Mo. Rev. Stat. § 571.117
SMALL CLAIMS COURT | |||||
In the Circuit Court of _________, Missouri | |||||
______, PLAINTIFF | |||||
) | |||||
) | |||||
vs. | ) | Case Number ______ | |||
) | |||||
______, DEFENDANT, | |||||
Carry Permit or Endorsement Holder | |||||
______, DEFENDANT, | |||||
Sheriff of Issuance | |||||
PETITION FOR REVOCATION OF A | |||||
CONCEALED CARRY PERMIT OR CONCEALED CARRY ENDORSEMENT | |||||
Plaintiff states to the court that the defendant, ______, has a concealed carry permit issued pursuant to sections 571.101 to 571.121, RSMo, or a concealed carry endorsement issued prior to August 28, 2013, and that the defendant's concealed carry permit or concealed carry endorsement should now be revoked because the defendant either never was or no longer is eligible for such a permit or endorsement pursuant to the provisions of sections 571.101 to 571.121, RSMo, specifically plaintiff states that defendant, ______, never was or no longer is eligible for such permit or endorsement for one or more of the following reasons: | |||||
(CHECK BELOW EACH REASON THAT APPLIES TO THIS DEFENDANT) | |||||
[] | Defendant is not at least nineteen years of age or at least eighteen years of age and a member of the United States Armed Forces or honorably discharged from the United States Armed Forces. | ||||
[] | Defendant is not a citizen or permanent resident of the United States. | ||||
[] | Defendant had not resided in this state prior to issuance of the permit and does not qualify as a military member or spouse of a military member stationed in Missouri. | ||||
[] | Defendant has pled guilty to or been convicted of a crime punishable by imprisonment for a term exceeding two years under the laws of any state or of the United States other than a crime classified as a misdemeanor under the laws of any state and punishable by a term of imprisonment of one year or less that does not involve an explosive weapon, firearm, firearm silencer, or gas gun. | ||||
[] | Defendant has been convicted of, pled guilty to or entered a plea of nolo contendere to one or more misdemeanor offenses involving crimes of violence within a five-year period immediately preceding application for a concealed carry permit issued pursuant to sections 571.101 to 571.121, RSMo, or a concealed carry endorsement issued prior to August 28, 2013, or if the applicant has been convicted of two or more misdemeanor offenses involving driving while under the influence of intoxicating liquor or drugs or the possession or abuse of a controlled substance within a five-year period immediately preceding application for a concealed carry permit issued pursuant to sections 571.101 to 571.121, RSMo, or a concealed carry endorsement issued prior to August 28, 2013. | ||||
[] | Defendant is a fugitive from justice or currently charged in an information or indictment with the commission of a crime punishable by imprisonment for a term exceeding one year under the laws of any state of the United States other than a crime classified as a misdemeanor under the laws of any state and punishable by a term of imprisonment of two years or less that does not involve an explosive weapon, firearm, firearm silencer, or gas gun. | ||||
[] | Defendant has been discharged under dishonorable conditions from the United States Armed Forces. | ||||
[] | Defendant is reasonably believed by the sheriff to be a danger to self or others based on previous, documented pattern. | ||||
[] | Defendant is adjudged mentally incompetent at the time of application or for five years prior to application, or has been committed to a mental health facility, as defined in section 632.005, RSMo, or a similar institution located in another state, except that a person whose release or discharge from a facility in this state pursuant to chapter 632, RSMo, or a similar discharge from a facility in another state, occurred more than five years ago without subsequent recommitment may apply. | ||||
[] | Defendant failed to submit a completed application for a concealed carry permit issued pursuant to sections 571.101 to 571.121, RSMo, or a concealed carry endorsement issued prior to August 28, 2013. | ||||
[] | Defendant failed to submit to or failed to clear the required background check. (Note: This does not apply if the defendant has submitted to a background check and been issued a provisional permit pursuant to subdivision (2) of subsection 5 of section 571.101, and the results of the background check are still pending.) | ||||
[] | Defendant failed to submit an affidavit attesting that the applicant complies with the concealed carry safety training requirement pursuant to subsection 1 of section 571.111, RSMo. | ||||
[] | Defendant is otherwise disqualified from possessing a firearm pursuant to 18 U.S.C. Section 922(g) or section 571.070, RSMo, because (specify reason): | ||||
The plaintiff subject to penalty for perjury states that the information contained in this petition is true and correct to the best of the plaintiff's knowledge, is reasonably based upon the petitioner's personal knowledge and is not primarily intended to harass the defendant/respondent named herein. | |||||
__________________, PLAINTIFF | |||||
§ 571.117, RSMo