2. Self-Certification for Firearm Safety Instructors

   Pursuant to New York State Penal Law § 400.00(19), all applicants for a New York State Concealed Carry Pistol Permit must complete a minimum of sixteen (16) hours of in-person live curriculum firearm safety training and two (2) hours of a live-fire range training course. 

   All Cortland County applicants, wishing to apply for a New York State Concealed Carry Pistol Permit will be required to submit a Certification of Completion of Training, prior to their application being submitted to a Licensing Officer.

   If you or your entity qualify as a Duly Authorized Instructor, as defined in New York State Penal Law § 265.00(19), and you would like to be listed on the Cortland County Clerk’s website, please fill out the below form. 

   IMPORTANT NOTICE: Filling out the below form and posting on the Cortland County Clerk’s website does not certify any individual or entity as a Duly Authorized Instructor, as defined in New York State Penal Law § 265.00(19), nor is it an endorsement of any particular course or provider. This form only allows those who wish to self-certify to make their information publicly available on the Cortland County Clerk’s website. 

4. Name*
6. Address line 1 (street # & name)*
7. Address line 2 (apt. #, suite. etc)
9. City*
10. State*
    -- Select One --NY
11. Zip code*
13. Email*
14. Phone*
16. Website (optional)
18. Provide additional comments for the County Clerk's office. Example: Email is for internal use only. Do not post on public list.

20. Firearm Safety Course - Classroom
    A minimum of sixteen (16) hours of in-person live curriculum that meets or exceeds the requirements set forth in New York State Penal Law § 400.00(19) and the "Minimum Standards For New York State Concealed Carry Firearm Safety Training" issued on August 23, 2022, as amended or updated from time to time, including a written proficiency test to the above-listed applicant that evaluates his/her/their understanding of the requirements set forth in New York State Penal Law § 400.00(19) and the "Minimum Standards For New York State Concealed Carry Firearm Safety Training" issued on August 23, 2022, as amended or updated from time to time.

    Firearm Safety Course – Live-Fire
    A minimum of two (2) hours of a live-fire range training course that meets or exceeds the requirements set forth in New York State Penal Law § 400.00(19) and the "Minimum Standards For New York State Concealed Carry Firearm Safety Training" issued on August 23, 2022, as amended or updated from time to time. 

    I am a Duly Authorized Instructor, as that term is defined in New York State Penal Law § 265.00(19), approved by the New York State Division of Criminal Justice Services and New York State Police to instruct the concealed carry firearms safety training. Please include the above individual or entity on the Cortland County Clerk's website and listed as providing the following training:

22. Please check one or both

    1. Firearm Safety Course - Classroom
    2. Firearm Safety Course - Live-Fire
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23. 1. Receive an email copy of this form.
24. Email address

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