Form Atf F 1 (5320.1) - Application To Make And Register A Firearm (Page 2 of 2) in pdf

Form Atf F 1 (5320.1) - Application To Make And Register A Firearm Page 2

EXAMINER

DATE

AUTHORIZED ATF OFFICIAL

DATE

ADDITIONAL REQUIREMENTS

PHOTOGRAPH

The Chief of Police, Sheriff, or other official acceptable to the Director must complete the “Law

Enforcement Certification” below. If the applicant is an individual (including a licensed collector)

AFFIX

a recent photograph must be attached in the space provided and FBI Form FD-258, Fingerprint

RECENT PHOTOGRAPH HERE

Card, completed in duplicate, must be submitted.

(Approximately 2” x 2”)

LAW ENFORCEMENT CERTIFICATION (See IMPORTANT note below)

I certify that I am the chief law enforcement officer of the organization named below having jurisdiction in the area of residence of

(Name of Maker)

I have no information indicating that the maker will use the firearm or device described on this application for other than lawful purposes. I have no information

that POSSESSION OF THE FIREARM DESCRIBED IN ITEM 4 ON THE FRONT OF THIS FORM WOULD PLACE THE MAKER IN VIOLATION OF STATE

OR LOCAL LAW.

(Signature and Title of Chief Law Enforcement Officer - see IMPORTANT note below)

BY (See IMPORTANT NOTE BELOW)

(Signature and Title of Delegated Person)

(Organization)

(Street Address)

(City, State, and ZIP Code)

(Date)

IMPORTANT: The chief law enforcement officer is considered to be the Chief of Police for the maker’s city or town of residence, the Sheriff for the maker’s

county of residence; the Head of the State Police for the maker’s State of residence; a State or local district attorney or prosecutor having jurisdiction in the

maker’s area of residence; or another person whose certifcation is acceptable to the Director, Bureau of Alcohol, Tobacco and Firearms. If someone has

specific delegated authority to sign on behalf of the Chief of Police, Sheriff, etc., this fact must be noted by printing the Chief’s, Sheriff’s, or other authorized

official’s name and title, followed by the word “by” and the full signature and title of the delegated person.

ATF F 1 (5320.1) (1-97)