FD-1212 VAF Fingerprint Card

Voluntary Appeal File (VAF)

PRINT ALL INFORMATION IN BLACK

*LAST NAME

FBI

*FIRST NAME

LEAVE BLANK

MIDDLE NAME

FD-1212 (Rev. XX-XX-XXXX)
OMB No. 1110-0046, Exp. XX-XX-XXXX

*SIGNATURE OF APPLICANT

*DATE OF BIRTH

ADDRESS OF APPLICANT

STATE OF RESIDENCE

MM/DD/YYYY

PLACE OF BIRTH

SEX

SOCIAL SECURITY NO.

RACE

ETHNICITY
HISPANIC OR LATINO

NOT HISPANIC OR LATINO

NICS TRANSACTION NUMBER (NTN) AND/OR STATE TRANSACTION NUMBER (STN)
(IF APPLICABLE)

COUNTRY OF CITIZENSHIP

ALIEN OR ADMISSION NUMBER
FINGERPRINTED BY
DATE FINGERPRINTED

1. R. THUMB

6.L. THUMB

2. R. INDEX

7. L. INDEX

LEFT FOUR FINGERS TAKEN SIMULTANEOUSLY

* DENOTES REQUIRED FIELDS

3. R. MIDDLE

4. R. RING

8. L. MIDDLE

9. L. RING

L. THUMB

R. THUMB

5. R. LITTLE

10. L. LITTLE

RIGHT FOUR FINGERS TAKEN SIMULTANEOUSLY

FEDERAL BUREAU OF INVESTIGATION
UNITED STATES DEPARTMENT OF JUSTICE

CRIMINAL JUSTICE INFORMATION SERVICES DIVISION, CLARKSBURG, WV 26306
___________________________________________________________________________

VOLUNTARY APPEAL FILE (VAF)
The VAF permits individuals to provide written consent to the FBI's Criminal Justice Information
Services (CJIS) Division to maintain information about themselves in the VAF to prevent future
extended delays and/or erroneous denials of a firearm transfer. A completed fingerprint card must
accompany an individual's signed VAF application in order for the individual to be considered for
entry into the VAF. Upon successful entry into the VAF, the FBI's CJIS Division will assign and
provide the individual a Unique Personal Identification Number (UPIN) to be utilized for future firearm
transfers. A National Instant Criminal Background Check System (NICS) background check is
required for subsequent firearm transfers; however, the UPIN will aid in confirming the individual’s
eligibility to possess or receive a firearm.
For additional information on submitting fingerprints to the FBI for entry into the VAF, please visit
https://www.edo.cjis.gov.
Privacy Act Statement:

Authority: The FBI’s acquisition, preservation, and exchange of fingerprints and associated information is generally authorized under 28 U.S.C.
534. The collection of information on this form is also authorized by 28 CFR 25.10(g).
Principal Purpose: The principal purpose for requesting your fingerprints and associated information is to allow the FBI to maintain your personal
information in the Voluntary Appeal File (VAF). The FBI will search your fingerprints in its Next Generation Identification (NGI) System to confirm
your identity and to locate any relevant criminal history information. Providing your fingerprints and associated information to the FBI is voluntary;
however, failure to provide the requested information will result in the FBI’s inability to retain your information in the VAF which may, in turn, result
in future erroneous denials or extended delays of firearms transfers.
Social Security Account Number (SSAN): Your SSAN (or the last 4 digits) is requested to keep records accurate because other people may have
the same name and date of birth. Your SSAN will be used to assist with verifying your identity. You are not required to provide your SSAN;
however, failure to provide your SSAN may delay the processing of your VAF application or require the submission of additional information to
verify your identity.
Routine Uses: During the processing of your application and for as long thereafter as your fingerprints and associated information are retained by
the FBI, your information may be disclosed pursuant to your consent, and may be disclosed without your consent as permitted by the Privacy Act
of 1974 and all applicable Routine Uses as may be published at any time in the Federal Register, including the Routine Uses for the National
Instant Criminal Background Check System (NICS) and the NGI System. Routine uses include, but are not limited to, disclosures to local, state,
tribal, and territorial criminal justice agencies to determine whether transferring a firearm, explosive, or related permit to you is prohibited by state
or federal law, or whether to grant or deny an appeal from a NICS transaction. Information you provide to support your application may be used to
update records in government databases.
Paperwork Reduction Act Statement:

According to the Paperwork Reduction Act of 1995, no persons are required to provide the information requested unless a valid OMB control
number is displayed. The valid OMB control number for this information collected is 1110-0046. The time required to complete this information
collected is estimated to be 10 minutes, including time reviewing instructions, gathering, completing, reviewing and submitting the information
collection. If you have any comments concerning the accuracy of this time estimate or suggestions for reducing this burden, please send to:
Department of Clearance Officer, United States Department of Justice, Justice Management Division, Policy and Planning Staff, Washington, DC
20530.
FD-1212

(Rev. XX-XX-XXXX)