APPLICATION TO MAKE AND REGISTER A FIREARM

DEPARTMENT OF THE TREASURYBUREAU OF ALCOHOL, TOBACCO AND FIREARMSAPPLICATION TO make AND REGISTER A FIREARM (Submit in duplicate. See Instructions attached.)1. TYPE OF APPLICATION (Check one)a. TAX PAID. Submit with your APPLICATION acheck or money order for $200 madepayable to the Department of the approval of the APPLICATION , thisoffice will acquire, affix, and cancel therequired National Firearms Act: stampfor TAX EXEMPT because FIREARM is beingmade on behalf of the United States, orany department, independent establish-ment, or agency TAX EXEMPT because FIREARM is beingmade by or on behalf of any State or pos-session of the United States, or any poli-tical subdivison thereof, or any officialpolice organization of such a governmententity engaged in criminal No. 1512-0024 (02/29/2004)TO: National Firearms Act Branch, Bureau of Alcohol, Tobacco and Firearms, Washington, DC 20226 The undersigned hereby makes APPLICATION , as required by Sections 5821 and 5822 of the National Fire-arms Act, Title 26 , Chapter 53, to make and REGISTER the FIREARM described APPLICATION IS MADE BY:INDIVIDUALCORPORATION OR OTHERGOVERNMENTBUSINESS ENTITYENTITY3a.

DEPARTMENT OF THE TREASURY. BUREAU OF ALCOHOL, TOBACCO AND FIREARMS. APPLICATION TO MAKE AND REGISTER A FIREARM (Detach this sheet before completing form)

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