Report of Operation of Law or Intra-Familial Handgun Transaction
Report of Operation of Law or Intra-Familial Handgun Transaction
Report of Operation of Law or Intra-Familial Handgun Transaction
A. Owner Information
LAST NAME ALIAS LAST NAME (If Any) RESIDENCE STREET ADDRESS MAILING ADDRESS (If Different) DATE OF BIRTH
Mo Day Yr
CITY SEX
STATE
ZIP
PLACE OF BIRTH (State or Country) If no, enter AR# or I-94# AND Country of Citizenship
DAYTIME PHONE #
U.S. CITIZEN?
YES NO
ID TYPE (Circle One) Enter your California Driver's License (CDL), California ID (CID), or Military ID (MIL) number in the ID Number box to the right. If using your military identification you must CDL CID MIL send a copy of your permanent duty station orders stating you are stationed in California.
ID NUMBER
B. Handgun(s) Information
Type of Handgun: SERIAL NUMBER Semiauto Revolver Single Shot Other: CALIBER HANDGUN ORIGIN
(U.S., Italy, China, etc.)
DATE ACQUIRED
Mo Day Yr
ACQUIRED FROM:
DATE ACQUIRED
Mo Day Yr
ACQUIRED FROM:
DATE ACQUIRED
Mo Day Yr
ACQUIRED FROM:
C. Declaration
I declare under penalty of perjury (Sections 126 and 672 PC) that all statements made by me on this application are true and complete. I expressly authorize DOJ to perform firearms eligibility checks of all relevant state and federal databases, including the National Instant Criminal Background Check System. I also understand that if I currently possess/own firearms and the results of this check reveal that I am ineligible either to lawfully possess or purchase firearms, I must relinquish any and all firearms in my possession.
INSTRUCTIONS ON REVERSE
DATE
Part C. Declaration
You must sign and date the application.