Client intake — Restore the Right

Before we collect the file

Completing this form does not file an application with the Department of Justice. Do not possess a firearm while prohibited. False statements on the official application are federal crimes.

I understand this is a private service, not DOJ, ATF, or any government office.

I understand that submitting intake does not authorize me to possess, receive, or purchase a firearm.

I will answer completely, including old, expunged, sealed, or set-aside matters I know about.

I understand federal relief does not automatically restore state or tribal firearm rights.

I have read the terms and privacy policy.

Identity and contact

Legal first name *

Middle name

Legal last name *

Suffix

All other names used (aliases, maiden, prior married)

Date of birth *

SSN (last 4 acceptable for this draft)

Citizenship

Mobile phone *

Email *

Current residential address *

City

State

ZIP

County of residence How should we reach you if a document is missing?

Why you are federally prohibited

Check every § 922(g) category that might apply. Over-inclusion is safer than an omission.

Felony conviction — § 922(g)(1)

Fugitive from justice — (g)(2)

Unlawful user of / addicted to a controlled substance — (g)(3)

Mental-health adjudication or commitment — (g)(4)

Certain alien status — (g)(5)

Dishonorable discharge — (g)(6)

Renounced U.S. citizenship — (g)(7)

Active domestic-violence protective order — (g)(8)

Misdemeanor crime of domestic violence — (g)(9)

In one paragraph, describe the event that caused the prohibition. Are you currently incarcerated or under any criminal supervision?

Conviction and court record

Add every adult conviction and any juvenile matter that was treated as adult. Start with the case that created the federal bar.

Sentence completion and waiting period

Date you were released from any incarceration on the disqualifying case Date you finished probation, parole, or supervised release Date the last financial condition was paid (fines, restitution, assessments) Is any restitution, fine, or court-ordered treatment still open? If anything remains, describe it Have you received a pardon, expungement, set-aside, or state rights restoration? If yes or pending, list the jurisdiction, date, and result

Where you have lived and been arrested

DOJ wants criminal-history checks covering every state lived in or arrested in since age 18, or the last 25 years.

States of residence since age 18 (comma-separated) States of arrest or citation, if different Approximate years in each state Have you ever lived outside the United States as an adult? If yes, list countries and years

Record since the prohibition

Current occupation and employer (or “retired / disabled / self-employed”) Work history since the conviction, in rough chronology Family and community ties you want reviewers to understand Treatment, recovery, education, military service, or other stability evidence In the last five years, any new arrest, charge, protective order, or police contact beyond a minor traffic stop? If yes, explain In the last five years: any threat or use of unlawful violence, or any threat or attempt of suicide, reported or not? Current substance-use or mental-health issues a reviewer should know about Why restoring your federal firearm rights is consistent with public safety — in your words

Three character references

Not related by blood or marriage. Known you at least three years. Not themselves prohibited under § 922(g). Confirm they will complete a sworn DOJ form before you list them.

Documents you already have

Check what you can put your hands on this week. Upload is optional in this static template; list filenames if you will email them separately.

Charging instrument

Plea agreement / factual basis

Presentence report

Judgment of conviction

Sentence-completion certificate

State criminal-history reports

Prior pardon / expungement papers

DD-214 or court-martial records

Mental-health orders or clinician letter

Filenames or links you will send Optional file picker (stays on this device unless you attach the files to your email)

Review and export

Download the packet, then email it to your operator. Or print the summary and keep it next to the official DOJ form when your slot opens.

How do you want us to follow up?

I declare that the information in this intake is true and complete to the best of my knowledge. I understand this is not the official OMB Form 1123-0017.

Typed signature (full legal name) * Date