Wisconsin Department Of Justice Division Of Criminal Investigation Law Enforcement Officer Safety Act Retired Law Enforcement Officer Identification Card printable pdf download

WISCONSIN DEPARTMENT OF JUSTICE DIVISION OF CRIMINAL INVESTIGATION

LAW ENFORCEMENT OFFICER SAFETY ACT

RETIRED LAW ENFORCEMENT OFFICER IDENTIFICATION CARD

LIABILITY WAIVER, RELEASE AND INDEMNIFICATION AGREEMENT P L E A S E

READ CAREFULLY BEFORE DECIDING WHETHER YOU WISH TO SIGN. THIS IS A

RELEASE OF LIABILITY AND WAIVER OF CERTAIN LEGAL RIGHTS. IT IS ALSO AN

ASSUMPTION OF CERTAIN OTHER LEGAL RESPONSIBILITIES.

I am a retired special agent of the Wisconsin Department of Justice (DOJ) Division of Criminal

Investigation (DCI) or a retired federal law enforcement officer who is eligible to attempt to qualify to

carry a concealed firearm under certain conditions, pursuant to the Law Enforcement Officers Safety Act

(LEOSA), commonly referred to as HR 218 and codified as 18 USC Sec. 926B and C. I recognize

that t he DOJ / DC I is not legally required to provide me with firearms instruction or a firearms

qualification course or to create a process for issuance of a Retired Law Enforcement Officer Safety

Act Identification Card pursuant to LEOSA.

DESCRIPTION OF RISKS

Firearms are lethal weapons; injury or death may result to me or others as a result of accidents or

intentional acts arising from my carrying and/or using a concealed weapon. I understand my decision

to carry and/or use a concealed weapon may also give rise to claims of legal liability, lawsuits, and

judgments for monetary and other damages against me.

I understand and agree to abide by the

following Uniform Rules for Gun Handling:

_______________________________________________________________________________

_____________________________________________________________________________

LIABILITY WAIVER, RELEASE AND INDEMNIFICATION

IN CONSIDERATION OF THE OPPORTUNITY TO PARTICIPATE IN DCI’S LEOSA

IDENTIFICATION CARD PROCESS, I, T H E U N D E R S I G N E D , ( O N M Y O W N

B E H A L F

A N D

O N

B E H A L F

O F

M Y

H E I R S ,

P E R S O N A L

R E P R E S E N T A T I V E S ,

S U C C E S S O R S ,

A N D

A S S I G N S ) HEREBY

RELEASE THE STATE OF WISCONSIN, ITS AGENCIES, ,

EMPLOYEES, OFFICERS,

OFFICIALS, AND/OR AGENTS (“RELEASED PARTIES”) FROM ANY AND ALL

LIABILITY, CLAIMS, DEMANDS, RIGHTS, LOSSES, CAUSES OF ACTION AND

DAMAGES THAT MAY ARISE IN CONNECTION WITH MY PARTICIPATION IN

THE DCI LEOSA IDENTIFICATION CARD PROCESS AND TO MYSELF ARISING

FROM OR IN ANY WAY RELATING TO MY CARRYING, POSSESSING, OR USING

ANY

WEAPON

UNDER

THE

PROVISIONS

THE

LEOSA.

FURTHER,

CONSIDERATION FOR PARTICIPATION IN DCI’S LEOSA IDENTIFICATION CARD

PROCESS FOR RETIRED DCI AGENTS, I HEREBY SPECIFICALLY AGREE TO

INDEMNIFY,

HOLD

HARMLESS,

ANSWER

AND

DEFEND

THE STATE OF

WISCONSIN,

I T S

A G E N C I E S ,

E M P L O Y E E S ,

OFFICERS,

OFFICIALS,

A N D / O R AGENTS, FROM ANY AND ALL LIABILITY, CLAIMS, DEMANDS, LOSSES

Wisconsin Department Of Justice Division Of Criminal Investigation Law Enforcement Officer Safety Act Retired Law Enforcement Officer Identification Card

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