ATF Form 5400.13 Application for Explosives License or Permit

ATF Form 5400.13 is a U.S. Department of Justice - Bureau of Alcohol, Tobacco, Firearms and Explosives form also known as the "Application For Explosives License Or Permit". The latest edition of the form was released in November 1, 2018 and is available for digital filing.

Download a PDF version of the ATF Form 5400.13 down below or find it on U.S. Department of Justice - Bureau of Alcohol, Tobacco, Firearms and Explosives Forms website.

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OMB No. 1140-0070
U.S. Department of Justice
Application for Explosives License or Permit
Bureau of Alcohol, Tobacco, Firearms and Explosives
Section A (Must be completed by all applicants.) Please print all information in block letters.
FOR ATF USE ONLY
1. Name of Applicant (If partnership, include name of each partner)
2. Trade Name or Business Name, if any
3. Employer Identification Number (EIN) or Social
Security Number (SSN) (Voluntary-see Privacy Act
Attach 2" x 2" Photograph Here
Information)
(See Instruction 8)
4. Name of County in Which
5a. Premises Address (No., Street, City, State, Zip Code)
Business is Located
5b. Mailing Address (If different from address in Item 5a.)
NOTE: A completed FD-258 (Fingerprint
Identification Card) must accompany this
application. (See Instruction 8)
6. Location (If no street address listed in Item 5a, provide directions and
7. Telephone Number (Include Area Code)
distance from nearest post office or city limits)
Business
(
)
Residence
(
)
Emergency (
)
Fax
(
)
E-Mail Address
8. Are you presently engaged in a business and/or operations for which a license or permit is required under 18 U.S.C., Chapter 40, Explosives?
(If yes, provide date business began.)
Yes/Date:
No
9. Is or will your business and/or operations be: (Check appropriate box)
Sole Proprietor
Partnership
Corporation
Limited Liability Company
Other (Specify)
10. Method of Payment (Check one)
Cashier's Check or
American
Check (Enclosed)
Visa
Mastercard
Discover
Diners Club
Money Order (Enclosed)
Express
Credit/Debit Card Number (No dashes)
Name as Printed on the Credit/Debit Card
Expiration Date (Month & year)
Address:
Credit/Debit Card
Billing Address:
City:
State:
Zip Code:
Please Complete to Ensure Payment is Credited to the Correct Application:
I am Paying the Application Fee for the Following Person, Corporation, or Partnership:
Total Application Fees:
I Authorize ATF to Charge my Credit/Debit Card the Above Amount.
Signature of Cardholder
Date
Your credit/debit card will be charged the above stated amount upon receipt of your application. The charge will be reflected on your credit/debit card
statement. In the event a license/permit is NOT issued, the above amount will be credited to the credit/debit card noted above.
ATF E-Form 5400.13/5400.16
Revised November 2018
OMB No. 1140-0070
U.S. Department of Justice
Application for Explosives License or Permit
Bureau of Alcohol, Tobacco, Firearms and Explosives
Section A (Must be completed by all applicants.) Please print all information in block letters.
FOR ATF USE ONLY
1. Name of Applicant (If partnership, include name of each partner)
2. Trade Name or Business Name, if any
3. Employer Identification Number (EIN) or Social
Security Number (SSN) (Voluntary-see Privacy Act
Attach 2" x 2" Photograph Here
Information)
(See Instruction 8)
4. Name of County in Which
5a. Premises Address (No., Street, City, State, Zip Code)
Business is Located
5b. Mailing Address (If different from address in Item 5a.)
NOTE: A completed FD-258 (Fingerprint
Identification Card) must accompany this
application. (See Instruction 8)
6. Location (If no street address listed in Item 5a, provide directions and
7. Telephone Number (Include Area Code)
distance from nearest post office or city limits)
Business
(
)
Residence
(
)
Emergency (
)
Fax
(
)
E-Mail Address
8. Are you presently engaged in a business and/or operations for which a license or permit is required under 18 U.S.C., Chapter 40, Explosives?
(If yes, provide date business began.)
Yes/Date:
No
9. Is or will your business and/or operations be: (Check appropriate box)
Sole Proprietor
Partnership
Corporation
Limited Liability Company
Other (Specify)
10. Method of Payment (Check one)
Cashier's Check or
American
Check (Enclosed)
Visa
Mastercard
Discover
Diners Club
Money Order (Enclosed)
Express
Credit/Debit Card Number (No dashes)
Name as Printed on the Credit/Debit Card
Expiration Date (Month & year)
Address:
Credit/Debit Card
Billing Address:
City:
State:
Zip Code:
Please Complete to Ensure Payment is Credited to the Correct Application:
I am Paying the Application Fee for the Following Person, Corporation, or Partnership:
Total Application Fees:
I Authorize ATF to Charge my Credit/Debit Card the Above Amount.
Signature of Cardholder
Date
Your credit/debit card will be charged the above stated amount upon receipt of your application. The charge will be reflected on your credit/debit card
statement. In the event a license/permit is NOT issued, the above amount will be credited to the credit/debit card noted above.
ATF E-Form 5400.13/5400.16
Revised November 2018
Responsible Person(s) List
11. Provide information for each individual owner, partner, and all other responsible persons (See Definition 3) in the trade or business operations identified in section A, block 2. List all names used by each
responsible person (i.e., nicknames, maiden name, name from previous marriage, etc.) (If additional space is needed use a separate sheet.)
Social Security
Country/
Date of Birth
Home Address and
Telephone
Number
Countries
Full Name
Race
Position at
Place of Birth
(Month/Day/
E-mail Address
Numbers
Sex
Ethnicity
of Citizen-
(Voluntary - will
(If the individual is an alien, also
(Mark all that apply)
Business
g
Year)
(Include ZIP Code)
(Home/Work)
i
j
help prevent
provide his/her U.S.-issued alien
ship
j
b
(XX/XX/XXXX)
misidentification)
d
e
number or admission number.)
h
c
a
f
Are you
American Indian or
Alaska Native
Hispanic
Asian
or
Latino?
Black or African
American
Native Hawaiian or
Yes
Other Pacific Islanders
No
White
Are you
American Indian or
Alaska Native
Hispanic
Asian
or
Latino?
Black or African
American
Native Hawaiian or
Yes
Other Pacific Islanders
No
White
Are you
American Indian or
Alaska Native
Hispanic
Asian
or
Latino?
Black or African
American
Native Hawaiian or
Yes
Other Pacific Islanders
No
White
Are you
American Indian or
Alaska Native
Hispanic
Asian
or
Latino?
Black or African
American
Native Hawaiian or
Yes
Other Pacific Islanders
No
White
Are you
American Indian or
Alaska Native
Hispanic
Asian
or
Latino?
Black or African
American
Native Hawaiian or
Yes
Other Pacific Islanders
No
White
ATF E-Form 5400.13/5400.16
Revised November 2018
12. Application is made for an explosives license or permit under 18 U.S.C., Chapter 40, as an: (See definitions 5 through 9)
Explosives License
Fee Renewal
Explosives Permit
Fee
Renewal
Fee
Fee
Manufacturer (Check the types of explosives you plan to
User of Explosives (Check the types of explosives you plan to
manufacture:)
use:)
High Explosives
Low Explosives
High Explosives
Fireworks
$200
$100
$100
$50
Fireworks
Theatrical Flash Powders
Blasting Agents
Other (Specify)
Blasting Agents
Other (Specify)
Low Explosives
Importer (Check the types of explosives you plan to import:)
Limited Permit (Intrastate Only) (Check the types of
explosives you plan to use:)
High Explosives
Fireworks
High Explosives
Fireworks
Blasting Agents
Other (Specify)
$200
$100
$25
$12
Blasting Agents
Other (Specify)
Low Explosives
Low Explosives
Dealer (Check the types of explosives you plan to deal in:)
High Explosives
Low Explosives
Fireworks
Blasting Agents
$200
$100
Black Powder
Other (Specify)
Total Fees
13. Is a State or local license or permit required for explosive business and/or operations? (If yes, provide license/permit numbers; if applied for license/
permit but not yet obtained, provide date of application.)
Yes/Numbers or Date
No
14. Is the applicant or any person named in item 11: (ALL questions must be answered by checking the "YES" or "NO" box.) (Give full details on a
Yes No
separate sheet for all "yes" answers in item 14.)
a. A fugitive from justice?
b. An unlawful user of, or addicted to, marijuana or any depressant, stimulant, or narcotic drug, or any other controlled substance?
c. Under indictment or information in any court for a felony, or any crime, for which the judge could imprison that person for more than one
year? (An information is a formal accusation of a crime by a prosecutor.) (See Definition 1.)
d. An alien in the United States? (If "yes," attach an explanatory statement showing that the person is a lawful permanent resident or a lawful
nonimmigrant or refugee/asylee.) (See Definition 2 and Exception 2.)
Statement Attached.
If the individual is an alien, provide the U.S.-issued alien number or admission number in item 11.
e. Presently appealing a conviction of a crime punishable by imprisonment for a term exceeding one year? (If "yes," attach an explanatory
statement showing date of conviction, court in which convicted, and court in which appeal is pending.)
Statement Attached.
15. Has the applicant or any person named in item 11 EVER: (Give full details on a separate sheet for all "yes" answers in item 15.)
Yes No
a. Been convicted in any court of a felony, or any other crime, for which the judge could have imprisoned that person for more than one year,
even if he or she received a shorter sentence, including probation? (See Definition 1 and Exception 1.)
b. Been adjudicated mentally defective (which includes having been adjudicated incompetent to manage his or her own affairs) or been
committed to a mental institution?
c. Been discharged from the Armed Forces under dishonorable conditions?
d. Renounced his or her United States citizenship?
Section B (Must be completed)
16. Hours of Operation and/or Availability of Business Activity (Please provide at least one hour in which you may be contacted by ATF Personnel.)
Time
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Open
Close
17. Applicant's Business and/or Operation is Located in:
A Commercial Building
A Residence
Other (Specify)
ATF E-Form 5400.13/5400.16
Revised November 2018
18. Applicant's Business and/or Operations Premises are:
Owned
A Leased/Rented*
Other (Specify)
19. Does User Permit Applicant Intend to Transport Explosive Materials in
20. Does User Permit Applicant Intend to Purchase Explosive Materials in
Interstate or Foreign Commerce? (If "yes," state where)
Interstate or Foreign Commerce? (If "yes," state where)
N/A
No
Yes
N/A
No
Yes
21. Do you Intend to Deal in Black Powder? Do You Have a Federal Firearms License? (If "yes," provide the Federal firearms license number)
No
Yes Federal Firearms License #: No
Storage Facility Data
Section 842(j), 18 U.S.C., provides "It shall be unlawful for any person to store any explosive material in a manner not in conformity with regulations
promulgated by the Attorney General." Before applying for a license or permit, the applicant must read and be familiar with the requirements as set forth in
27 CFR, Part 555, Subpart K - STORAGE. An application for a license will be denied if upon an investigation it is found that storage facilities are
inadequate.
22a. All of the applicant's storage facilities listed on the attached Explosives Storage Magazine Description Worksheet(s) and meet the minimum
requirements as set forth in 27 CFR, Part 555, Subpart K - Storage. If "no" i.e., storage facilities do not meet minimum requirements) explain on separate
sheet. (See Instruction 10.)
22b. Please indicate the total number of explosives storage magazine(s).
22c. If the applicant has no storage facilities, provide contingency plan for unexpected surplus explosive materials by completing Explosives Storage
Magazine Description Worksheet Item J. (See Instruction 10.)
Section C - Certification (Must be completed by all applicants)
23. Under the penalties imposed by 18 U.S.C. 844, I certify that the answers are true, correct, and complete. I also certify that I am familiar with all
published State laws and local ordinances relating to explosive materials for the location in which I intend to do business. In addition, if the application is
for a Limited Permit, I certify that I will not receive explosive materials on more than 6 separate occasions during the 12-month period for which my
limited permit is valid.
Applicant's Signature
Title
Date
For Bureau of Alcohol, Tobacco, Firearms, and Explosives Use Only
24. Application is
Reason for Disapproval/Termination
Approved
Withdrawn*
Disapproved*
* (Fee will be refunded)
Signature of Licensing Official
Date
ATF E-Form 5400.13/5400.16
Revised November 2018
Explosives Storage Magazine Description Worksheet
For ATF Use Only
(Submit one for each magazine; you may photocopy for additional magazines)
Applicant name:
Global Positioning System (GPS)
Coordinates
Magazine ID no:
State/local explosives magazine certificate number, if any:
Storage magazine address:
A. Type of magazine (e.g., permanent, mobile/portable, indoor/outdoor, building, igloo, tunnel, dugout, box, trailer, semitrailer, or other mobile magazine):
ATF Type: (Check one)
I
II
III
IV
V
B. Location of magazine and distance from licensed place of business and other magazine:
C. Distance to nearest storage magazine, regardless of ownership:
D. Describe terrain features, roads, structures, buildings, utilities, etc., that could be damaged if the contents of the magazine exploded:
E. Distance(s) between the magazine and the feature(s):
Indicate if magazine is:
Barricaded
Unbarricaded
Show distance in feet to:
Closest highway:
Closest inhabited bldg:
Closest passenger railway:
F. Materials, including thicknesses, used in construction of magazine:
Roof:
Top:
Walls:
Bottom:
Doors:
Floor:
G.
1. Security, physical safeguards, safety equipment, and anti-theft measures:
2. Locks (Check all that apply):
Three-point Lock
Mortise Locks
Padlocks
3. If Padlocks:
Shackle Diameter:
No. of Tumblers:
Steel Hoods: Yes
No
Case-hardened: Yes
No
H. Dimensions and capacity of magazine:
Capacity (in pounds or number of detonators):
Height:
Length:
Width:
I. Explosives to be stored: Quantity or Weight
Class:
High
Low
Blasting Agents
Detonators
J.
Owned
Borrowed
Leased
Rented
Contingency Plan
1. Magazine is (Check one):
2. Owner of magazine if borrowed, leased, rented, or on contingency:
3. Address and phone number of owner:
K.
Names and telephone numbers of persons who can open magazine for inspection:
L.
Special conditions, such as difficulty accessing in winter, etc.:
M. A plat plan must be furnished, not necessarily to scale, which will indicate, at a minimum, (1) all buildings on the premises, and (2) all magazines
identified. with distances between the magazines, as well as the distances between magazines and inhabited buildings, public highways, and passenger railways.
Prepared by:
Date:
ATF E-Form 5400.13/5400.16
(Name and Title)
Revised November 2018

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