Security Guard Change Of Status
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1New York State
Department of State
Division of Licensing Services
Security Guard
P.O. BOX 22052
Albany, NY 12201-2052
Customer Service: (518) 474- 7569
Security Guard Change of Status
INSTRUCTIONS:
$ Please print the required information as requested.
$ To change your status from an unarmed security guard to an armed security guard, you must submit this
form along with a certificate showing completion of a 47-hour firearms course.
$ You must return your current security guard ID card.
In addition armed security guards must complete an 8-hour annual firearms course. This course must be
completed within one calendar year of completion of the 47-hour firearms course, and every year
thereafter.
For purposes of registration, you may be granted a waiver from training if you can demonstrate completion
of training that meets or exceeds the minimum standards for the 8-hour pre-assignment or 47-hour firearms
courses. Requests for waivers should be directed to the NYS Division of Criminal Justice Services
(DCJS), Security Guard Program. To request a waiver, contact DCJS directly at (518) 457-4135 (or
rd
write them at 80 South Swan Street, 3
Fl., Albany, NY 12210-8002). If approved, DCJS will send you
a waiver letter to submit with your application to the Department of State.
$ Mail this form, along with the fee and any required documentation to the above address. You may pay by
check or money order made payable to the Department of State or charge any fee to MasterCard or Visa,
using a credit card authorization form. Do not send cash. A $20 fee will be charged for any check returned
by your bank.
FEE DUE:
$25**
UID NUMBER
NAME ON LICENSE
HOME STREET ADDRESS (NO. AND STREET)
APT/UNIT/PO BOX
CITY
STATE
ZIP+4
SOCIAL SECURITY NUMBER
x
Signature
Date
Print Name:
DOS-1619-f (Rev. 10/15)
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