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Registration Of Privately-Owned Weapons

REGISTRATION OF PRIVATELY-OWNED WEAPONS

For use of this form, see Fort Knox Reg 210-1

DATA REQUIRED BY THE PRIVACY ACT OF 1974

AUTHORITY:

10 U. S. C. 3013 and Army Regulation 190-14, Carrying of Firearms and Use of Force for Law Enforcement Security Duties.

PRINCIPAL PURPOSE:

To authorize storage of a privately-owned weapon on the installation and to record legitimate ownership of the weapon(s).

ROUTINE USE:

Used for private identification.

DISCLOSURE:

Voluntary. No rights or benefits are lost as a direct result of not providing the information.

1. NAME OF OWNER (Last, First, MI):

2. DOB:

3. GRADE/RANK/STATUS:

4. HEIGHT:

5. WEIGHT:

6. EYE COLOR: 7. HAIR COLOR: 8. ORGANIZATION:

9. E-MAIL ADDRESS:

10. WORK PHONE NUMBER: (Coml & DSN)

11. FAX NUMBER:

12. HOME ADDRESS:

13. HOME PHONE NUMBER:

14. ACTIVE DUTY MILITARY MEMBERS AND RETIREES STORING FIREARMS ON FORT KNOX FOR MORE THAN 72 HOURS MUST REGISTER THEM

WITHIN 72 HOURS WITH THE DIRECTORATE OF EMERGENCY SERVICES. ALL OTHER PERSONNEL (INCLUDING MILITARY FAMILY MEMBERS) STORING

FIREARMS ON FORT KNOX FOR MORE THAN 24 HOURS MUST REGISTER THEM WITHIN 24 HOURS WITH THE DIRECTORATE OF EMERGENCY

SERVICES. DURING DUTY HOURS REGISTRATION IS CONDUCTED AT ONE-STOP VEHICLE/WEAPONS REGISTRATION OFFICE (BLDG 1384, 1st FLOOR).

DURING NON-DUTY HOURS REGISTRATION IS CONDUCTED AT THE MILITARY POLICE STATION (BLDG 298). I HAVE READ AND UNDERSTAND THE POST

REGULATIONS GOVERNING FIREARMS (Fort Knox Reg 210-1, 4 Mar 10).

(Signature of Owner)

(Date)

15. I UNDERSTAND THAT PRIVATELY-OWNED WEAPONS STORED ON FORT KNOX MUST BE PROPERLY REGISTERED WITH THE DIRECTORATE OF

EMERGENCY SERVICES. ANY CHANGES IN THE FIREARM REGISTRATION MUST BE REPORTED WITHIN 3 DUTY DAYS TO THE DIRECTORATE OF

EMERGENCY SERVICES (ONE-STOP).

(Signature of Commander)

(Date)

NOTE: Upon signature, commanders will retain a copy for unit files. Soldier will now proceed to the Provost Marshal's Office to register the

weapon(s).

THE ORIGINAL OF THIS REGISTRATION WILL BE RETAINED BY THE OWNER AND IS NOT TRANSFERABLE.

DESCRIPTION OF FIREARMS AND STORAGE

TYPE (Rifle, Pistol, Shotgun)

CALIBER/

MAKE

TYPE OF ACTION (Bolt, Pump,

SERIAL #

MODEL #

PLACE OF STORAGE

GAUGE

Antique, & Semi-automatic)

FK PE V2.00 ES

PREVIOUS EDITIONS ARE OBSOLETE.

FK FORM 2759-E, JAN 2011

Registration Of Privately-Owned Weapons

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