COMMONWEALTH OF PENNSYLVANIA 
COURT NOTIFICATION OF PROHIBITING OFFENSE 
UNLAWFUL USER OF CONTROLLED SUBSTANCE 

In accordance with 18 Pa.C.S. § 6111.1(f)(1)(ii), Notwithstanding any statute to the contrary, judges of the courts of common pleas shall 
notify the Pennsylvania State Police of any finding of fact or court order related to any person described in 18 U.S.C. § 922(g)(3), relating to 
persons who are unlawful users of or addicted to any controlled substance (as defined in section 102 of the Controlled Substances Act [21 
U.S.C. 802]).  

The  notification  shall  be  transmitted  by  the  judge  within  seven  days  of  the  finding  of  fact  or  court  order  by  first  class  mail  to  the 
Pennsylvania State Police, Attention:  PICS Unit, 1800 Elmerton Avenue, Harrisburg, PA  17110.   
(Please type or print clearly with a black or blue ballpoint ink pen.)  

Pursuant to federal guidelines, inference of current drug use includes but is not limited to the following:  a conviction for a drug offense in 
the past year; an admission of drug use or dependency in a criminal or civil proceeding; a positive drug test of a person, paraphernalia, or 
substance, regardless of the offense that is being adjudicated or has been adjudicated.  This is not an exhaustive list; inference of use may 
be determined any number of ways, as long as the conduct, drug test, conviction, etc., occurred within the past year. 

SUBJECT INFORMATION 
Last Name   

Date of Birth   

Street Address   

First Name   

Middle Name   

SSN (Optional, but will help prevent misidentification)   

City  

State  

Zip Code 

SID No.  

OTN  

Court Docket No. 

County Submitting Notification 

Sex  

Race  

Height 

Weight  

Hair  

Eyes  

AOPC 2251 REV. 05/03/2010 / PSP No. SP4-138 (9-2009) 

UNLAWFUL USER/OFFENSE INFORMATION (A copy of the court order or finding of fact may be attached to this form.) 

Title/Section 
Subsection 

Description 

Grade 

Disposition 

Date of Conviction, Positive Drug 
Test, Admission of Use, etc. 

Name of Notifying Official 

Please Print Name 

Signature of Notifying Official

Date 

27 C.F.R. § 478.11  UNLAWFUL USER OF OR ADDICTED T O ANY CONTROLLED SUBSTANCE 

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A person who uses a controlled substance and has lost the power of self-control with reference to the use of the controlled substance; and any
person who is a current user of a controlled substance in a manner other than as prescribed by a licensed physician.

Such use is not limited to the use of drugs on a particular day, or within a matter of days or weeks before, but rather that the unlawful use has
occurred recently enough to indicate that the individual is actively engaged in such conduct.

A person may be an unlawful current user of a controlled substance even though the substance is not being used at the precise time the person
seeks  to  acquire  a  firearm  or  receives  or  possesses  a  firearm.    An  inference  of  current  use  may  be  drawn  from  evidence  of  a  recent  use  or
possession of a controlled substance or a pattern of use or possession that reasonably covers the present time.  For example:

• A conviction for use or possession of a controlled substance within the past year;
• Multiple arrests for such offenses within the past five years if the most recent arrest occurred within the past year; or
• Persons found through a drug test to use a controlled substance unlawfully, provided that the test was administered within the past

year.

For a current or former member of the Armed Forces, an inference of current use may be drawn from recent disciplinary or other administrative
action based on confirmed drug use, e.g., court-martial conviction, nonjudicial punishment, or an administrative discharge based on drug use or
drug rehabilitation failure.

As defined in 21 U.S.C. § 802 and 21 C.F.R. Part 1308, the term “controlled substance” includes but is not limited to marijuana, depressants, stimulants, and 
narcotic drugs. The term “controlled substance” does not include distilled spirits, wine, malt beverages, or tobacco (as those terms are defined or used in 
Subtitle E of the Internal Revenue Code of 1986, as amended). 

PRIVACY ACT NOTICE:  Solicitation of this information is authorized under Title 18 Pa. C.S. § 6111.1.  Disclosure of your social security number 
is  voluntary.    Your  social  security  number,  if  provided,  may  be  used  to  verify  your  identity  and  prevent  misidentification.    All  information 
supplied, including your social security number, is confidential and not subject to public disclosure. 

AOPC 2251 REV. 05/03/2010 / PSP No. SP4-138 (9-2009)