(c) Form of application and content.--The application for a
license to carry a firearm shall be uniform throughout this
Commonwealth and shall be on a form prescribed by the
Pennsylvania State Police. The form may contain provisions, not
exceeding one page, to assure compliance with this section.
Issuing authorities shall use only the application form
prescribed by the Pennsylvania State Police. One of the
following reasons for obtaining a firearm license shall be set
forth in the application: self-defense, employment, hunting and
fishing, target shooting, gun collecting or another proper
reason. The application form shall be dated and signed by the
applicant and shall contain the following statement:
I am the holder of a valid firearm eligibility license. I
have never been convicted of a crime that prohibits me
from possessing or acquiring a firearm under Federal or
State law. I am of sound mind and have never been
committed to a mental institution. I hereby certify that
the statements contained herein are true and correct to
the best of my knowledge and belief. I understand that,
if I knowingly make any false statements herein, I am
subject to penalties prescribed by law. I authorize the
sheriff, or his designee, or, in the case of first class
cities, the chief or head of the police department, or
his designee, to inspect only those records or documents
relevant to information required for this application. If
I am issued a license and knowingly become ineligible to
legally possess or acquire firearms, I will promptly
notify the sheriff of the county in which I reside or, if
I reside in a city of the first class, the chief of
police of that city.
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