U.S. Department of Justice  

OMB No. 1140-0106 (06/30/2024)  

Bureau of Alcohol, Tobacco, Firearms and Explosives Arson and Explosives Training Request for  Non-ATF Employees  

Course of Interest  

Course ID Course Title  

Participant Information  

Name (Last, First, Middle Initial) Rank/Title  

Social Security Number (Last 4 digits)

Sex  

Male Female

Department/Agency Name Agency Type (Please check one)  Federal Local International Law Enforcement  

State Military  

Hazardous Device School Basic Class Number Advanced Explosives Disposal Techniques Graduation Date  

HDS Certification Expiration Date:

Department/Agency Address (Number, Street, City, State, and Zip Code) Work E-Mail Address

Office Telephone Number (Including area code) Length of Time in Public Service  

Fax Telephone Number (Including area code)

Supervisor’s Name Telephone Number (Including area code)  

Supervisor’s Signature

Supervisor’s E-Mail Address

Briefly Describe Your Area of Responsibility and Duties

For Arson and Explosives Training  

E-mail this form to NCETR-mailbox@atf.gov  

or the individual course e-mail as listed on the course website.  

Contact Number: (256) 261-7500  

For Students Interested in the National Firearms Examiner Academy, Please Use ATF E-Form 6330.1.  

Privacy Act Information  

This information is provided pursuant to Public Law 93-579 (Privacy Act of 1974) December 31, 1974, relative to the collection of information from prospective students to  attend the ATF Training.  

1. Authority. 5 U.S.C. §§ 1302, 3301, 3304, and 7201; 42 U.S.C. § 4222; and 46 F.R. 16586.  

2. Purpose. The information requested on this form is necessary to process requests from prospective students to attend the ATF National Center for Explosives Training  and Research training courses.  

3. Routine Uses. The information will be used solely to process the student application form.  

4. Disclosure of your Social Security Number (SSN). Disclosure of the individual’s SSN is voluntary. Under Executive Order 9367, ATF has the authority to solicit an   individual’s SSN. The SSN is used to verify the individual’s identity. Failure to provide the SSN will delay the processing of an individual’s application to attend ATF’s  arson and explosives training.  

Paperwork Reduction Act Notice  

This request is in accordance with the Paperwork Reduction Act of 1995. The information collection is used to determine the eligibility of the applicant to  attend ATF training.  

The estimated average burden associated with this collection is 6 minutes per respondent or recordkeeper, depending on individual circumstances.  Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be directed to the Reports Management  Officer, Resource Management Staff, Contracts and Forms Office, Bureau of Alcohol, Tobacco, Firearms and Explosives, Washington, DC 20226.  

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.  ATF Form 6310. 1  

Revised June 2021