Order For Removal Of Firearm Disability - Mental Health Board
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1__________________________ JUDICIAL DISTRICT
IN THE INTEREST OF
)
)
CASE NO. ________________
)
_______________________
)
ORDER FOR REMOVAL OF FIREARM DISABILITY
Alleged to be a Mentally
)
Ill and Dangerous Person
)
Subject
)
This matter comes before the ____________ Judicial District Mental Health Board on the _______ day of
_______________, 201__ , pursuant to Neb. Rev. Stat. § 71-963. A hearing was/was not held.
The (Deputy) County Attorney, _____________________, was/was not present along with the subject and the
subject’s counsel, _______________________.
The matter is submitted to the Mental Health Board upon information filed herein, the testimony elicited, and the
evidence that was adduced. ___[name of county attorney or official designee]___ provided the Board with evidence
of, and the Board considered: the circumstances surrounding the subject’s mental health commitment or
adjudication; all records of the subject’s mental health and criminal history available to the Board; the subject’s
reputation through character evidence; and changes in the subject’s condition, treatment, treatment history, or
circumstances relevant to the removal of the firearm-related disability. The subject was also provided the
opportunity to present any relevant information to the Board and did/did not (circle one) do so. The Board
considered all information presented and, upon consideration thereof, the Board finds:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
__________________________________________________________________________
The Mental Health Board further finds that in the opinion of the Mental Health Board the subject is not likely to act
in a manner that is dangerous to public safety and removing the subject’s firearm-related disabilities will not be
contrary to the public interest.
Other:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
___________________________________________________________________________
IT IS THEREFORE ORDERED THAT ANY FIREARMS DISABILITIES IMPOSED BY LAW AS A RESULT
OF MENTAL HEALTH COMMITMENTS OR ADJUDICATIONS IMPOSED BY THIS BOARD ARE
REMOVED FOR THE SUBJECT AS OF THE DATE OF THIS ORDER. THIS ORDER DOES NOT REMOVE
ANY FIREARMS DISABILITIES RESULTING FROM MENTAL HEALTH COMMITMENTS OR
ADJUDICATIONS IMPOSED BY ANY OTHER BOARD, COMMISSION, OR LAWFUL AUTHORITY.
Dated: _________________________________.
MENTAL HEALTH BOARD OF THE
___________ JUDICIAL DISTRICT,
____________________________________
Chairperson
____________________________________
Member/Alternate
____________________________________
Member/Alternate
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