Atf Form 3310.4 - Report Of Multiple Sale Or Other Disposition Of Pistols And Revolvers

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OMB No. 1140-0003 (02/29/2012)

U.S. Department of Justice

Report of Multiple Sale or Other

Bureau of Alcohol, Tobacco, Firearms and Explosives

Disposition of Pistols and Revolvers

(Please complete all information)

2a. Federal Firearms Licensee (FFL) Number

1. Date Transferred

2b. Business or Trade Name and Address (If you have complete information available on a rubber stamp, please place information here.)

2c. Is this firearm connected to another multiple sale? (If yes, specify date)

Yes

Date

2d. If you sold these firearms at a gun show or other qualifying event, identify the event and provide a complete address of the event.

3. Any Combination of Pistols and Revolvers Acquired in the Last Five Business Days

Type (Pistol or revolver)

Serial Number

Manufacturer

Importer

Model

Caliber

Disposition

Date

4. Transferee's Name (Last, first, middle)

5. Residence Address (Number, street, city, county, state, zip code)

6. Sex

7. Race

American Indian or Alaska Native

Asian

Native Hawaiian or Pacific Islander

African American or Black

Other (Specify)

Hispanic or Latino

White

8. Identification Number

9. Type of Identification

10. ID State

12. Place of Birth (City, county, state, country)

11. Date of Birth

13. If the buyer of the firearms listed in item 4 is an officer authorized to act on behalf of a corporation, company, association, partnership or other such

business entity, you must complete the following:

Name and Address of Business Entity

14a. Identify the official designated by the state or local authorities where you, the FFL, will be forwarding copy 2.

Name of Agency

Street Address, City, and State

14b. Date Copy 2 was Forwarded to Agency

15. Additional Information Relating to the Transfer of the Firearms

16. Name of Employee Filling Out This Form

17. Date This Form Was Completed

ATF Form 3310.4

When Fax is Available, Please Fax to 1-877-283-0288.

Revised March 2009