Firearm Transfer Request

Transferee Information

Information on the individual receiving this transfer
Name: *
Phone Number: *

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Email:
Please ensure that at least one method of contact is provided, or we will be unable to process this request.

Transferer Information

Information on the company / individual sending this transfer
Is the Transferer an FFL? *
 Yes 
 No 
Name: *
Phone Number: *

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Fax Number:

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Email:
Please ensure that at least one method of contact is provided, or we will be unable to process this request.

Transfer Information

Information about the firearm(s) being transferred.

Item #1

Please describe the firearm being transferred
Type of Firearm: *
 Handgun 
 Long Gun 
 Receiver 
 Other 
Quantity: *
Description (Brand, Model, Caliber, etc.): *
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