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MONUMENT POLICE DEPARTMENT 645 Beacon Lite Road Monument, CO 80132 [PHONE REDACTED] Fax: [PHONE REDACTED] townofmonument.org Application for Release of Firearm Information for Applicant This form is to be completed by the firearm owner requesting release of any firearm from the custody of the Monument Police Department (MPD). The purpose of this form is to gather the necessary information to conduct a background check and ensure that the individual receiving the firearm is not prohibited from possessing a firearm pursuant to state and/or federal law. The Colorado Bureau of Investigation (CBI) Firearms InstaCheck Unit is responsible for performing Disposition of Firearm background checks on behalf Colorado’s Law Enforcement Agencies. Please contact the MPD Evidence Section prior to submitting this form to ensure that your firearm is eligible for release. If the case report associated with your firearm has not reached a final disposition, it may not be eligible for release. Depending on the nature and circumstances of the case you may be asked to provide proof of ownership of the firearm. Background checks can take 1-5 business days for completion. Upon receiving the results of your background check from CBI, we will contact you to notify you of the results. If you are found to be “eligible” to possess a firearm, you will be able to schedule an appointment to pick up your firearm. You must pick up your firearm within 7 days of the of the completion of the background check or the background check will need to be re-submitted. Please not that it is unlawful to carry certain firearms on Town of Monument property. When you come to pick up your firearm you will be given instruction on how to legally transport your firearm out of the building and off the property. Failure to comply, may result in criminal charges. If the CBI returns results indicating that you are not eligible to possess a firearm your firearm will not be released to you. MPD employees will not be able to provide you with details of why you were denied. You have the right to appeal that decision with the CBI InstaCheck Unit. Your appeal must be submitted in writing directly to the CBI within 30 days of the disposition. For more information on the appeals process please visit or contact the CBI InstaCheck Appeals Unit at (303) 813-5700. For any additional questions or concerns, please contact the MPD Evidence Section at (719) 481- 3253 Ext 1603 or [EMAIL REDACTED]. ---PAGE BREAK--- MONUMENT POLICE DEPARTMENT 645 Beacon Lite Road Monument, CO 80132 [PHONE REDACTED] Fax: [PHONE REDACTED] townofmonument.org Application for Release of Firearm Applicant Information: Please Print CASE NAME: Last First Middle ALIAS: SEX: □Male □Female RACE: □Black □White □Asian/Pacific Islander □American Indian or Alaskan Native SSN: - - SSN is not required, however, it is recommended to enhance the accuracy of the background check.** PLACE OF BIRTH: DRIVERS LICENSE NUMBER: STATE: ARE YOU A U.S. CITIZEN? □Yes □No If you are not a U.S. Citizen, please provide a valid nine-digit Alien Registration number or valid eleven- digit I-94 Admission number: CURRENT ADDRESS: PHONE NUMBER: I certify that the above information is true and correct to the best of my knowledge, APPLICANT SIGNATURE: DATE: Internal Use Evid □ Information sheet provided to applicant □ RERC Submitted □ Photocopy of ID obtained □ RERC Returned □ Gun Cleared CCIC □ Applicant Notified SIGN