OMB No. 1140-0013 (03/31/2014)
U.S. Department of Justice
Application for Tax-Exempt Transfer of Firearm
Bureau of Alcohol, Tobacco, Firearms and Explosives
and Registration to Special Occupational Taxpayer
(National Firearms Act)
ATF Control Number
To be submitted in duplicate by transferor of firearm
1. Transferee's Name and Address (as they appear on the Federal Firearms License, including trade name,
if any)
To: National Firearms Act Branch
Bureau of Alcohol, Tobacco, Firearms
and Explosives
244 Needy Road, Martinsburg, WV 25405
2b. Transferor's Telephone Number and Area Code
Sole Proprietor
Partnership
Corporation
2a. Transferor's Name and Address (as they appear on the Federal Firearms License, including trade
name, if any)
Sole Proprietor
Partnership
Corporation
The above-named and undersigned transferor and special (occupational) taxpayer hereby makes application as required by Section 5812 of the National Firearrms Act to
transfer, without payment of tax, and register the firearm described below to special (occupational) taxpayer identified as the transferee in this application.
3. Description of Firearm (Complete items a through h, if applicable)
d. Model
a. Name and Address of Manufacturer and/or
b. Type of Firearm
c. Caliber,
Importer of Firearm
(See instruction 1c)
Gauge or
Length
e. Of Barrel
f. Overall
Size
(Inches)
(Specify)
g. Serial Number
h. Additional Description or Data Appearing on Firearm (Attach additional sheet if necessary)
4. Transferee's Federal Firearms License
5. Transferee's Special (Occupational) Tax Status
(Give complete 15-digit number) (See Instruction 2b)
a. Employer Identification Number
b. Class
First 6 digits
2-digits
2-digits
5-digits
6. Transferor's Federal Firearms License
7. Transferor's Special (Occupational) Tax Status
(Give complete 15-digit number) (See Instruction 2b)
a. Employer Identification Number
b. Class
First 6 digits
2-digits
2-digits
5-digits
8. Consent to Disclosure of Information to Transferee (See instruction 8).
I do or do not (circle one) authorize ATF to provide information relating to
this application to the above-named transferee.
I believe I am entitled to exemption from payment of the transfer tax imposed by Section 5811, National Firearms Act (NFA), on the firearm described above because
the transferee named herein is qualified under the NFA to manufacture, import or deal in that type of firearm.
UNDER PENALTIES OF PERJURY, I DECLARE that I have examined this application, and to the best of my knowledge and belief it is true, correct and complete.
10. Name and Title of Authorized Official
9. Original Signature or Transferor (Or authorized official)
11. Date
(Print or type)
The Space Below is for the Use of the Bureau of Alcohol, Tobacco, Firearms and Explosives
By Authority of the Director, this Application has been Examined, and the Transfer and Registration of the Firearm Described Herein and the Interstate Movement of
that Firearm, When Applicable, to the Transferee Are:
Approved (with the following conditions, if any)
Disapproved (For the following reasons)
Authorized ATF Official
Date
ATF E-Form 3 (5320.3)
Revised October 2004