Agency Firearm Release Request Form - Memphis Police Department
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MEMPHIS POLICE DEPARTMENT
170 N. Main Street, Memphis, TN 38103
Office: (901) 636-3716 E-Mail: MPD.LegalOffice@MemphisTN.gov
AGENCY FIREARM RELEASE REQUEST FORM
DISCLAIMER: This form is to be used only by the law enforcement agency responsible for retrieving property which is in
the custody or control of the Memphis Police Department’s Property and Evidence Unit. This form exists only as an
official claim of said property and may not be used to transfer a firearm or to prove ownership of a firearm. Submission
of this form does not guarantee eligibility to retrieve property being held with the Memphis Police Department.
A. Agency and Contact Information
Agency Name:
Contact (First Name, Last Name and Abbreviated Title):
Address:
City:
State:
Zip Code:
Work Phone Number (Include Area Code):
Work Cell Phone Number (Include Area Code):
E-mail Address:
B. Case and Firearm(s) Information
Applicants may request multiple firearms per one application if each firearm is tagged under the same Incident Report Number. To request
additional firearms tagged under different Incident Report Numbers, please print and submit a separate application.
Incident Report Number (10 digits, ending in ‘ME’):
Property Receipt Number:
Stolen Report Number:
Make:
Model:
Serial Number:
NCIC Number:
Make:
Model:
Serial Number:
NCIC Number:
Make:
Model:
Serial Number:
NCIC Number:
OFFICE USE ONLY
Case Reflects Pending Court Disposition
To be shipped to agency upon completion
NOT to be shipped to agency upon completion
Date Received:
Date Processed:
Processed by (Last Name and IBM#):
Stamp Approved or Denied Here
Officer Assigned (Last Name and IBM#):
Precinct:
Date Submitted:
Date Returned:
Location ID:
Submit completed application and a copy of a valid Employee ID Badge by mail:
Memphis Police Department
170 N. Main Street
Memphis, TN 38103
Attn: Legal/AFRR Application
Or by e-mail:
MPD.LegalOffice@MemphisTN.gov
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