Attachment 2(J) - CSO Form 014.pdf
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- DJMS-12-R-0020
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Attachment 2(J) - CSO-234
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PAGE 1 OF 2 CSO FORM 014 (Rev. 9/10)
Section J - Attachment 2(J)
U.S. Department of Justice
United States Marshals Service
COURT SECURITY OFFICER (CSO)
WEAPONS QUALIFICATION RECORD
1. NAME (Last, First, MI)
2. DISTRICT
3. ASSIGNED FACILITY
4. DATE COURSES FIRED
(mm/dd/yyyy)
QUALIFICATION RESULTS
5a. WEAPON
TYPE
5b. QUALIFICATION
6. MAKE
7. MODEL
8. CALIBER
9. BARREL
LENGTH
10. PROPERTY
OF:
11. SERIAL NUMBER
HANDGUN
QUALIFICATION
USMS
12. Ammunition Used
(Brand, Caliber, Weight, Type [JHP,JSP, Etc.]
13. SCORE
14. QUALIFICATION
LEVEL
15. SHOOTER’S
INIITIALS
16. DATE OF
RETESTS
(If applicable)
Qualification
1st Retest
2nd Retest
17. USE OF DEADLY FORCE AND FIREARMS POLICY:
I have read and understand the current DOJ Uniform Deadly Force
Policy as well the contract requirements.
Signature: Date: ___________
18. CONTRACTOR’S FIREARMS INSTRUCTION CERTIFICATION:
This certifies that the course of fire, qualification level, scores, weapons and ammunition used are authorized and indicated herein, and that the individual stated above demonstrated proficiency with their issued weapon.
Signature: Date: ____________
19. WEAPON INSPECTION:
The firearm described herein has been inspected by the contractor’s authorized Firearms Instructor (named in Block 18) and:
Does [ ] / Does Not [ ] meet the contract requirements.
20. HOLSTER INSPECTION:
The holsters and accessory equipment used ( magazines/magazine holders) have also been inspected and:
Does [ ] / Does Not [ ] meet the contract requirements as to design and serviceability.
21. BODY ARMOR INSPECTION:
The body armor described herein has been inspected by the contractor’s authorized Firearms Instructor (named in Block 18) and:
Does [ ] / Does Not [ ] meet USMS serviceability requirements.
22. VERIFIED BY: (NOTE: THE WEAPONS QUALIFICATION TEST MUST BE VERIFIED BY A REPRESENTATIVE OF THE USMS
PRINTED NAME: SIGNATURE: ___________________________________________
TITLE: DATE:
23. REMARKS:
PAGE 2 OF 2 CSO FORM 014 (Rev. 9/10)
Section J - Attachment 2(J)
INSTRUCTIONS FOR COMPLETING THE CSO WEAPONS QUALIFICATION FORM
1. Contractor’s name.
2. District assignment (D/MA, S/NY, D/MD, E/VA, etc.).
3. Facility assignment.
4. The date on which the course of fire was performed.
5a. No additional information is necessary.
5b. No additional information is necessary.
6. The name of the weapon=s manufacturer.
7. The manufacturer=s designation for the weapon.
8. The caliber of the weapon.
9. No additional information is necessary.
10. No additional information is necessary.
11. The weapons serial number.
12. The exact load shot during course of fire as designated from the current contract.
13. The score fired during the course of fire. If a retest is required, note subsequent scores on the appropriate lines.
14. The ranking of the CSO=s score (de, ex, ss, mm, dnq). See the chart below for the exact ranking for each course of fire.
15. The contractor initials the qualification record, thus indicating that the information provided is correct.
16. Dates of two allowed subsequent retests (Provide only if applicable.)
17. No additional information is necessary.
18. Certification by the Contractor=s Firearms Instructor
19. Verification that the weapon was inspected and meets the USMS standards.
20. Verification that the contractor=s equipment meets the USMS standards.
21/22. Verification by authorized USMS Representative that the contractor and the CSO met the USMS standards and contract requirements.
QUALIFICATION RANKINGS
Distinguished Expert (DE)
Expert (EX)
238 - 249
Sharpshooter (SS)
213 - 237
Marksman (MM)
175 - 212
Did Not Qualify (DNQ)
174 or below
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