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U.S. Department of Justice

OMB No. 1140-0008 (02/28/2015)

Bureau of Alcohol, Tobacco, Firearms and Explosives

Application and Permit for Permanent

Exportation of Firearms

(Chapter 53, Title 26, United States Code) (Submit in Quadruplicate. See Instructions on Reverse.)

To: Director, Bureau of Alcohol, Tobacco, Firearms and Explosives, 244 Needy Road, Martinsburg, WV 25405

Part 1 - Application. The undersigned transferor hereby makes application to export the firearm(s) described herein. The application is

supported by the attached certified copy of written order or contract of sale of such firearm(s) to consignee.

1. Name and Address of Foreign Consignee

2. Intended Port of Exportation

3. Number of Firearms Included in

(including air freight)

this Application

4. Description of Firearm(s) (If additional space is needed, continue on a separate sheet using the format below.)

Type (Machine gun, destructive device, short

Caliber,

Length of

Overall

Line

barreled shotgun or rifle, etc.)

Gauge or Size

Model

Barrel(s)

Length

Serial Number

No.

(a)

(b)

(c)

(d)

(e)

(f)

5. Name of Exporter (And trade name if any)

6. Address (number, street, city, county, State, zip code)

7. Federal Firearms License (If any) (Give

8. Employer Identification Number (If any)

9. State Department License Number for this

Complete 15-digit number)

Specific Shipment

Under penalties of perjury, I certify that I am the lawful possessor of the firearm(s) described on this form and any accompanying sheets, and that

I have examined this application and, to the best of my knowledge and belief, it is true, correct and complete.

10. Signature and Title (Owner or authorized official) (See instruction 1c.)

11. Date of Application

Part 2 - Permit (This portion to be completed by Bureau of Alcohol, Tobacco, Firearms and Explosives)

12. This Application is:

13. Assessment of Tax Incurred by this Transfer

Will Be Made Unless Proper Evidence of

Approved

Disapproved: (Reason)

Exportation is Received on or Before:

14. Examiner

15. Date

16. Authorized ATF Official

17. Date

Part 3 - Certification by Customs

I hereby certify that the described merchandise, covered by a shipper's export declaration on file in this office, was laden and cleared as described

below:

Laden In (Name and/or type of carrier)

Date Cleared

Foreign Destination

Signature of Customs Official

Port Of

Date

Part 4 - Certification of Mailing by Parcel Post/Exportation

I certify that there has (have) been posted to this office today, parcel(s) addressed as indicated in Item 1, Part 1 of this application, declared to be

firearms by the transferor named in Item 5, Part 1, or the transferor's authorized agent, who has waived the right to withdraw same from the

mails.

Post Office Name or Stamp

Signature of Postmaster, By

Date Posted

ATF E-Form 9 (5320.9)

Revised October 2009

Atf E-Form 9 - Application And Permit For Permanent Exportation Of Firearms - U.s. Department Of Justice - 2009

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