Form Bof 4544a - Report Of Operation Of Law Or Intra-Familial Handgun Transaction

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STATE OF CALIFORNIA

DEPARTMENT OF JUSTICE

BOF 4544A (Rev. 01/2012)

PAGE 1 of 2

CALIFORNIA DEPARTMENT OF JUSTICE

BUREAU OF FIREARMS

Report of Operation of Law or

Intra-Familial Handgun Transaction

A processing fee of $19.00 must accompany this application.

(Instructions on Reverse)

A. Owner Information

Last Name:

First Name:

Middle Name:

Alias Last Name (if any):

Alias First Name:

Alias Middle Name:

Residence Street Address:

City:

State:

Zip Code:

Mailing Address (if different):

City:

State:

Zip Code:

Date of Birth (mm/dd/yyyy):

Place of Birth (state or country):

Sex: Phone No. (include area code):

Yes

If no, enter Alien Registration No. or I-94 No.:

Country of Citizenship:

U.S.

Citizen?

ID Type (check one):

Enter your California driver license (CDL), California ID (CID), or

ID Number:

Handgun Safety

Military ID (MIL) number in the ID number box to the right. If using

Certificate (HSC) No.:

military identification you must send a copy of your permanent duty

CDL

CID

MIL

station orders stating you are stationed in California.

B. Handgun(s) Information

Handgun Type:

Serial Number:

Color:

Semiauto

Revolver

Single Shot

Other:

Make:

Caliber:

Handgun Origin:

Barrel Length:

Model:

IN.

CM.

Date Acquired (mm/dd/yyyy): How Possession was Obtained: Acquired From:

Family Member

(Specify Relationship):

Other:

Handgun Type:

Serial Number:

Color:

Semiauto

Revolver

Single Shot

Other:

Make:

Caliber:

Handgun Origin:

Barrel Length:

Model:

IN.

CM.

Date Acquired (mm/dd/yyyy): How Possession was Obtained: Acquired From:

Family Member

(Specify Relationship):

Other:

Handgun Type:

Serial Number:

Color:

Semiauto

Revolver

Single Shot

Other:

Make:

Model:

Caliber:

Handgun Origin:

Barrel Length:

IN.

CM.

Date Acquired (mm/dd/yyyy): How Possession was Obtained: Acquired From:

Family Member

(Specify Relationship):

Other:

C. Declaration

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. I expressly authorize the Department of

Justice to perform firearms eligibility checks of all relevant state and federal databases, including the Federal Bureau of Investigation's National Instant

Criminal Background Check System. I also understand that if I currently possess or own firearms and the results of this check reveal that I am ineligible

either to lawfully possess or purchase firearms, I must relinquish any and all firearms in my possession.

Signature

Date