Atf E-Form 5300.38 - Application For An Amended Federal Firearms License - U.s Department Of Justice Page 2

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21. Indicate Type of Business Premises at the New Location:

Commercial

Residential

Storefront

Single/Family Dwelling

Office

Condominium

Rod & Gun Club

Apartment

Hotel/Motel

Military Base

Public Housing

Other (Specify)

If the New Premises Are Located on a Military Installation, Attach a Written Authorization From the Base Commander to Conduct the Firearms Business

on the Military Installation.

22. If the New Premises Are Owned By the Applicant, Are There Any Restrictions or Covenants Which Prohibit the Owner From Operating a Business on

the Premises? If Yes, on a Separate Sheet, Describe Such Restrictions or Covenants.

Yes

23. Do Any Zoning Ordinances Prohibit the Conduct of a Firearms Business

24. Is a License, Permit, or Payment of Occupational or Business Tax

on the New Premises?

Required Under State or Local Law to Engage in a Firearms Business

From the Premises? If So, Provide Copies.

Yes

25. Sign Here

Title

Date

Section II - Certification of Compliance With State and Local Law

As Required By 18 U.S.C. 923(d)(1), I Certify That:

1. The business to be conducted under the Federal firearms license is not prohibited by State or local law at the premises indicated in question 5.

2. Within 30 days after the application is approved the business to be conducted at the location indicated in question 5 will comply with the requirements of

State and local law applicable to the conduct of business.

3. Business will not be conducted under the amended license until the requirements of State and local law applicable to the business have been met.

4. Notification of this application has been provided to the chief law enforcement officer of the locality in which the premises indicated in question 5 are

located by mailing copy 2 of this form to such officer.

26. Certification: Under the Penalties Imposed By 18 U.S.C. 924, I Declare That I Have Examined This Application and the Documents

Submitted in Support Hereof, and to the Best of My Knowledge and Belief, They are True, Correct and Complete.

Sign Here

Date

ATF E-Form 5300.38

Revised October 2004