Department Of Emergency Services And Public Protection Sale Or Transfer Of All Firearms
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1STATE OF CONNECTICUT
DEPARTMENT OF EMERGENCY SERVICES AND PUBLIC PROTECTION
DIVISION OF STATE POLICE
Sale or Transfer of All Firearms
Date of Sale
Sale Authorization No.
Manufacturer
Exact Model
Serial Number
Caliber/Gauge
General Description
Barrel Length
Handgun
Date of Birth
Place of Birth
Long Gun
Other
*
Purchaser or Transferee’s Pistol Permit, Eligibility
Purchaser or Transferee
(Print First, Middle, Last Name)
Certificate, Police ID or FFL #
Purchaser or Transferee’s Address
(No., Street, City/Town, ZIP Code)
Seller or Transferor’s
Seller or Transferor’s Pistol Permit, Eligibility Certificate,
(Print First, Middle, Last Name)
Police ID or FFL #
Seller or Transferor’s Address
Date of Birth
(No., Street, City/Town, ZIP Code)
Signature of Seller or Transferor
Signature of Purchaser or Transferee
Seller, obtain authorization number by calling (860) 685-8400. Retain the original copy for your records, give one copy to the purchaser as a
receipt, submit one copy to the local police authority where the purchaser resides, and submit a final copy to the Department of Emergency
Services and Public Protection, Special Licensing and Firearms Unit, 1111 Country Club Road, Middletown, Connecticut 06457-2389. See
Appendix A, DESPP-788-C, to declare large capacity magazines.
* “Other” refers to frames, receivers, NFA weapons, etc. See instructions for Question 18 on ATF form 4473
DPS-3-C (Rev. 06/30/13)
STATE OF CONNECTICUT
DEPARTMENT OF EMERGENCY SERVICES AND PUBLIC PROTECTION
DIVISION OF STATE POLICE
Sale or Transfer of All Firearms
Date of Sale
Sale Authorization No.
Manufacturer
Exact Model
Serial Number
Caliber/Gauge
General Description
Barrel Length
Handgun
Date of Birth
Place of Birth
Long Gun
Other
*
Purchaser or Transferee’s Pistol Permit, Eligibility
Purchaser or Transferee
(Print First, Middle, Last Name)
Certificate, Police ID or FFL #
Purchaser or Transferee’s Address
(No., Street, City/Town, ZIP Code)
Seller or Transferor’s
Seller or Transferor’s Pistol Permit, Eligibility Certificate,
(Print First, Middle, Last Name)
Police ID or FFL #
Seller or Transferor’s Address
Date of Birth
(No., Street, City/Town, ZIP Code)
Signature of Seller or Transferor
Signature of Purchaser or Transferee
Seller, obtain authorization number by calling (860) 685-8400. Retain the original copy for your records, give one copy to the purchaser as a
receipt, submit one copy to the local police authority where the purchaser resides, and submit a final copy to the Department of Emergency
Services and Public Protection, Special Licensing and Firearms Unit, 1111 Country Club Road, Middletown, Connecticut 06457-2389. See
Appendix A, DESPP-788-C, to declare large capacity magazines.
PRINT
* “Other” refers to frames, receivers, NFA weapons, etc. See instructions for Question 18 on ATF form 4473
DPS-3-C (Rev. 06/30/13)
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