Printable E Check Enrollment Form in PDF Customize E Check Enrollment Here

Printable E Check Enrollment Form in PDF

The E Check Enrollment Form is a document required for Federal Firearms Licensees (FFLs) who wish to utilize the National Instant Criminal Background Check System (NICS) E-Check service. This form collects essential information such as the FFL number, business contact details, and a unique code word for verification purposes. Completing this form is crucial for FFLs to comply with federal regulations and maintain their ability to conduct background checks on firearm purchasers.

Customize E Check Enrollment Here
Overview

The E Check Enrollment form is an essential document for Federal Firearms Licensees (FFLs) who wish to utilize the FBI's National Instant Criminal Background Check System (NICS) E-Check service. This form requires specific information to ensure proper enrollment and compliance with federal regulations. Key sections include the FFL number, which is a unique identifier assigned by the Bureau of Alcohol, Tobacco, Firearms and Explosives, and a code word that serves as a security measure during communications with NICS. Additionally, the form collects contact details such as business phone numbers, mailing and physical addresses, and email addresses, which are crucial for notifications and correspondence. A point of contact is also designated, ensuring that the FBI has a reliable representative for any inquiries. The form emphasizes the importance of understanding the responsibilities associated with NICS, including the legal obligations outlined in the Brady Handgun Violence Prevention Act. Completing the form accurately and submitting it via fax, email, or mail is vital for FFLs to gain access to the NICS E-Check system. This process not only facilitates background checks but also helps maintain compliance with federal laws governing firearm transactions.

Dos and Don'ts

When filling out the E Check Enrollment form, it's important to follow specific guidelines to ensure your application is processed smoothly. Here are seven things you should and shouldn't do:

  • Do type or print neatly in black ink using uppercase letters.
  • Do provide a complete mailing address, including city, state, and zip code.
  • Do ensure the code word is between six and ten characters long, avoiding profanity.
  • Do include the business phone number with the area code.
  • Don't leave any mandatory fields blank; this could delay your enrollment.
  • Don't use an obscene code word; this will result in rejection of your application.
  • Don't forget to read the NICS E-Check Subscribers Agreement before signing.

Misconceptions

  • Misconception 1: The E Check Enrollment form is only for new Federal Firearms Licensees (FFLs).
  • This is incorrect. The form is required for all FFLs who wish to use the FBI NICS E-Check, regardless of whether they are new or established licensees.

  • Misconception 2: Completing the form is optional for FFLs.
  • In fact, submission of the form is mandatory for FFLs who want to access NICS inquiry privileges. Without completing the form, FFLs cannot conduct NICS checks.

  • Misconception 3: The code word can be any word, including profanity.
  • This is false. The code word must be between six to ten characters long and cannot contain any obscene words or phrases.

  • Misconception 4: The form can be submitted in any format.
  • The form must be submitted by fax, email, or mail as specified in the instructions. Each submission method has its own requirements that must be followed.

  • Misconception 5: There is no need to notify the FBI if FFL ownership changes.
  • On the contrary, it is essential to inform the FBI NICS Section of any ownership changes. A new acknowledgment must also be signed to ensure compliance.

  • Misconception 6: Providing an email address is not necessary.
  • This is incorrect. An email address is required to receive important notifications, including a User Name and Password for accessing the NICS E-Check system.

  • Misconception 7: The form can be filled out in any ink color.
  • The instructions specify that the form should be completed using black ink only. This ensures clarity and uniformity in processing.

  • Misconception 8: There are no penalties for failing to complete the form.
  • Failure to complete the form may result in the inability to conduct NICS inquiries, which is a legal requirement for transferring firearms.

  • Misconception 9: The witness signature is optional.
  • The witness signature is a required part of the enrollment process. It serves to verify that the acknowledgment has been properly executed.

More PDF Forms

Form Attributes

Fact Name Fact Description
OMB Number The E Check Enrollment form is identified by OMB No. 1110-0026.
FFL Number Requirement Each applicant must provide a 15-digit Federal Firearms License (FFL) number assigned by the Bureau of Alcohol, Tobacco, Firearms and Explosives.
Code Word Specification A code word, used for identity verification, must be between six and ten characters long and cannot contain profanity.
Contact Information Applicants must include a business phone number, mailing address, and physical address for effective communication.
Point of Contact If different from the licensee, a point of contact person must be designated along with their phone number.
Submission Methods The completed form can be submitted via fax, email, or mail to the FBI NICS Section.
Legal Obligations By signing the form, the FFL acknowledges understanding their responsibilities under the Gun Control Act of 1968.
Privacy Act Compliance The information collected is governed by the Privacy Act of 1974 and is used for NICS enrollment and user identification.

Document Preview Example

Federal Bureau of Investigation

OMB NO. 1110-0026

National Instant Criminal Background Check System (NICS)

 

Federal Firearms Licensee (FFL) Enrollment / NICS E-Check Enrollment Form

 

Please TYPE or PRINT neatly in BLACK INK using UPPERCASE letters.

 

1. FFL NUMBER NOTE: 03 LICENSEES NEED NOT ENROLL:

 

-

 

 

-

 

 

 

-

 

 

 

 

 

 

 

 

2. CODE WORD (Must be six to ten characters - NO PROFANITY)

-

-

3. BUSINESS PHONE NUMBER

-

 

 

 

-

4.NAME OF FFL: (Name that appears on FFL License. If company name, place in LAST Name block and place overflow in FIRST and MI blocks-if necessary.)

LAST NAME (LICENSEE NAME)

FIRST NAME

 

MI

 

CADENCE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5.NAME OF LICENSEE BUSINESS (TRADE/BUSINESS NAME):

6.MAILING ADDRESS:

CITY

STATE

ZIP CODE

-

7. PHYSICAL ADDRESS:

CITY

STATE

ZIP CODE

-

8.E-MAIL ADDRESS:

9.POINT OF CONTACT PERSON (If different than Item 4 above):

LAST NAME

FIRST NAME

 

MI

 

CADENCE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10.POINT OF CONTACT PHONE NUMBER:

-

 

 

 

-

 

 

 

 

 

11. BUSINESS FAX NUMBER (optional):

-

 

 

 

-

 

 

 

 

 

******************************************FBI NICS E-Check Users Complete this Section******************************************* Every FFL wanting to use the FBI NICS E-Check must complete and submit by fax, e-mail, or mail this entire form and provide the following additional information (12 and 13 below). A User Name and Password will be e-mailed to the address provided in Block #13.

12. LAST NAME

 

 

FIRST NAME

 

MI

 

CADENCE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13. E-MAIL ADDRESS

Note: If there is a change in FFL ownership, the FBI NICS Section must be notified and a new acknowledgment must be signed.

By executing this document and by the use of the above code word, the FFL acknowledges understanding of its obligations and responsibilities under the NICS (as detailed in the Gun Control Act of 1968, as amended and the Responsibilities of a Federal Firearms Licensee [FFL] under the National Instant Criminal Background Check System) and intent to honor those obligations and responsibilities. Intending to be legally bound, I hereby execute this acknowledgment on behalf of the above-mentioned FFL and certify under penalty of perjury that I have full authority from the FFL to make a legally binding commitment on its behalf.

Please be sure to read the NICS E-Check Subscribers Agreement before signing this document.

14. User/Applicant Signature:

 

 

 

Date executed:

15. FFL Witness:

 

 

 

 

 

___________________________________________

Date executed: ______________________________________

FEDERAL FIREARMS LICENSEE (FFL) ENROLLMENT FORM ITEMS

OMB NO. 1110-0026

1.FFL NUMBER – This is the 15 digit number assigned by the Bureau of Alcohol, Tobacco, Firearms and Explosives.

2.CODE WORD – This is a code word of your choice to be used as a verification of identity when you contact the NICS Section. The code word MUST be between 6 and 10 characters in length, and can include both numbers and letters. NO OBSCENE WORDS OR PHRASES PLEASE.

3.BUSINESS PHONE NUMBER – Please write the complete business telephone number including area code.

4.NAME OF FEDERAL FIREARM LICENSEE – The name of the individual or corporation licensed by the Bureau of Alcohol, Tobacco, Firearms and Explosives to sell firearms. If the name is a corporation name, and additional space is required, you may use the First Name spaces.

5.NAME OF LICENSEE BUSINESS – Trade/Business name.

6.MAILING ADDRESS – Please fill in the entire mailing address section complete with city, state, and zip code.

7.PHYSICAL ADDRESS – Please fill in the entire physical address section complete with city, state, and zip code.

8.E-MAIL ADDRESS – You may receive notifications and messages from the NICS Section via e-mail.

9.POINT OF CONTACT PERSON/FBI NICS E-CHECK APPLICANT – This is the person the FBI will call first when contacting your store. It is only needed if different from the name of the licensee. This may be a store manager or other responsible individual chosen by the licensee to represent the licensee for NICS matters, including codeword changes, validation of the FBI NICS E-Check users, etc.

10.POINT OF CONTACT PHONE NUMBER – This is the telephone number the FBI will call first when contacting your store. It is only needed if different from the business phone number. Please include area code.

11.BUSINESS FAX NUMBER (optional) Please fill in the complete number including area code.

(FBI NICS E-Check users only)

12. NAME OF FFL EMPLOYEE WHO WILL BE ACCESSING THE FBI NICS E-CHECKThis employee will be an administrative user and can add additional users as necessary. When adding additional users, you may assign them the user role you deem necessary. The enrollment form can be faxed to

(888) 550-6427, e-mailed to <nics_commandcenter@ic.fbi.gov>, or mailed to the Federal Bureau of Investigation, NICS Section, P.O. Box 4278, Clarksburg, West Virginia 26302.

13.E-MAIL ADDRESS – You must provide an e-mail address. A User Name and Password will be e-mailed to the e-mail address provided in this block. You may also receive notifications and messages from the NICS Section via e-mail.

Please read – NICS E-Check Subscriber’s Agreement before signing this document.

14.SIGNATURE – Under the authority of Brady Handgun Violence Prevention Act of 1993 (Brady Act), 18 U.S.C. Chapter 44, as implemented by 28 C.F.R.

Part 25, the FBI requires completion of this acknowledgment by all FFLs as a condition of being granted NICS inquiry privileges. The NICS has been established within the FBIs Criminal Justice Information Services (CJIS) Division for the purpose of performing instant background checks on prospective

firearm transferees. The primary purpose of this acknowledgment is to ensure that FFLs accessing and using the NICS understand and accept the attendant

obligations and responsibilities. This acknowledgment will be used to identify and validate those FFLs who may be granted NICS inquiry privileges to legally obligate the FFL to comply with these obligations and responsibilities and as evidence of an FFLs knowledge and acceptance of these obligations

and responsibilities whenever such matters may be in issue. Completion of this acknowledgment by an FFL is voluntary but an FFL who does not complete this acknowledgment will not be able to make a NICS inquiry. It is a criminal violation of federal law for an FFL to transfer a firearm to a non-FFL without making a NICS inquiry.

15. FFL WITNESS – This is the signature of an individual witnessing the aforementioned signature. DATE EXECUTED – This is the date that the enrollment document was signed by each person.

A person is not required to respond to any collection of information unless it displays a currently valid OMB control number. The FBI has created the NICS Enrollment Form so that it is easily understood and requires the least possible burden on you to provide us with information. The reporting burden for collection of information on the NICS Enrollment Form is computed as: (1) learning about the documents, 2 minutes; (2) completing the NICS Enrollment Form, 3 minutes; (3) assembling, mailing, faxing or e-mailing the form to the FBI, 3 minutes for an estimated average of 8 minutes per response. To submit comments regarding the accuracy of the estimates, to provide suggestions for making this form simpler, or to enroll by providing this form, you can submit it to the NICS Section by fax at (888) 550-6427, by e-mail to <nicsfflemail@ic.fbi.gov>, or by mail to the Federal Bureau of Investigation, NICS Section, P.O. Box 4278, Clarksburg, West Virginia 26302-4278.

Privacy Act Statement: Pursuant to the Privacy Act of 1974, 5 U.S.C. 552a, we are providing the following information regarding this collection of information. The authority under which this information is being collected is the Brady Handgun Violence Prevention Act of 1993 (Public Law 103-159) and 28 CFR Part 25. The principal purposes for which the information will be used are to enroll an FFL into the NICS, log a user onto the FBI NICS E-Check, and identify FFLs that submit NICS checks. The information collected may be shared with other government agencies for authorized purposes and with certain other persons and entities for other purposes as provided for in the most recently published routine uses for the NICS (Justice/FBI-018). The form requests both mandatory and optional information. If you omit mandatory information, we may not be able to process your request.

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