Application For Tax Paid Transfer And Registration Of Firearm


OMB No. 1140-0014 (xx/xx/xxxx)
U.S. Department of Justice
Application for Tax Paid Transfer and
Bureau of Alcohol, Tobacco, Firearms and Explosives
Registration of Firearm
ATF Control Number
National Firearms Act Branch
Bureau of Alcohol, Tobacco, Firearms and Explosives, P.O. Box 530298, Atlanta, GA 30353-0298
2a. Transferee’s Name and Address (Include trade name, if any) (See instruction 2d)
1. Type of Transfer (Check one)
Submit the appropriate tax payment with
the application. The tax may be paid
2b. County
by credit or debit card, check, or money
order. Please complete item 20. Upon
3a. Transferor’s Name and Address (Include trade name, if any) (Executors: see instruction 2k)
approval of the application, we will affix
and cancel the required National Firearms
Act stamp. (See instructions 2b, 2i and 3)
3b. Transferor’s Telephone (Area Code and
3e. e-mail address
3d. Number, Street, City, State and Zip
3c. If Applicable: Decedent’s Name, Address, and Date of Death
Code of Residence (or Firearms
Business Premises) If Different from
Item 3a.
The above-named and undersigned transferor hereby makes application as required by Section 5812 of the National Firearms Act to transfer and register the firearm described
below to the transferee.
d. Model
Description of Firearm (Complete items a through h) (See instruction 2m)
Name and Address of Maker, Manufacturer and/or
c. Caliber
b. Type of Firearm
Importer of Firearm
(See definitions)
e. Of Barrel:
f. Overall:
g. Serial Number
Additional Description or Data Appearing on Firearm (Attach additional sheet if necessary)
Transferee’s Federal Firearms License (If any)
6. Transferee’s Special (Occupational) Tax Status (If any)
(Give complete 15-digit number) (See instruction 2c)
a. Employer Identification Number
b. Class
First 6 digits
2 digits
2 digits
5 digits
8. Transferor’s Special (Occupational) Tax Status (If any)
Transferor’s Federal Firearms License (If any)
a. Employer Identification Number
b. Class
First 6 digits
2 digits
2 digits
5 digits
Under Penalties of Perjury, I Declare that I have examined this application, and to the best of my knowledge and belief it is true, correct and complete, and that the transfer
of the described firearm to the transferee and receipt and possession of it by the transferee are not prohibited by the provisions of Title 18, United States Code; Chap 44;
Title 26, United States Code; Chap 53; or any provisions of State or local law.
10. Name and Title of Authorized Official (Print or type) 11. Date
Signature of Transferor (Or authorized official)
The Space Below is for the use of the Bureau of Alcohol, Tobacco, Firearms and Explosives
Stamp Denomination
By Authority of The Director, This Application Has Been Examined, and the Transfer and Registration of the Firearm
Described Herein and the Interstate Movement of that Firearm, When Applicable, to the Transferee are:
Approved (With the following conditions, if any)
Disapproved (For the following reasons)
Signature of Authorized ATF Official
Previous Editions Are Obsolete
ATF Form 4 (5320.4)
Revised (


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