Atf E-Form 5300.11 - Annual Firearms Manufacturing And Exportation Report

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OMB No. 1140-0017 (10/31/2009)
U.S. Department of Justice
Bureau of Alcohol, Tobacco, Firearms and Explosives
Annual Firearms Manufacturing and Exportation
Report Under 18 U.S.C. Chapter 44, Firearms
(See Instructions on Page 2)
1. Name of Licensee
2. Trade Name (If any)
3. Federal Firearms License Number
4. Employer Identification Number (EIN)
5a. Address (Number, Street)
5b. City
5c. State
5d. ZIP Code
6. Mail Address (If different than item 5)
7. Reporting Period of this Report
a. Annual for Calendar Year Ending December 31, 2
or, If Business has been Discontinued
b. Final Report for the Period January 1, 2
through
(Date of discontinuance)
8. Number of Firearms Produced, by Types, for the Period Covered by this Report
(see instructions on reverse) (If no manufacture was accomplished, enter "0")
Type of Firearm
Number of Firearms Produced by Calibers
Total
Produced
(Pistols and Revolvers Only)
Production
TO 9MM
TO .22
TO .25
TO .32.
TO .380
TO .50
PARA.
0
a. Pistol
TO .38
TO .357
TO .44
TO .22
TO .32
TO .50
SPEC.
MAG.
MAG
0
b. Revolvers
c. Rifles
d. Shotguns and
Combination Guns
e. Machine Guns
f. Any Other Weapon
(NFA)
g. Miscellaneous
Firearms (Identify Type)
9. Number of Firearms, by Types, for the Period Covered by this Report which were Exported
(If no exportation was accomplished, enter "0")
Types of Firearms Exported
Quantity
Types of Firearms Exported
Quantity
a. Pistol
e. Machine Guns
b. Revolvers
f. Any Other Weapon (NFA)
g. Miscellaneous Firearms
c. Rifles
(Identify Type)
d. Shotguns and Combination Guns
h. [Reserved]
Under penalties of perjury, I declare that I have examined this report and, to the best of my knowledge and belief, it is true, correct and complete.
10. Name
11. Title
12. Signature
13. Telephone Number
14. Date
ATF E-Form 5300.11
Revised November 2003

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