Form Cv-800 - Respondent'S Statement Of Possession Of Firearms
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1STATE OF WISCONSIN, CIRCUIT COURT,
COUNTY
Amended
Respondent’s Name
Respondent’s Statement of
Street Address, City, State, Zip Code
Possession of Firearms
Case No.
Phone Number
ANSWER THE FOLLOWING QUESTIONS AND BRING THIS COMPLETED FORM TO THE INJUNCTION HEARING:
1. Do you now or have you in the past six months owned or possessed any firearm(s)?
"Firearm" means a weapon that acts by force of gunpowder to fire a projectile, regardless of whether it is
inoperable due to disassembly. (§167.31(1)(c), Wis. Stats.)
NO.
[If you answered no, please continue to signature line.]
YES.
[If you answered yes, please continue to Question 2.]
2. For each firearm you currently own or possess, or within the past six months have owned or possessed, provide the
following information:
Surrendered or Sold
Receipt
Type of
Serial
Current Location
Make/Model
(No or Yes. If Yes, to whom)
(No or Yes)
Firearm
of Firearm(s)
Number
No
Yes
To Whom
No
Yes
[If you need room for additional firearms, attach additional sheet to this form]
The Respondent is advised that failure to completely and accurately complete this statement may result in felony
false swearing, punishable by a fine not to exceed $10,000, or imprisonment not to exceed 6 years, or both.
I have read this document and the facts stated in it are true.
Respondent’s Signature
DISTRIBUTION:
1. Court
2. Petitioner
Name Printed or Typed
3. Respondent
4. Law Enforcement
Date
5. Other:
CV-800, 09/14 Respondent’s Statement of Possession of Firearms
§813.1285(5)(a), Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
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