ReliefFromDisability PDF
ReliefFromDisability PDF
ReliefFromDisability PDF
Civil Division
In Re: Case No. ________________
Applicant’s Name
Applicant’s Address
I, _____________, apply to the Court for relief from the statutory disability to possess a firearm.
This application is submitted pursuant to Ohio Rev. Code 2923.14. I, ______________, assert that
all the requirements for granting relief from disability listed in Ohio Rev. Code 2923.14(B) and
2923.14(D) have been satisfied, and that an order should be issued, upon hearing, granting relief
from disability based upon the following findings which are supported by the attached affidavit.
1. Applicant currently resides in ____________ County, which is the same County in which this
application is being filed.
2. The following is a list of all indictments, convictions, or adjudications upon which Applicant's
disability is based.
Applicant was convicted of the following offense(s) ______________ on the date of
________with the case number of ______________, in the Court of __________, in
___________County, with the following sanctions_______________________________.
Applicant was adjudicated of the following offenses ______________ on the date of
________with the case number of ______________, in the Court of __________, in
___________County, with the following sanctions_______________________________.
Applicant is currently under indictment for the following offense
(s)___________________________.
4. The Applicant is not otherwise prohibited by law from acquiring, having or using firearms.
5. The Applicant has led a law-abiding life since his/her discharge from community control and
appears likely to continue to do so based on the facts set forth in the attached affidavit.
Affidavit
__________________
Affiant
_____________________
Notary Public
Certificate of Service
I certify that a copy of the attached document was mailed to (the County
Prosecutor)________________________________________, by regular U.S. Mail to (Street
Address)_____________________________________________________, (City, State, Zip
Code) ____________________________________________________________,on (Date)
_____________________________.
_______________________
Signature