Ammunition Order Form
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13423 W. 43rd Place
Los Angeles, Ca 90008
Phone: (323) 294-5555 Fax: (323) 443-3997
eMail:
Date
Ammunition Order Form
Name
Dep't / Agency
Street Address
Street Address Line 2
City
State
Zip Code
Phone Number
Email Address
Please Attach a copy of your driver's license along with this form, in order to process your order in a
timely fashion.
I hereby declare under the penalty of perjury that I am over 21 years of age and there is no state,
local or federal laws prohibiting me from purchasing and or receiving ammunition.
Federal Law prohibits the purchase of ammunition by minors, drug addicts, convicted felons, illegal
aliens, mentally ill, or those convicted of a misdemeanor crime of domestic violence.
Signature
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Parent category: Business