NYSAFE Act "Opt-Out" Privacy Form

New York State’s new gun law (NYSAFE Act) includes the ability for pistol permit holders to request that their information be kept private and confidential by completing and submitting a State Police “Opt-Out” privacy form.

In order to "Opt-Out" and have your information kept private, please click on the following link to access the form:

Opt-Out Privacy Form

Print out the form, complete it in its entirety, sign it, and drop off or mail the original form to:

Monroe County Clerk's Office
c/o Pistol Permit Office
39 W. Main Street, Room 101
Rochester, New York 14614

Forms should be returned to the County in which your permit was issued. We cannot accept forms for other Counties. Your Firearms License # is the Carry number on your permit.

According to the State Police, when you submit your form you will be considered “approved” unless otherwise contacted. Unless your form is denied, there will be no need to follow up with the County Clerk’s Office.