate partner in a reasonable fear
of bodily injury to that person or a child; and
(3) includes a finding that I represent a credible threat to the physical safety of an intimate partner or child or
by its terms explicitly prohibits the use, attempted use, or threatened use of physical force against an
intimate partner or child that would reasonably be expected to cause bodily injury.
• I am not an unlawful user of any controlled substance as defined in Chapter 152 of Minnesota Statutes.
• I am not currently and never have been committed by a judicial determination for treatment for the habitual
use of a controlled substance as defined in Minnesota Statutes, §§ 152.01 and 152.02, unless my ability to
possess a firearm has been restored under Minnesota Statutes, §624.713, subdivision 4.