Fh Form 190-19 - Privately-Owned Firearms Registration Page 3
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3PRIVATELY-OWNED FIREARMS REGISTRATION
(For use of this form, see FH Reg 190-11. The proponency for this form is DES.)
PRIVACY ACT STATEMENT
AUTHORITY:
10 USC 3013
To register privately-owned firearms stored or used on Fort Hood.
PRINCIPAL PURPOSE:
ROUTINE USES:
Your social security number is used as an additional and/or alternate means of identification to facilitate filing and
retrieval.
DISCLOSURE:
Voluntary; however, failure to provide necessary information will result in denial of registration.
SEE PAGE 1 FOR INSTRUCTIONS
SECTION I - REGISTRATION
1. NAME
(Last, First, MI):
2. SSN:
3. RANK / TITLE:
4. FORT HOOD UNIT OR ACTIVITY / CONTRACTOR COMPANY NAME:
5. WORK TELEPHONE:
7. HOME TELEPHONE:
6. HOME ADDRESS:
(Street, City, and State)
8c. CAL/GAUGE
8d. TYPE*
8e. SERIAL NUMBER
8a. MAKE OF FIREARM
8b. MODEL OF FIREARM
9b. COMMANDER'S SIGNATURE:
9a. COMMANDER'S PRINTED NAME:
10. CLASS: CLASS (A) - Permits registrant to store firearm in Family / bachelor type quarters only.
CLASS (B) - Requires registrant to store firearm in unit arms room only.
CLASS (C) - Requires registrant to store firearm in off-post location only.
NOTE: Cross out non-applicable classes and complete item 11.
11. STORAGE LOCATION OF FIREARM:
(Negative NCIC)
12a. PRINTED NAME:
12b. SIGNATURE AND DATE:
(Registrar)
-- Firearms will not be stored in troop billets.
-- Firearms will not be concealed.
-- Registration will be carried with the firearm whenever it is removed from the authorized storage facility and transported on Fort Hood.
-- Registration is not transferable. Notify the crime records section in building 23020, room 102 (Provost Marshal Office) upon ETS, PCS, sell, etc.
-- See FH Reg 190-11 for detailed information.
13b. SIGNATURE AND DATE:
13a. PRINTED NAME OF REGISTRANT:
14. EXPIRATION DATE:
Page 3 of 3
FORT HOOD FORM 190-19, SEPTEMBER 2013
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