Atf E-Form 1 - Application To Make And Register A Firearm

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OMB No. 1140-0011 (06/30/2019)
U.S. Department of Justice
Application to Make and Register a Firearm
Bureau of Alcohol, Tobacco, Firearms and Explosives
ATF Control Number
To: National Firearms Act Branch, Bureau of Alcohol, Tobacco, Firearms and Explosives, P.O. Box 530298, Atlanta, GA 30353-0298
(Submit in duplicate. See instructions attached.)
As required by Sections 5821(b), 5822, and 5841 of the National Firearms Act, Title 26 U.S.C., Chapter 53, the
1.
Type of Application (Check one)
undersigned hereby submits application to make and register the firearm described below.
Tax Paid. Submit your tax payment of $200
2.
Application is made by:
3a.
Trade name (If any)
a.
with the application.. The tax may be paid by
TRUST or LEGAL
GOVERNMENT
credit or debit card, check, or money order.
INDIVIDUAL
ENTITY
ENTITY
Please complete item 17. Upon approval of
3b.
Applicant's name and mailing address (Type or print below and between the dots) (See instruction 2d)
the application, we will affix and cancel the
required National Firearms Act Stamp.
(See instruction 2c and 3)
Tax Exempt because firearm is being made on
b.
behalf of the United States, or any department,
independent establishment, or agency thereof.
Tax Exempt because firearm is being made by
c.
3c.
If P.O. Box is shown above, street address must be given here
or on behalf of any State or possession of the
United States, or any political subdivision
thereof, or any official police organization of
3d. County
3e.
Telephone area code and number
3f. e-mail address (optional)
such a government entity engaged in criminal
investigations.
4
Description of Firearm (complete items a through k) (See instruction 2j)
a.
b.
Type of Firearm to be made
c.
Caliber or
d.
Model
Name and Address of Original Manufacturer and/or
(See definition 1c)
Gauge
Importer of Firearm (if any)
If a destructive device, complete
(Specify
Length
e. Of Barrel:
f. Overall
item 4j
one)
(Inches)
g.
Serial Number
h.
Additional Description (Include all numbers and other identifying data to
i.
State Why You Intend To Make Firearm (Use additional sheet if
necessary)
include maker's name, city and state which will appear on the firearm)
(use additional sheet if necessary)
j.
Type of destructive device (check one box):
Firearm
Explosives (if the Explosives box is checked, complete item 5 and see instruction 2l)
If an explosive type destructive device, identify the type of explosive(s):
k. Is this firearm being reactivated?
Yes
No (See definition 1k)
5.
Applicant's Federal Firearms License (If any) or Explosives License or Permit Number
6.
Special (Occupational) Tax Status (If applicable) (See definitions)
a.
Employer Identification Number
b.
Class
(Give complete 15-digit Number)
Under Penalties of Perjury, I Declare that I have examined this application, including accompanying documents, and to the best of my knowledge and belief it is true, accurate
and complete and the making and possession of the firearm described above would not constitute a violation of Title 18, U.S.C., Chapter 44, Title 26, U.S.C., Chapter 53; or any
provisions of State or local law.
7.
Signature of Applicant
8.
Name and Title of Authorized Official
9.
Date
The space below is for the use of the Bureau of Alcohol, Tobacco, Firearms, and Explosives
By authority of the Director, Bureau of Alcohol, Tobacco, Firearms and Explosives, this application has been examined and the applicant's making and registration of the firearms
described above is:
Approved (With the following conditions, if any)
Disapproved (For the following reasons)
Authorized ATF Official
Date
Previous Editions are Obsolete
ATF E-Form 1 (5320.1)
ATF Copy
Revised May 2016

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