Personal Firearms And Weapons Registration Form printable pdf download

PERSONAL FIREARMS AND WEAPONS REGISTRATION FORM

USASC&FG 210-13

Please Read Privacy Act Statement Below Before Completing Requested Information

PRIVACY ACT STATEMENT

AUTHORITY:

10 U.S.C., 3013; 44 U.S.C. 3101, AR 190-11; AND USASC&FG Regulation 210-13

PRINCIPLE PURPOSE: To record personal information on an individual who registers their firearms or privately owned weapons (POWs) on Fort Gordon

or who requests and authorize a National Crime Information Center (NCIC) criminal and driver history check as a prerequisite to bringing firearms onto Fort

Gordon. ROUTINE USES: To use as proof of firearms or POWs registration and proof of a NCIC check/expiration date and to maintain a record denoting

an authorized storage location for firearms and other POWs. Routine use could include disclosure to other investigative authorities. SSN and Drivers

License number used for identification and retrieving data from files. DISCLOSURE: Disclosure is voluntary. Personnel, who do not disclose the

necessary information, to include SSN, will not be authorized to register, store or bring firearms or POWs onto Fort Gordon. Personnel on or entering the

installation in possession of firearms or POWs without a valid and approved Fort Gordon Form 9243 could result in confiscation of their weapons,

disciplinary action, denial of entry to Fort Gordon, or other appropriate action. Note: In block 11, use the three letter abbreviation for the month you

were born. i.e., if you were born on 8 June 1972 enter in block 11 the following: 08/Jun/1972.

1. Name: (Last, First, MI)

2. Work Phone:

3. Grade / Civ:

4. SSN:

5. Home Address: (Street#, City, State, Zip Code)

6. Home Phone:

7. Authorized Location for Weapons Stored on post:

8. Unit: (For military only)

9. Drivers License:

10. State:

11. Date of Birth: (dd/ mmm/ yyyy)

12. Sex: (M / F)

Registration of POWs are required for all military, DOD civilians, or their family members residing on the installation and for all military bringing firearms

onto the installation. DOD civilians and non-DOD civilians residing off the installation, who authorize a NCIC check, can skip sections 13-through 17.

13. Type of Firearm or Weapon

14. Make

15. Model

16. Caliber

17. Serial Number

18.

DOD and non-DOD civilians who check or initial section 18 and complete sections 1 through 12, as applicable, and 21 through 23,

authorize Fort Gordon Officials to conduct a criminal and driver history check as a prerequisite for bringing firearms onto Fort Gordon.

Section 19 and 20 is for official use only. Section 19 applies only to DOD civilians and non DOD civilians who authorized a NCIC check

19. Enter date (dd/mmm/yyyy) when a favorable NCIC check was conducted.

20. DES, MP Desk Approval Stamp, Signature and Date:

Authorization to bring POWs onto the installation based upon a favorable NCIC check

expires one year after the check was conducted

In section 13 In the row directly beneath the last firearm or weapon entry, type or print in ink, the words, // Last Item //. If more than one sheet is required to

register weapons, the weapon’s owner must complete, with appropriate signatures and dates, another Personal Firearms and Weapons Registration form.

Military personnel at the grade of 04, CW4, or E8 and below or their family members residing on the installation must have the battalion commander sign

this form prior to registering their firearms or weapons. All military or civilian personnel must have the company commander’s approval to store weapons in

an arms room. A battalion or company commander’s signature is not required for military or civilians who reside off the installation.

Take the original and three copies of the completed forms to the Military Police Desk Sergeant in the Law Enforcement Center. DO NOT BRING THE

WEAPONS INTO THE MP STATION.

Signatories of this form certify that they will comply with the Domestic Violence Amendment to the Gun Control Act of 1968, Army regulations, local

regulations and local and state laws on ownership, possession, registration, transportation and safe use of privately owned weapons and ammunition.

Signatories of this form further certify that the name that appears in block 1 and 21 is the legal owner of the weapons listed in sections 13-17, or the DOD

civilian or non DOD civilian in possession of firearms has been approved to use them on the installation based upon a valid and favorable NCIC check

entered on this form in section 19. Unless otherwise determined by Fort Gordon Law Enforcement Officials or Security Guards, It shall be assumed that

personnel in possession of an approved FG Form 9243 have permission by the owner whose name appears in section 1 and 21, to use the firearms or

weapons in their possession.

21. Typed or Printed Name of Firearms or Weapons Owner:

22. Signature of Owner:

23. Date Signed:

24. Typed or Printed Rank / Name of Bn. or Co. Commander:

25. Signature of Bn. or Co. Commander:

26. Date Signed:

All Previous Editions are Obsolete

FG FORM 9243-R-E, OCT 2012