Form Msp 29-57 - Renewal Of Regulated Firearms Dealer'S License Application
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1
2MARYLAND STATE POLICE
Toll Free 1 (800) 525-5555
Firearms Registration Section
1111 Reisterstown Road
Pikesville, Maryland 21208
(410) 653-4500
2014/2015
Renewal of Regulated Firearms Dealer’s License Application – FISCAL YEAR (FY) ___________
Instructions
Type or legibly print all required information contained on the front and rear of this form. Ensure that this application is notarized. Attach
copies of your current Federal Firearms License, current Trader’s License if an inventory is maintained, and Maryland Sales and Use
Tax License. Also, submit a clear and recognizable photograph, except if a photograph was submitted with an application within the
preceding 5 years. Submit this form, copies of the required licenses, photograph (if applicable), and the annual renewal fee of $25 in the
form of a check or money order (No Cash) to the Firearms Registration Section at the above address.
Maryland Law
Public Safety Article, Title 5, Section 5-111, Annotated Code of Maryland, states that regulated firearms dealers’ licenses shall expire on
th
the 30
day of June each year. It is unlawful for a person to engage in the business of selling, renting, or transferring regulated firearms
unless he/she lawfully possesses a current regulated firearms dealer’s license.
Licensee Information
(If the applicant is a corporation, the application shall be completed and executed by a corporate officer who is a resident of the State of Maryland.)
Maryland Regulated Firearms Dealer’s License #:___________________
Driver ID#: ___________________________________________
Social Security #:
-
-
.
Name Last: ____________________________
First:
___________________________
Middle:
_____________________
Suffix:
_____
Street Address: ___________________________________________________________________
Check if Baltimore City resident
Town/City: _________________________
County:
_________________________
State:
______________________
Zip:
___________
DOB:
______
___
___
___
___
Place of Birth: City
_
_____________________
Country
___
______
Height:
_______
Weight:
________
Month
Day
Year
Race: ______ Sex: ______
Eyes:
______
Hair:
______
Occupation:
_________________________
Phone: Home (________
)
___
_____ ____________
-
Work (
________ ________ ____________
)
-
Licensee’s Status (check one): Owner
Partner
Corporate Office
_
Business Information
Business Name:______________________________________________________________________________________________
Street Address:____________________________________________________________________
Check if Baltimore City address
Town / City:
__
____________________________
County:
_
_____________________________
State: MD Zip:
_________________
Phone: Business (_____ _____ _________
)
-
Fax (
_____ _____ _________
)
-
Email address:
____________________________
License Type (check one): Individual License
Corporation License
Sales Activities (check one): Retail
Wholesale
Both
Type of Business: Dealer
Gunsmith
Both
List any other business engaged in by the applicant at the same location for which this regulated firearms dealer’s license is desired:
____________________________________________________________________________________________________________
List any changes in the ownership or management of the business from that shown on the last license application: ________________
____________________________________________________________________________________________________________
Below For Maryland State Police Use Only
Date form forwarded: __________________________________
Date form received:
_____________________________________
Current disposition date: ___________________________________
Current Disposition:
______________________________________
Signature of approving official: ______________________________
Comments:
_________________________________________________
MSP 29-57 (04/08)
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