Firearm Bill Of Sale Form Page 2

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4. BUYER’S DISCLOSURE
BUYER DECLARES THE FOLLOWING STATEMENTS ARE TRUE AND HE/SHE:
• Is not under the legal age to own a firearm;
• Has never been convicted in any court of a crime punishable by imprisonment for
a term exceeding 1 year;
• Is not a fugitive from justice;
• Is not an unlawful user of or addicted to any controlled substance;
• Has never been adjudicated as a mental defective or has been committed to a
mental institution;
• Is not an alien illegally or unlawfully in the United states or an alien admitted to
the United states under a nonimmigrant visa;
• Has not been discharged from the Armed Forces under dishonorable conditions;
• Having been a citizen of the United states, has never renounced his or her
citizenship;
• Is not subject to a court order that restrains the person from harassing, stalking,
or threatening an intimate partner or child of such intimate partner;
• Has not been convicted of a misdemeanor crime of domestic violence
• Can lawfully receive, possess, ship, or transport a firearm;
• Is not a person who is under indictment or information for a crime punishable by
imprisonment for a term exceeding 1-year;
BUYER’S SIGNATURE: _______________________________________
5. SELLER’S DISCLOSURE
SELLER DECLARES THE FOLLOWING STATEMENTS ARE TRUE AND HE/SHE:
• Has verified that the firearm details are correct and the serial number is legible;
• Is the lawful owner of the firearm and has the legal right to sell the firearm;
• Has no knowledge of defects in the firearm;
• Believes the firearm is fit to be used for its intended purpose;
• Has never been used in a manner of questionable or certain illegality;
• Assumes no responsibility after the transfer of ownership has taken place;
SELLER’S SIGNATURE: _______________________________________
6. SIGNATURE AREA
As of this ____ day of _________________, 20___ the buyer and seller agree to the
above described terms and conditions for the sale/trade/exchange of the firearm.

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