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Form 10 With Instructions - Application For Registration Of Firearms Acquired By Certain Governmental Entities

OMB No. 1140-0016 (06/30/2008)

U.S. Department of Justice

Bureau of Alcohol, Tobacco, Firearms and Explosives

Application for Registration of Firearms

Acquired by Certain Governmental Entities

(Submit in duplicate) Please read instructions on reverse carefully before completing this form.

TO: National Firearms Act Branch, Bureau of Alcohol, Tobacco, Firearms and Explosives, 244 Needy Road, Martinsburg, WV 25401

The undersigned hereby makes application to register to the governmental entity identified in this application the

27 CFR 479.104 provides for limited

firearm describe below.

registration of otherwise unregisterable

1. Name of Department or Agency Making Application to Register Firearm

firearms by certain governmental

entities, for official use only. If this

application is approved, it is with the

1a. Street Address of Department or Agency

1b. City

condition that the firearm is for

"OFFICIAL USE ONLY"

2. Telephone Number (Include Area Code)

1c. State

1d. Zip Code

3. Description of Firearm (Complete items 7a through 7i)

3a. Name of Manufacturer and/or Importer of Firearm

3b. Address of Manufacturer and/or Importer of Firearm

3c. Type of Firearm (See Definitions) 3d. Caliber, Gauge or Size

3e. Model

3f. Barrel Length (Inches) 3g. Overall Length (Inches)

3h. Serial Number (See Instruction 1)

3i. Additional Description (Include all numbers on firearm, and location of each number. If firearm is unservicesable, describe how it was made

unserviceable.)

4. Location Where Firearms is Usually Kept

5. From Whom was Firearm Received? (Optional response - This information may assist ATF in removing records relating to previous registrations of

this firearm.)

I CERTIFY THAT the above described firearm is for OFFICIAL USE ONLY and that I have examined this application and, to the best of my knowledge

and belief, it is true, correct and complete.

6. Signature of Authorized Official (See Instruction 1)

7. Name and Title of Authorized Official

8. Date

Space below is for use by the Bureau of ATF - Please do not write below

By authority of the Director, Bureau of Alcohol, Tobacco, Firearms and Explosives this application has been examined and the registration of the described

firearm to the government entity described above is:

Remarks:

Approved for Official Use

Disapproved

Authorized ATF Official

Date

ATF E-Form 10 (5320.10)

Revised July 2005

Form 10 With Instructions - Application For Registration Of Firearms Acquired By Certain Governmental Entities

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