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Provide the full name \(printed or typed\) below for each Responsible Person associated with the applicant trust or legal entity \(if there are more Responsible Persons than can be listed on the form, attach a separate sheet listing the additional Responsible Person\(s\)\). Please note that a completed 5320.23, National Firearms Act \(NFA\) Responsible Person Questionnaire, must be submitted with the Form 5 application for each Responsible Person. Full Name)/Type/Annot>> endobj 1051 0 obj <>/P 33 0 R /Parent 1043 0 R /Rect[ 325.718 602.561 585.238 613.911]/StructParent 732/Subtype/Widget/T(TextField10n[0])/TU(22. Provide the full name \(printed or typed\) below for each Responsible Person associated with the applicant trust or legal entity \(if there are more Responsible Persons than can be listed on the form, attach a separate sheet listing the additional Responsible Person\(s\)\). Please note that a completed 5320.23, National Firearms Act \(NFA\) Responsible Person Questionnaire, must be submitted with the Form 5 application for each Responsible Person. Full Name)/Type/Annot>> endobj 1052 0 obj <>/P 33 0 R /Parent 1043 0 R /Rect[ 325.718 580.672 586.576 597.334]/StructParent 734/Subtype/Widget/T(TextField711n[0])/TU(22. Provide the full name \(printed or typed\) below for each Responsible Person associated with the applicant trust or legal entity \(if there are more Responsible Persons than can be listed on the form, attach a separate sheet listing the additional Responsible Person\(s\)\). Please note that a completed 5320.23, National Firearms Act \(NFA\) Responsible Person Questionnaire, must be submitted with the Form 5 application for each Responsible Person. Full Name)/Type/Annot>> endobj 1053 0 obj <>/P 33 0 R /Parent 1043 0 R /Rect[ 326.174 560.523 586.59 577.182]/StructParent 736/Subtype/Widget/T(TextField12n[0])/TU(22. Provide the full name \(printed or typed\) below for each Responsible Person associated with the applicant trust or legal entity \(if there are more Responsible Persons than can be listed on the form, attach a separate sheet listing the additional Responsible Person\(s\)\). Please note that a completed 5320.23, National Firearms Act \(NFA\) Responsible Person Questionnaire, must be submitted with the Form 5 application for each Responsible Person. Full Name)/Type/Annot>> endobj 1054 0 obj <>/P 33 0 R /Parent 1043 0 R /Rect[ 362.903 665.765 434.903 677.089]/StructParent 731/Subtype/Widget/T(TextField18[0])/TU(21. Number of Responsible Persons \(See definitions\) associated with the transferee trust or legal entity)/Type/Annot>> endobj 1055 0 obj <>/P 30 0 R /Parent 1042 0 R /Rect[ 26.555 694.579 292.181 712.63]/StructParent 676/Subtype/Widget/T(TextField4[0])/TU(12. Law Enforcement Notification \(See instruction 2.F\) - The transferee is to provide notification of the proposed acquisition and possession of the firearm described on this Form 5 by providing a copy of the completed form to the chief law enforcement officer in the agency identified below: - Agency or Department Name)/Type/Annot>> endobj 1056 0 obj <>/P 30 0 R /Parent 1042 0 R /Rect[ 318.212 693.672 583.064 714.424]/StructParent 675/Subtype/Widget/T(TextField5[0])/TU(12. Law Enforcement Notification \(See instruction 2.F\) - 12. Law Enforcement Notification \(See instruction 2f\) - The transferee is to provide notification of the proposed acquisition and possession of the firearm described on this Form 5 by providing a copy of the completed form to the chief law enforcement officer in the agency identified below: - Name and Title of Official)/Type/Annot>> endobj 1057 0 obj <>/P 30 0 R /Parent 1042 0 R /Rect[ 25.217 666.555 586.372 682.608]/StructParent 677/Subtype/Widget/T(TextField6[0])/TU(12. Law Enforcement Notification \(See instruction 2.F\) - 12. Law Enforcement Notification \(See instruction 2f\) - The transferee is to provide notification of the proposed acquisition and possession of the firearm described on this Form 5 by providing a copy of the completed form to the chief law enforcement officer in the agency identified below: - Address \(Street address or P.O. Box, City, State and Zip Code\) to which sent \(mailed or delivered\)\))/Type/Annot>> endobj 1058 0 obj <>/P 30 0 R /Parent 1042 0 R /Rect[ 53.49 590.978 290.73 600.355]/StructParent 679/Subtype/Widget/T(NameTitleTransferee[0])/TU(13. Transferee Necessity Statement \(Do not complete if the transferee is a government agency\) \(See instruction 2.E\) Name and title of Transferee)/Type/Annot>> endobj 1059 0 obj <>/P 30 0 R /Parent 1042 0 R /Rect[ 378.697 570.526 582.556 588.526]/StructParent 680/Subtype/Widget/T(Reasons[0])/TU(13. Transferee Necessity Statement \(Do not complete if the transferee is a government agency\) \(See instruction 2.E\) I, have a reasonable necessity to possess the machinegun, short-barreled rifle,short-barreled shotgun, or destructive device described on this application for the following reason\(s\))/Type/Annot>> endobj 1060 0 obj <>/P 30 0 R /Parent 1042 0 R /Rect[ 44.031 554.034 582.999 568.817]/StructParent 681/Subtype/Widget/T(reasons2[0])/TU(13. Transferee Necessity Statement \(Do not complete if the transferee is a government agency\) \(See instruction 2.E\) I, have a reasonable necessity to possess the machinegun, short-barreled rifle,short-barreled shotgun, or destructive device described on this application for the following reason\(s\))/Type/Annot>> endobj 1061 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 405.04 469.225 414.04 478.225]/StructParent 682/Subtype/Widget/T(CheckboxYes1[0])/TU(14. a. Do you intend to make any firearm listed on this form for sale or other disposition to any person described in questions 14.c. through 14.l. or a person described in question 14.m. who does not fall under an exception? Yes)/Type/Annot>> endobj 1062 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 428.845 468.684 437.845 477.684]/StructParent 696/Subtype/Widget/T(CheckBoxNo1[0])/TU(14. a. Do you intend to make any firearm listed on this form for sale or other disposition to any person described in questions 14.c. through 14.l. or a person described in question 14.m. who does not fall under an exception? No)/Type/Annot>> endobj 1063 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 404.649 444.43 413.649 453.43]/StructParent 683/Subtype/Widget/T(CheckBoxYes2[0])/TU(14. b. Do you intend to sell or otherwise dispose of any firearm listed on this form in furtherance of any felony or other offense punishable by imprisonment for a term of more than one year, a Federal crime of terrorism, or a drug trafficking offense? Yes)/Type/Annot>> endobj 1064 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 428.899 444.021 437.899 453.021]/StructParent 697/Subtype/Widget/T(CheckBoxNo2[0])/TU(14. b. Do you intend to sell or otherwise dispose of any firearm listed on this form in furtherance of any felony or other offense punishable by imprisonment for a term of more than one year, a Federal crime of terrorism, or a drug trafficking offense? No)/Type/Annot>> endobj 1065 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 406.046 366.53 415.046 375.53]/StructParent 684/Subtype/Widget/T(CheckBoxYes3[0])/TU(14. e. Are you a fugitive from justice? \(See definition 1.T\) Yes)/Type/Annot>> endobj 1066 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 429.151 366.524 438.151 375.524]/StructParent 698/Subtype/Widget/T(CheckboxNo3[0])/TU(14. e. Are you a fugitive from justice? \(See definition 1.T\) No)/Type/Annot>> endobj 1067 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 404.955 339 413.955 348]/StructParent 685/Subtype/Widget/T(CheckBoxYes4[0])/TU(14. f. Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance? Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside. Yes)/Type/Annot>> endobj 1068 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 429.151 338.719 438.151 347.719]/StructParent 699/Subtype/Widget/T(CheckBoxNo4[0])/TU(14. f. Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance? Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside. No)/Type/Annot>> endobj 1069 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 405.397 306.279 414.397 315.279]/StructParent 686/Subtype/Widget/T(CheckBoxYes5[0])/TU(14. g. On or after the age of 16, have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution? \(See definition 1.O and 1.P\) Yes)/Type/Annot>> endobj 1070 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 428.697 306.279 437.697 315.279]/StructParent 700/Subtype/Widget/T(CheckBoxNo5[0])/TU(14. g. On or after the age of 16, have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution? \(See definition 1.O and 1.P\) No)/Type/Annot>> endobj 1071 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 405.349 285.671 414.349 294.671]/StructParent 687/Subtype/Widget/T(CheckBoxYes6[0])/TU(14. h. Have you been discharged from the Armed Forces under dishonorable conditions? Yes)/Type/Annot>> endobj 1072 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 428.306 285.642 437.306 294.642]/StructParent 701/Subtype/Widget/T(CheckBoxNo6[0])/TU(14. h. Have you been discharged from the Armed Forces under dishonorable conditions? No)/Type/Annot>> endobj 1073 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 404.955 264.552 413.955 273.552]/StructParent 688/Subtype/Widget/T(CheckBoxYes7[0])/TU(14. i. Are you subject to a court order restraining you from harassing, stalking, or threatening your child or an intimate partner or child of such partner? \(See definition 1.Q\) Yes)/Type/Annot>> endobj 1074 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 428.567 264.572 437.567 273.572]/StructParent 702/Subtype/Widget/T(CheckBoxNo7[0])/TU(14. i. Are you subject to a court order restraining you from harassing, stalking, or threatening your child or an intimate partner or child of such partner? \(See definition 1.Q\) No)/Type/Annot>> endobj 1075 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 405.394 244.881 414.394 253.881]/StructParent 689/Subtype/Widget/T(CheckBoxYes8[0])/TU(14. j. Have you ever been convicted in any court of a misdemeanor crime of domestic violence? \(See definition 1.R\) Yes)/Type/Annot>> endobj 1076 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 428.697 244.82 437.697 253.82]/StructParent 703/Subtype/Widget/T(CheckBoxNo8[0])/TU(14. j. Have you ever been convicted in any court of a misdemeanor crime of domestic violence? \(See definition 1.R\) No)/Type/Annot>> endobj 1077 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 47.129 49.408 56.129 58.408]/StructParent 725/Subtype/Widget/T(CheckBox5usa[0])/TU(20a. Country of Citizenship \(Check/List more than one, if applicable. Nationals of the United States may check U.S.A.\) \(See definition 1.S\) - United States of America)/Type/Annot>> endobj 1078 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 176.419 47.537 185.419 56.537]/StructParent 726/Subtype/Widget/T(CheckBox5other[0])/TU(20a. Country of Citizenship \(Check/List more than one, if applicable. Nationals of the United States may check U.S.A.\) \(See definition 1.S\) - Other country/Countries \(specify\):)/Type/Annot>> endobj 1079 0 obj <>/P 30 0 R /Parent 1042 0 R /Rect[ 317.894 49.808 538.441 65.305]/StructParent 724/Subtype/Widget/T(TextField6other[0])/TU(20a. Country of Citizenship \(Check/List more than one, if applicable. Nationals of the United States may check U.S.A.\) \(See definition 1.S\) - Other country/Countries \(specify\):)/Type/Annot>> endobj 1080 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 407.316 226.458 416.316 235.458]/StructParent 690/Subtype/Widget/T(CheckBoxYes11[0])/TU(14. k. Have you ever renounced your United States citizenship? Yes)/Type/Annot>> endobj 1081 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 431.941 226.458 440.941 235.458]/StructParent 704/Subtype/Widget/T(CheckBoxNo11[0])/TU(14. k. Have you ever renounced your United States citizenship? No)/Type/Annot>> endobj 1082 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 406.667 209.564 415.667 218.564]/StructParent 691/Subtype/Widget/T(CheckBoxYes12[0])/TU(14. l. Are you an alien illegally or unlawfully in the United States? Yes)/Type/Annot>> endobj 1083 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 431.303 208.874 440.303 217.874]/StructParent 705/Subtype/Widget/T(CheckBoxNo12[0])/TU(14. l. Are you an alien illegally or unlawfully in the United States? No)/Type/Annot>> endobj 1084 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 407.537 192.067 416.537 201.067]/StructParent 692/Subtype/Widget/T(CheckBoxYes13[0])/TU(14. m.1. Are you an alien who has been admitted to the United States under a nonimmigrant visa? Yes)/Type/Annot>> endobj 1085 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 431.314 191.839 440.314 200.839]/StructParent 706/Subtype/Widget/T(CheckBoxNo13[0])/TU(14. m.1. Are you an alien who has been admitted to the United States under a nonimmigrant visa? No)/Type/Annot>> endobj 1086 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 407.078 177.171 416.078 186.171]/StructParent 693/Subtype/Widget/T(CheckBoxYes14[0])/TU(14. m.2. If YES, do you fall within any of the exceptions stated in the instructions? Attach the documentation to the application. Yes)/Type/Annot>> endobj 1087 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 430.855 177.317 439.855 186.317]/StructParent 707/Subtype/Widget/T(CheckBoxNo14[0])/TU(14. m.2. If YES, do you fall within any of the exceptions stated in the instructions? Attach the documentation to the application. No)/Type/Annot>> endobj 1088 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 445.498 176.511 454.498 185.511]/StructParent 710/Subtype/Widget/T(checkbox18f2NA[0])/TU(14. m.2. If YES, do you fall within any of the exceptions stated in the instructions? Attach the documentation to the application. N/A)/Type/Annot>> endobj 1089 0 obj <>/P 30 0 R /Parent 1042 0 R /Rect[ 361.208 161.084 584.748 171.428]/StructParent 712/Subtype/Widget/T(TextField19[0])/TU(16. If you are an alien. record your U.S.-Issued alien or Admission number \(AR#, USCIS#, or I94#\):)/Type/Annot>> endobj 1090 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 348.891 142.227 356.891 150.227]/StructParent 715/Subtype/Widget/T(CheckBox20upinyes[0])/TU(17. Have you been issued a Unique Personal Identification Number \(UPIN\)? \(See instructions 2.H\) Yes)/Type/Annot>> endobj 1091 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 378.895 142.227 386.895 150.227]/StructParent 714/Subtype/Widget/T(CheckBox20upinno[0])/TU(17. Have you been issued a Unique Personal Identification Number \(UPIN\)? \(See instructions 2.H\) No)/Type/Annot>> endobj 1092 0 obj <>/P 30 0 R /Parent 1042 0 R /Rect[ 481.609 143.328 581.338 153.351]/StructParent 713/Subtype/Widget/T(TextField20ifyes[0])/TU(17. Have you been issued a Unique Personal Identification Number \(UPIN\)? \(See instructions 2.H\) If yes please provide)/Type/Annot>> endobj 1093 0 obj <>/P 30 0 R /Parent 1042 0 R /Rect[ 314.099 106.71 584.402 124.787]/StructParent 716/Subtype/Widget/T(dob16[0])/TU(18. Date of Birth)/Type/Annot>> endobj 1094 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 95.737 94.317 104.737 103.317]/StructParent 717/Subtype/Widget/T(ehl[0])/TU(19a. Ethnicity. Hispanic or Latino )/Type/Annot>> endobj 1095 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 95.741 77.965 104.741 86.965]/StructParent 718/Subtype/Widget/T(nhl[0])/TU(19a. Ethnicity. Not Hispanic or Latino)/Type/Annot>> endobj 1096 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 249.621 93.621 258.621 102.621]/StructParent 719/Subtype/Widget/T(aian[0])/TU(19b. Race. American Indian or Alaska Native)/Type/Annot>> endobj 1097 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 248.616 77.72 257.616 86.72]/StructParent 720/Subtype/Widget/T(a[0])/TU(19b. Race. Asian)/Type/Annot>> endobj 1098 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 397.48 93.954 406.48 102.954]/StructParent 721/Subtype/Widget/T(baa[0])/TU(19b. Race. Black or African American)/Type/Annot>> endobj 1099 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 396.986 77.757 405.986 86.757]/StructParent 722/Subtype/Widget/T(nhopi[0])/TU(19b. Race. Native Hawaiian or Other Pacific Islander)/Type/Annot>> endobj 1100 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 522.793 92.9 531.793 101.9]/StructParent 723/Subtype/Widget/T(w[0])/TU(19b. Race. White)/Type/Annot>> endobj 1101 0 obj <>/TP 1>>/P 30 0 R /Parent 1042 0 R /Rect[ 443.531 281.758 587.803 426.027]/StructParent 711/Subtype/Widget/T(ImageField1[0])/TU(15. Photograph \(Click here to attach\))/Type/Annot>> endobj 1102 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 405.031 409.636 414.031 418.636]/StructParent 694/Subtype/Widget/T(CheckBox15yes[0])/TU(14. c. Are you under indictment or information in any court for a felony, or any other crime, for which the judge could imprison you for more than one year? \(See definition 1.N\) Yes)/Type/Annot>> endobj 1103 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 427.875 409.636 436.875 418.636]/StructParent 708/Subtype/Widget/T(CheckBox15no[0])/TU(14. c. Are you under indictment or information in any court for a felony, or any other crime, for which the judge could imprison you for more than one year? \(See definition 1.N\) No)/Type/Annot>> endobj 1104 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 405.516 385.842 414.516 394.842]/StructParent 695/Subtype/Widget/T(CheckBox16yes[0])/TU(14. d. Have you ever been convicted in any court for a felony, or any other crime, for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation? \(See definition 1.N\) Yes)/Type/Annot>> endobj 1105 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 30 0 R /Parent 1042 0 R /Rect[ 427.407 385.842 436.407 394.842]/StructParent 709/Subtype/Widget/T(CheckBox16no[0])/TU(14. d. Have you ever been convicted in any court for a felony, or any other crime, for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation? \(See definition 1.N\) No)/Type/Annot>> endobj 1106 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 103.878 704.999 309.88 716.332]/StructParent 629/Subtype/Widget/T(bet365 Control[0])/TU(bet365 Control Number)/Type/Annot>> endobj 1107 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 403.546 704.957 583.486 715.649]/StructParent 628/Subtype/Widget/T(InternalControl[0])/TU(Internal Control Number)/Type/Annot>> endobj 1108 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 27 0 R /Parent 1041 0 R /Rect[ 28.62 609.719 36.62 617.719]/StructParent 631/Subtype/Widget/T(CheckBox5firearm[0])/TU(1. Type of Transfer: tax exempt - I believe that I am entitled to exemption from the payment of the Transfer Tax Imposed by section 5811 \(26 U.S.C. Chapter 53\) on the Firearm described herein for the following reason \(See Instruction 2.B\): - Firearm is unserviceable and is being transferred as a curio or ornament)/Type/Annot>> endobj 1109 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 27 0 R /Parent 1041 0 R /Rect[ 29.063 589.332 37.063 597.332]/StructParent 633/Subtype/Widget/T(CheckBox6firearm[0])/TU(1. Type of Transfer: tax exempt - I believe that I am entitled to exemption from the payment of the Transfer Tax Imposed by section 5811 \(26 U.S.C. Chapter 53\) on the Firearm described herein for the following reason \(See Instruction 2.B\): - Firearm is being transferred to or from a Government Entity)/Type/Annot>> endobj 1110 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 27 0 R /Parent 1041 0 R /Rect[ 29.063 569.173 37.063 577.173]/StructParent 639/Subtype/Widget/T(CheckBox7firearm[0])/TU(1. Type of Transfer: tax exempt - I believe that I am entitled to exemption from the payment of the Transfer Tax Imposed by section 5811 \(26 U.S.C. Chapter 53\) on the Firearm described herein for the following reason \(See Instruction 2.B\): - Firearm is being transferred to a lawful heir or by operation of law)/Type/Annot>> endobj 1111 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 27 0 R /Parent 1041 0 R /Rect[ 28.621 548.336 36.621 556.336]/StructParent 640/Subtype/Widget/T(CheckBox8firearm[0])/TU(1. Type of Transfer: tax exempt - I believe that I am entitled to exemption from the payment of the Transfer Tax Imposed by section 5811 \(26 U.S.C. Chapter 53\) on the Firearm described herein for the following reason \(See Instruction 2.B\): - Other \(Specify\))/Type/Annot>> endobj 1112 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 98.518 551.489 177.117 561.064]/StructParent 641/Subtype/Widget/T(Other[0])/TU(1. Type of Transfer: tax exempt - I believe that I am entitled to exemption from the payment of the Transfer Tax Imposed by section 5811 \(26 U.S.C. Chapter 53\) on the Firearm described herein for the following reason \(See Instruction 2.B\): - Other \(Specify\))/Type/Annot>> endobj 1113 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 184.141 607.827 585.453 670.827]/StructParent 630/Subtype/Widget/T(TransfereeNameandAddress[0])/TU(2a. Transferee's Full Legal Name and Address \(Include trade name, if any\) \(See instruction 2.K\))/Type/Annot>> endobj 1114 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 475.081 577.924 581.434 590.567]/StructParent 638/Subtype/Widget/T(County[0])/TU(2b. County/Parish)/Type/Annot>> endobj 1115 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 27 0 R /Parent 1041 0 R /Rect[ 185.32 581.442 194.32 590.442]/StructParent 635/Subtype/Widget/T(CheckBox9ind[0])/TU(2a. Transferee's Full Legal Name and Address \(Include trade name, if any\) \(See instruction 2.K\) - Individual)/Type/Annot>> endobj 1116 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 27 0 R /Parent 1041 0 R /Rect[ 292.405 579.647 301.405 588.647]/StructParent 636/Subtype/Widget/T(CheckBox9trust[0])/TU(2a. Transferee's Full Legal Name and Address \(Include trade name, if any\) \(See instruction 2.K\) - Trust)/Type/Annot>> endobj 1117 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 27 0 R /Parent 1041 0 R /Rect[ 375.276 580.095 384.276 589.095]/StructParent 637/Subtype/Widget/T(CheckBox9gov[0])/TU(2a. Transferee's Full Legal Name and Address \(Include trade name, if any\) \(See instruction 2.K\) - Government Entity)/Type/Annot>> endobj 1118 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 184.141 543.872 583.429 565.16]/StructParent 642/Subtype/Widget/T(DecedentNameandAddress[0])/TU(3a. If Applicable: Decedent's Name, Address, and Date of Death)/Type/Annot>> endobj 1119 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 27.609 504.969 582.088 532.397]/StructParent 643/Subtype/Widget/T(TransferorNameandAddress[0])/TU(3b. Transferor's Name and Address \(Include trade name, if any\) \(Executors: see instruction 2.K\))/Type/Annot>> endobj 1120 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 28.293 461.233 176.247 478.882]/StructParent 645/Subtype/Widget/T(TransferorNumber[0])/TU(3c. Transferor's Telephone \(area code and number\))/Type/Annot>> endobj 1121 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 180.122 461.234 281.112 478.199]/StructParent 646/Subtype/Widget/T(emailadd1[0])/TU(3d. E-Mail address)/Type/Annot>> endobj 1122 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 286.472 462.146 583.103 483.559]/StructParent 644/Subtype/Widget/T(NumberStreetCityStateZipDifferent[0])/TU(3e. Number, Street, City, State and Zip Code of Residence \(Or firearms business premises\) If Different from Item 3a.)/Type/Annot>> endobj 1123 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 29.633 361.354 236.936 405.317]/StructParent 648/Subtype/Widget/T(NameandAddressofMakerManuImporter[0])/TU(4a. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Name and Address of Maker, Manufacturer and/or Importer of Firearm)/Type/Annot>> endobj 1124 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 241.651 361.936 360.037 390.58]/StructParent 651/Subtype/Widget/T(TypeofFirearm[0])/TU(4b. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Type of Firearm \(See definitions 1.C\))/Type/Annot>> endobj 1125 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 365.394 361.279 416.888 389.265]/StructParent 652/Subtype/Widget/T(CaliberorGauge[0])/TU(4c. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Caliber or Gauge)/Type/Annot>> endobj 1126 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 422.249 414.063 584.249 429.384]/StructParent 647/Subtype/Widget/T(Model[0])/TU(4d. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Model)/Type/Annot>> endobj 1127 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 460.369 386.634 523.369 404.634]/StructParent 649/Subtype/Widget/T(LengthofBarrel[0])/TU(4e. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Length \(Inches\) of Barrel:)/Type/Annot>> endobj 1128 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 526.575 385.98 580.575 403.98]/StructParent 650/Subtype/Widget/T(LengthOverall[0])/TU(4f. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Length \(Inches\) Overall:)/Type/Annot>> endobj 1129 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 105.024 326.919 305.578 349.894]/StructParent 653/Subtype/Widget/T(AdditionalDescription[0])/TU(4h. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Additional Description or Data Appearing on Firearm \(Attach additional sheet if necessary\))/Type/Annot>> endobj 1130 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 27 0 R /Parent 1041 0 R /Rect[ 524.883 339.279 533.883 348.279]/StructParent 654/Subtype/Widget/T(CheckBoxYes[0])/TU(4i. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Has the Firearm been rendered unserviceable as defined in Definition 1m? \(If "yes," describe the method by which the firearm has been rendered unserviceable. Use additional sheets.\) Yes)/Type/Annot>> endobj 1131 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 27 0 R /Parent 1041 0 R /Rect[ 557.629 339.279 566.629 348.279]/StructParent 655/Subtype/Widget/T(CheckBoxNo[0])/TU(4i. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Has the Firearm been rendered unserviceable as defined in Definition 1.M? \(If "yes," describe the method by which the firearm has been rendered unserviceable. Use additional sheets.\) Yes\r\(If "No," describe any other method by which firearm has been rendered unserviceable. Use additional sheets. - No)/Type/Annot>> endobj 1132 0 obj <>/MaxLen 6/P 27 0 R /Parent 1041 0 R /Rect[ 28.78 272.214 110.381 287.544]/StructParent 658/Subtype/Widget/T(FederalFirearmsLicense6dig[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\)- First 6 digits)/Type/Annot>> endobj 1133 0 obj <>/MaxLen 2/P 27 0 R /Parent 1041 0 R /Rect[ 115.852 272.214 171.913 287.544]/StructParent 659/Subtype/Widget/T(FederalFirearmsLicense2dig[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\)- 2 digits)/Type/Annot>> endobj 1134 0 obj <>/MaxLen 2/P 27 0 R /Parent 1041 0 R /Rect[ 176.803 272.214 236.781 287.544]/StructParent 660/Subtype/Widget/T(FederalFirearmsLicense2dig2[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\)- 2 digits)/Type/Annot>> endobj 1135 0 obj <>/MaxLen 5/P 27 0 R /Parent 1041 0 R /Rect[ 242.138 272.378 305.01 287.708]/StructParent 661/Subtype/Widget/T(FederalFirearmsLicense5dig[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\) 5 digits)/Type/Annot>> endobj 1136 0 obj <>/MaxLen 6/P 27 0 R /Parent 1041 0 R /Rect[ 28.097 214.634 110.622 230.763]/StructParent 666/Subtype/Widget/T(TFederalFirearmsLicense6dig[0])/TU(7. Transferor's Federal Firearms License \(If any\) - First 6 digits)/Type/Annot>> endobj 1137 0 obj <>/MaxLen 2/P 27 0 R /Parent 1041 0 R /Rect[ 115.177 214.634 172.777 230.763]/StructParent 667/Subtype/Widget/T(TFederalFirearmsLicense2dig[0])/TU(7. Transferor's Federal Firearms License \(If any\) - 2 digits)/Type/Annot>> endobj 1138 0 obj <>/MaxLen 2/P 27 0 R /Parent 1041 0 R /Rect[ 176.134 214.634 237.09 230.763]/StructParent 668/Subtype/Widget/T(TFederalFirearmsLicense2dig2[0])/TU(7. Transferor's Federal Firearms License \(If any\) - 2 digits)/Type/Annot>> endobj 1139 0 obj <>/MaxLen 5/P 27 0 R /Parent 1041 0 R /Rect[ 243.95 214.951 306.752 230.573]/StructParent 669/Subtype/Widget/T(TFederalFirearmsLicense5dig[0])/TU(7. Transferor's Federal Firearms License \(If any\) - 5 digits)/Type/Annot>> endobj 1140 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 309.197 271.54 444.316 300.966]/StructParent 656/Subtype/Widget/T(TransfereeSpecialTaxStatus[0])/TU(6a. Transferee's Special \(Occupational\) Tax Status \(If any\) - Employer Identification Number)/Type/Annot>> endobj 1141 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 449.677 271.539 587.449 301.62]/StructParent 657/Subtype/Widget/T(TransfereeSpecialTaxStatusClass[0])/TU(6b. Transferee's Special \(Occupational\) Tax Status \(If any\) - Class)/Type/Annot>> endobj 1142 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 310.363 214.888 444.799 244.312]/StructParent 670/Subtype/Widget/T(TransferorSpecialTaxStatus[0])/TU(8a. Transferor's Special \(Occupational\) Tax Status \(If any\) - Employer Identification Number)/Type/Annot>> endobj 1143 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 450.334 215.343 586.791 246.11]/StructParent 671/Subtype/Widget/T(TransferorSpecialTaxStatusClass[0])/TU(8b. Transferor's Special \(Occupational\) Tax Status \(If any\) - Class)/Type/Annot>> endobj 1144 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 309.197 160.563 501.171 173.886]/StructParent 672/Subtype/Widget/T(NameTitleAuthorizedOfficial[0])/TU(10. Name and Title of Authorized Official \(Print or type\))/Type/Annot>> endobj 1145 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 507.186 159.905 582.772 174.543]/StructParent 673/Subtype/Widget/T(DateField1[0])/TU(11. Date)/Type/Annot>> endobj 1146 0 obj <>/P 27 0 R /Parent 1041 0 R /Rect[ 28.293 160.56 303.866 173.886]/StructParent 674/Subtype/Widget/T(SignatureField1[0])/TU(9. Signature of Transferor \(Or authorized official\))/Type/Annot>> endobj 1147 0 obj <>/MaxLen 6/P 27 0 R /Parent 1041 0 R /Rect[ 29.438 257.122 111.039 271.491]/StructParent 662/Subtype/Widget/T(FederalFirearmsLicense6dig6[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\)- First 6 digits)/Type/Annot>> endobj 1148 0 obj <>/MaxLen 2/P 27 0 R /Parent 1041 0 R /Rect[ 116.51 257.122 172.571 271.491]/StructParent 663/Subtype/Widget/T(FederalFirearmsLicense2dig7[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\)- 2 digits)/Type/Annot>> endobj 1149 0 obj <>/MaxLen 2/P 27 0 R /Parent 1041 0 R /Rect[ 177.46 257.122 237.438 271.491]/StructParent 664/Subtype/Widget/T(FederalFirearmsLicense2dig28[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\)- 2 digits)/Type/Annot>> endobj 1150 0 obj <>/MaxLen 5/P 27 0 R /Parent 1041 0 R /Rect[ 242.796 257.468 305.668 270.901]/StructParent 665/Subtype/Widget/T(FederalFirearmsLicense5dig9[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\) 5 digits)/Type/Annot>> endobj 1151 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 27 0 R /Parent 1041 0 R /Rect[ 185.941 595.114 194.941 604.114]/StructParent 632/Subtype/Widget/T(ole[0])/TU(2a. Transferee's Full Legal Name and Address \(Include trade name, if any\) \(See instruction 2.K\) - Other Legal Entity)/Type/Annot>> endobj 1152 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 27 0 R /Parent 1041 0 R /Rect[ 292.252 595.566 301.252 604.566]/StructParent 634/Subtype/Widget/T(corp[0])/TU(2a. Transferee's Full Legal Name and Address \(Include trade name, if any\) \(See instruction 2.K\) - Corporation)/Type/Annot>> endobj 1153 0 obj <>/P 24 0 R /Parent 1040 0 R /Rect[ 26.169 741.422 308.871 753.452]/StructParent 616/Subtype/Widget/T(sob[0])/TU(20b. State of Birth)/Type/Annot>> endobj 1154 0 obj <>/P 24 0 R /Parent 1040 0 R /Rect[ 312.659 742.377 582.308 754.407]/StructParent 615/Subtype/Widget/T(cob[0])/TU(20c. Country of Birth)/Type/Annot>> endobj 1155 0 obj <>/P 24 0 R /Parent 1040 0 R /Rect[ 331.055 696.657 463.586 710.626]/StructParent 618/Subtype/Widget/T(DateField5[0])/TU(Date)/Type/Annot>> endobj 1156 0 obj <>/P 24 0 R /Parent 1040 0 R /Rect[ 31.337 696.656 247.757 710.186]/StructParent 617/Subtype/Widget/T(SignatureField2[0])/TU(Signature of Transferee)/Type/Annot>> endobj 1157 0 obj <>/P 24 0 R /Parent 1040 0 R /Rect[ 29.982 601.138 288.221 612.516]/StructParent 621/Subtype/Widget/T(TextField7n[0])/TU(22. Provide the full name \(printed or typed\) below for each Responsible Person associated with the applicant trust or legal entity \(if there are more Responsible Persons than can be listed on the form, attach a separate sheet listing the additional Responsible Person\(s\)\). Please note that a completed 5320.23, National Firearms Act \(NFA\) Responsible Person Questionnaire, must be submitted with the Form 5 application for each Responsible Person. Full Name)/Type/Annot>> endobj 1158 0 obj <>/P 24 0 R /Parent 1040 0 R /Rect[ 30.441 579.038 288.68 595.04]/StructParent 623/Subtype/Widget/T(TextField8n[0])/TU(22. Provide the full name \(printed or typed\) below for each Responsible Person associated with the applicant trust or legal entity \(if there are more Responsible Persons than can be listed on the form, attach a separate sheet listing the additional Responsible Person\(s\)\). Please note that a completed 5320.23, National Firearms Act \(NFA\) Responsible Person Questionnaire, must be submitted with the Form 5 application for each Responsible Person. Full Name)/Type/Annot>> endobj 1159 0 obj <>/P 24 0 R /Parent 1040 0 R /Rect[ 30.651 559.069 287.994 575.048]/StructParent 625/Subtype/Widget/T(TextField9n[0])/TU(22. Provide the full name \(printed or typed\) below for each Responsible Person associated with the applicant trust or legal entity \(if there are more Responsible Persons than can be listed on the form, attach a separate sheet listing the additional Responsible Person\(s\)\). Please note that a completed 5320.23, National Firearms Act \(NFA\) Responsible Person Questionnaire, must be submitted with the Form 5 application for each Responsible Person. Full Name)/Type/Annot>> endobj 1160 0 obj <>/P 24 0 R /Parent 1040 0 R /Rect[ 325.23 601.605 584.75 612.955]/StructParent 620/Subtype/Widget/T(TextField10n[0])/TU(22. Provide the full name \(printed or typed\) below for each Responsible Person associated with the applicant trust or legal entity \(if there are more Responsible Persons than can be listed on the form, attach a separate sheet listing the additional Responsible Person\(s\)\). Please note that a completed 5320.23, National Firearms Act \(NFA\) Responsible Person Questionnaire, must be submitted with the Form 5 application for each Responsible Person. Full Name)/Type/Annot>> endobj 1161 0 obj <>/P 24 0 R /Parent 1040 0 R /Rect[ 325.23 579.716 586.088 596.378]/StructParent 622/Subtype/Widget/T(TextField711n[0])/TU(22. Provide the full name \(printed or typed\) below for each Responsible Person associated with the applicant trust or legal entity \(if there are more Responsible Persons than can be listed on the form, attach a separate sheet listing the additional Responsible Person\(s\)\). Please note that a completed 5320.23, National Firearms Act \(NFA\) Responsible Person Questionnaire, must be submitted with the Form 5 application for each Responsible Person. Full Name)/Type/Annot>> endobj 1162 0 obj <>/P 24 0 R /Parent 1040 0 R /Rect[ 325.687 559.568 586.103 576.227]/StructParent 624/Subtype/Widget/T(TextField12n[0])/TU(22. Provide the full name \(printed or typed\) below for each Responsible Person associated with the applicant trust or legal entity \(if there are more Responsible Persons than can be listed on the form, attach a separate sheet listing the additional Responsible Person\(s\)\). Please note that a completed 5320.23, National Firearms Act \(NFA\) Responsible Person Questionnaire, must be submitted with the Form 5 application for each Responsible Person. Full Name)/Type/Annot>> endobj 1163 0 obj <>/P 24 0 R /Parent 1040 0 R /Rect[ 362.415 664.81 434.415 676.134]/StructParent 619/Subtype/Widget/T(TextField18[0])/TU(21. Number of Responsible Persons \(See definitions\) associated with the transferee trust or legal entity)/Type/Annot>> endobj 1164 0 obj <>/P 21 0 R /Parent 1039 0 R /Rect[ 26.555 696.487 292.181 714.538]/StructParent 563/Subtype/Widget/T(TextField4[0])/TU(12. Law Enforcement Notification \(See instruction 2.F\) - The transferee is to provide notification of the proposed acquisition and possession of the firearm described on this Form 5 by providing a copy of the completed form to the chief law enforcement officer in the agency identified below: - Agency or Department Name)/Type/Annot>> endobj 1165 0 obj <>/P 21 0 R /Parent 1039 0 R /Rect[ 318.212 695.58 583.064 716.332]/StructParent 562/Subtype/Widget/T(TextField5[0])/TU(12. Law Enforcement Notification \(See instruction 2.F\) - 12. Law Enforcement Notification \(See instruction 2f\) - The transferee is to provide notification of the proposed acquisition and possession of the firearm described on this Form 5 by providing a copy of the completed form to the chief law enforcement officer in the agency identified below: - Name and Title of Official)/Type/Annot>> endobj 1166 0 obj <>/P 21 0 R /Parent 1039 0 R /Rect[ 25.217 668.463 586.372 684.516]/StructParent 564/Subtype/Widget/T(TextField6[0])/TU(12. Law Enforcement Notification \(See instruction 2.F\) - 12. Law Enforcement Notification \(See instruction 2f\) - The transferee is to provide notification of the proposed acquisition and possession of the firearm described on this Form 5 by providing a copy of the completed form to the chief law enforcement officer in the agency identified below: - Address \(Street address or P.O. Box, City, State and Zip Code\) to which sent \(mailed or delivered\)\))/Type/Annot>> endobj 1167 0 obj <>/P 21 0 R /Parent 1039 0 R /Rect[ 53.49 592.886 290.73 602.263]/StructParent 566/Subtype/Widget/T(NameTitleTransferee[0])/TU(13. Transferee Necessity Statement \(Do not complete if the transferee is a government agency\) \(See instruction 2.E\) Name and title of Transferee)/Type/Annot>> endobj 1168 0 obj <>/P 21 0 R /Parent 1039 0 R /Rect[ 378.697 572.434 582.556 590.434]/StructParent 567/Subtype/Widget/T(Reasons[0])/TU(13. Transferee Necessity Statement \(Do not complete if the transferee is a government agency\) \(See instruction 2.E\) I, have a reasonable necessity to possess the machinegun, short-barreled rifle,short-barreled shotgun, or destructive device described on this application for the following reason\(s\))/Type/Annot>> endobj 1169 0 obj <>/P 21 0 R /Parent 1039 0 R /Rect[ 44.031 555.942 582.999 570.725]/StructParent 568/Subtype/Widget/T(reasons2[0])/TU(13. Transferee Necessity Statement \(Do not complete if the transferee is a government agency\) \(See instruction 2.E\) I, have a reasonable necessity to possess the machinegun, short-barreled rifle,short-barreled shotgun, or destructive device described on this application for the following reason\(s\))/Type/Annot>> endobj 1170 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 405.04 471.133 414.04 480.133]/StructParent 569/Subtype/Widget/T(CheckboxYes1[0])/TU(14. a. Do you intend to make any firearm listed on this form for sale or other disposition to any person described in questions 14.c. through 14.l. or a person described in question 14.m. who does not fall under an exception? Yes)/Type/Annot>> endobj 1171 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 428.845 470.591 437.845 479.591]/StructParent 583/Subtype/Widget/T(CheckBoxNo1[0])/TU(14. a. Do you intend to make any firearm listed on this form for sale or other disposition to any person described in questions 14.c. through 14.l. or a person described in question 14.m. who does not fall under an exception? No)/Type/Annot>> endobj 1172 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 404.649 446.338 413.649 455.338]/StructParent 570/Subtype/Widget/T(CheckBoxYes2[0])/TU(14. b. Do you intend to sell or otherwise dispose of any firearm listed on this form in furtherance of any felony or other offense punishable by imprisonment for a term of more than one year, a Federal crime of terrorism, or a drug trafficking offense? Yes)/Type/Annot>> endobj 1173 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 428.899 445.929 437.899 454.929]/StructParent 584/Subtype/Widget/T(CheckBoxNo2[0])/TU(14. b. Do you intend to sell or otherwise dispose of any firearm listed on this form in furtherance of any felony or other offense punishable by imprisonment for a term of more than one year, a Federal crime of terrorism, or a drug trafficking offense? No)/Type/Annot>> endobj 1174 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 406.046 368.438 415.046 377.438]/StructParent 571/Subtype/Widget/T(CheckBoxYes3[0])/TU(14. e. Are you a fugitive from justice? \(See definition 1.T\) Yes)/Type/Annot>> endobj 1175 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 429.151 368.432 438.151 377.432]/StructParent 585/Subtype/Widget/T(CheckboxNo3[0])/TU(14. e. Are you a fugitive from justice? \(See definition 1.T\) No)/Type/Annot>> endobj 1176 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 404.955 340.907 413.955 349.907]/StructParent 572/Subtype/Widget/T(CheckBoxYes4[0])/TU(14. f. Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance? Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside. Yes)/Type/Annot>> endobj 1177 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 429.151 340.627 438.151 349.627]/StructParent 586/Subtype/Widget/T(CheckBoxNo4[0])/TU(14. f. Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance? Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside. No)/Type/Annot>> endobj 1178 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 405.397 308.186 414.397 317.186]/StructParent 573/Subtype/Widget/T(CheckBoxYes5[0])/TU(14. g. On or after the age of 16, have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution? \(See definition 1.O and 1.P\) Yes)/Type/Annot>> endobj 1179 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 428.697 308.186 437.697 317.186]/StructParent 587/Subtype/Widget/T(CheckBoxNo5[0])/TU(14. g. On or after the age of 16, have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution? \(See definition 1.O and 1.P\) No)/Type/Annot>> endobj 1180 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 405.349 287.579 414.349 296.579]/StructParent 574/Subtype/Widget/T(CheckBoxYes6[0])/TU(14. h. Have you been discharged from the Armed Forces under dishonorable conditions? Yes)/Type/Annot>> endobj 1181 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 428.306 287.55 437.306 296.55]/StructParent 588/Subtype/Widget/T(CheckBoxNo6[0])/TU(14. h. Have you been discharged from the Armed Forces under dishonorable conditions? No)/Type/Annot>> endobj 1182 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 404.955 266.46 413.955 275.46]/StructParent 575/Subtype/Widget/T(CheckBoxYes7[0])/TU(14. i. Are you subject to a court order restraining you from harassing, stalking, or threatening your child or an intimate partner or child of such partner? \(See definition 1.Q\) Yes)/Type/Annot>> endobj 1183 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 428.567 266.48 437.567 275.48]/StructParent 589/Subtype/Widget/T(CheckBoxNo7[0])/TU(14. i. Are you subject to a court order restraining you from harassing, stalking, or threatening your child or an intimate partner or child of such partner? \(See definition 1.Q\) No)/Type/Annot>> endobj 1184 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 405.394 246.788 414.394 255.788]/StructParent 576/Subtype/Widget/T(CheckBoxYes8[0])/TU(14. j. Have you ever been convicted in any court of a misdemeanor crime of domestic violence? \(See definition 1.R\) Yes)/Type/Annot>> endobj 1185 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 428.697 246.727 437.697 255.727]/StructParent 590/Subtype/Widget/T(CheckBoxNo8[0])/TU(14. j. Have you ever been convicted in any court of a misdemeanor crime of domestic violence? \(See definition 1.R\) No)/Type/Annot>> endobj 1186 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 47.129 51.316 56.129 60.316]/StructParent 613/Subtype/Widget/T(CheckBox5usa[0])/TU(20a. Country of Citizenship \(Check/List more than one, if applicable. Nationals of the United States may check U.S.A.\) \(See definition 1.S\) - United States of America)/Type/Annot>> endobj 1187 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 176.419 49.445 185.419 58.445]/StructParent 614/Subtype/Widget/T(CheckBox5other[0])/TU(20a. Country of Citizenship \(Check/List more than one, if applicable. Nationals of the United States may check U.S.A.\) \(See definition 1.S\) - Other country/Countries \(specify\):)/Type/Annot>> endobj 1188 0 obj <>/P 21 0 R /Parent 1039 0 R /Rect[ 317.894 51.715 538.441 67.212]/StructParent 612/Subtype/Widget/T(TextField6other[0])/TU(20a. Country of Citizenship \(Check/List more than one, if applicable. Nationals of the United States may check U.S.A.\) \(See definition 1.S\) - Other country/Countries \(specify\):)/Type/Annot>> endobj 1189 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 407.316 228.365 416.316 237.365]/StructParent 577/Subtype/Widget/T(CheckBoxYes11[0])/TU(14. k. Have you ever renounced your United States citizenship? Yes)/Type/Annot>> endobj 1190 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 431.941 228.365 440.941 237.365]/StructParent 591/Subtype/Widget/T(CheckBoxNo11[0])/TU(14. k. Have you ever renounced your United States citizenship? No)/Type/Annot>> endobj 1191 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 406.667 211.472 415.667 220.472]/StructParent 578/Subtype/Widget/T(CheckBoxYes12[0])/TU(14. l. Are you an alien illegally or unlawfully in the United States? Yes)/Type/Annot>> endobj 1192 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 431.303 210.782 440.303 219.782]/StructParent 592/Subtype/Widget/T(CheckBoxNo12[0])/TU(14. l. Are you an alien illegally or unlawfully in the United States? No)/Type/Annot>> endobj 1193 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 407.537 193.975 416.537 202.975]/StructParent 579/Subtype/Widget/T(CheckBoxYes13[0])/TU(14. m.1. Are you an alien who has been admitted to the United States under a nonimmigrant visa? Yes)/Type/Annot>> endobj 1194 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 431.314 193.747 440.314 202.747]/StructParent 593/Subtype/Widget/T(CheckBoxNo13[0])/TU(14. m.1. Are you an alien who has been admitted to the United States under a nonimmigrant visa? No)/Type/Annot>> endobj 1195 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 407.078 179.079 416.078 188.079]/StructParent 580/Subtype/Widget/T(CheckBoxYes14[0])/TU(14. m.2. If YES, do you fall within any of the exceptions stated in the instructions? Attach the documentation to the application. Yes)/Type/Annot>> endobj 1196 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 430.855 179.225 439.855 188.225]/StructParent 594/Subtype/Widget/T(CheckBoxNo14[0])/TU(14. m.2. If YES, do you fall within any of the exceptions stated in the instructions? Attach the documentation to the application. No)/Type/Annot>> endobj 1197 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 445.498 178.419 454.498 187.419]/StructParent 597/Subtype/Widget/T(checkbox18f2NA[0])/TU(14. m.2. If YES, do you fall within any of the exceptions stated in the instructions? Attach the documentation to the application. N/A)/Type/Annot>> endobj 1198 0 obj <>/P 21 0 R /Parent 1039 0 R /Rect[ 361.208 162.992 584.748 173.336]/StructParent 599/Subtype/Widget/T(TextField19[0])/TU(16. If you are an alien. record your U.S.-Issued alien or Admission number \(AR#, USCIS#, or I94#\):)/Type/Annot>> endobj 1199 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 348.891 144.134 356.891 152.134]/StructParent 601/Subtype/Widget/T(CheckBox20upinyes[0])/TU(17. Have you been issued a Unique Personal Identification Number \(UPIN\)? \(See instructions 2.H\) Yes)/Type/Annot>> endobj 1200 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 378.895 144.134 386.895 152.134]/StructParent 602/Subtype/Widget/T(CheckBox20upinno[0])/TU(17. Have you been issued a Unique Personal Identification Number \(UPIN\)? \(See instructions 2.H\) No)/Type/Annot>> endobj 1201 0 obj <>/P 21 0 R /Parent 1039 0 R /Rect[ 481.609 145.236 581.338 155.259]/StructParent 600/Subtype/Widget/T(TextField20ifyes[0])/TU(17. Have you been issued a Unique Personal Identification Number \(UPIN\)? \(See instructions 2.H\) If yes please provide)/Type/Annot>> endobj 1202 0 obj <>/P 21 0 R /Parent 1039 0 R /Rect[ 26.169 108.618 310.753 126.227]/StructParent 603/Subtype/Widget/T(ssn16[0])/TU(18. Social Security Number: \(SSN\) \(See Instructions 2.H\))/Type/Annot>> endobj 1203 0 obj <>/P 21 0 R /Parent 1039 0 R /Rect[ 314.099 108.617 584.402 126.694]/StructParent 604/Subtype/Widget/T(dob16[0])/TU(18. Date of Birth)/Type/Annot>> endobj 1204 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 95.737 96.225 104.737 105.225]/StructParent 605/Subtype/Widget/T(ehl[0])/TU(19a. Ethnicity. Hispanic or Latino )/Type/Annot>> endobj 1205 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 95.741 79.873 104.741 88.873]/StructParent 606/Subtype/Widget/T(nhl[0])/TU(19a. Ethnicity. Not Hispanic or Latino)/Type/Annot>> endobj 1206 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 249.621 95.529 258.621 104.529]/StructParent 607/Subtype/Widget/T(aian[0])/TU(19b. Race. American Indian or Alaska Native)/Type/Annot>> endobj 1207 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 248.616 79.628 257.616 88.628]/StructParent 608/Subtype/Widget/T(a[0])/TU(19b. Race. Asian)/Type/Annot>> endobj 1208 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 397.48 95.862 406.48 104.862]/StructParent 609/Subtype/Widget/T(baa[0])/TU(19b. Race. Black or African American)/Type/Annot>> endobj 1209 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 396.986 79.665 405.986 88.665]/StructParent 610/Subtype/Widget/T(nhopi[0])/TU(19b. Race. Native Hawaiian or Other Pacific Islander)/Type/Annot>> endobj 1210 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 522.793 94.807 531.793 103.807]/StructParent 611/Subtype/Widget/T(w[0])/TU(19b. Race. White)/Type/Annot>> endobj 1211 0 obj <>/TP 1>>/P 21 0 R /Parent 1039 0 R /Rect[ 443.531 283.666 587.803 427.935]/StructParent 598/Subtype/Widget/T(ImageField1[0])/TU(15. Photograph \(Click here to attach\))/Type/Annot>> endobj 1212 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 405.031 411.544 414.031 420.544]/StructParent 581/Subtype/Widget/T(CheckBox15yes[0])/TU(14. c. Are you under indictment or information in any court for a felony, or any other crime, for which the judge could imprison you for more than one year? \(See definition 1.N\) Yes)/Type/Annot>> endobj 1213 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 427.875 411.544 436.875 420.544]/StructParent 595/Subtype/Widget/T(CheckBox15no[0])/TU(14. c. Are you under indictment or information in any court for a felony, or any other crime, for which the judge could imprison you for more than one year? \(See definition 1.N\) No)/Type/Annot>> endobj 1214 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 405.516 387.75 414.516 396.75]/StructParent 582/Subtype/Widget/T(CheckBox16yes[0])/TU(14. d. Have you ever been convicted in any court for a felony, or any other crime, for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation? \(See definition 1.N\) Yes)/Type/Annot>> endobj 1215 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 21 0 R /Parent 1039 0 R /Rect[ 427.407 387.75 436.407 396.75]/StructParent 596/Subtype/Widget/T(CheckBox16no[0])/TU(14. d. Have you ever been convicted in any court for a felony, or any other crime, for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation? \(See definition 1.N\) No)/Type/Annot>> endobj 1216 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 102.438 704.528 308.44 715.861]/StructParent 515/Subtype/Widget/T(bet365 Control[0])/TU(bet365 Control Number)/Type/Annot>> endobj 1217 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 402.106 704.486 582.046 715.178]/StructParent 514/Subtype/Widget/T(InternalControl[0])/TU(Internal Control Number)/Type/Annot>> endobj 1218 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 18 0 R /Parent 1038 0 R /Rect[ 27.18 609.249 35.18 617.249]/StructParent 517/Subtype/Widget/T(CheckBox5firearm[0])/TU(1. Type of Transfer: tax exempt - I believe that I am entitled to exemption from the payment of the Transfer Tax Imposed by section 5811 \(26 U.S.C. Chapter 53\) on the Firearm described herein for the following reason \(See Instruction 2.B\): - Firearm is unserviceable and is being transferred as a curio or ornament)/Type/Annot>> endobj 1219 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 18 0 R /Parent 1038 0 R /Rect[ 27.623 588.862 35.623 596.862]/StructParent 519/Subtype/Widget/T(CheckBox6firearm[0])/TU(1. Type of Transfer: tax exempt - I believe that I am entitled to exemption from the payment of the Transfer Tax Imposed by section 5811 \(26 U.S.C. Chapter 53\) on the Firearm described herein for the following reason \(See Instruction 2.B\): - Firearm is being transferred to or from a Government Entity)/Type/Annot>> endobj 1220 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 18 0 R /Parent 1038 0 R /Rect[ 27.623 568.702 35.623 576.702]/StructParent 525/Subtype/Widget/T(CheckBox7firearm[0])/TU(1. Type of Transfer: tax exempt - I believe that I am entitled to exemption from the payment of the Transfer Tax Imposed by section 5811 \(26 U.S.C. Chapter 53\) on the Firearm described herein for the following reason \(See Instruction 2.B\): - Firearm is being transferred to a lawful heir or by operation of law)/Type/Annot>> endobj 1221 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 18 0 R /Parent 1038 0 R /Rect[ 27.181 547.866 35.181 555.866]/StructParent 526/Subtype/Widget/T(CheckBox8firearm[0])/TU(1. Type of Transfer: tax exempt - I believe that I am entitled to exemption from the payment of the Transfer Tax Imposed by section 5811 \(26 U.S.C. Chapter 53\) on the Firearm described herein for the following reason \(See Instruction 2.B\): - Other \(Specify\))/Type/Annot>> endobj 1222 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 97.078 551.019 175.677 560.594]/StructParent 527/Subtype/Widget/T(Other[0])/TU(1. Type of Transfer: tax exempt - I believe that I am entitled to exemption from the payment of the Transfer Tax Imposed by section 5811 \(26 U.S.C. Chapter 53\) on the Firearm described herein for the following reason \(See Instruction 2.B\): - Other \(Specify\))/Type/Annot>> endobj 1223 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 182.701 607.357 584.013 670.357]/StructParent 516/Subtype/Widget/T(TransfereeNameandAddress[0])/TU(2a. Transferee's Full Legal Name and Address \(Include trade name, if any\) \(See instruction 2.K\))/Type/Annot>> endobj 1224 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 473.641 577.454 579.994 590.097]/StructParent 524/Subtype/Widget/T(County[0])/TU(2b. County/Parish)/Type/Annot>> endobj 1225 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 18 0 R /Parent 1038 0 R /Rect[ 183.88 580.971 192.88 589.971]/StructParent 521/Subtype/Widget/T(CheckBox9ind[0])/TU(2a. Transferee's Full Legal Name and Address \(Include trade name, if any\) \(See instruction 2.K\) - Individual)/Type/Annot>> endobj 1226 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 18 0 R /Parent 1038 0 R /Rect[ 290.965 579.177 299.965 588.177]/StructParent 522/Subtype/Widget/T(CheckBox9trust[0])/TU(2a. Transferee's Full Legal Name and Address \(Include trade name, if any\) \(See instruction 2.K\) - Trust)/Type/Annot>> endobj 1227 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 18 0 R /Parent 1038 0 R /Rect[ 373.836 579.624 382.836 588.624]/StructParent 523/Subtype/Widget/T(CheckBox9gov[0])/TU(2a. Transferee's Full Legal Name and Address \(Include trade name, if any\) \(See instruction 2.K\) - Government Entity)/Type/Annot>> endobj 1228 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 182.701 543.402 581.989 564.69]/StructParent 528/Subtype/Widget/T(DecedentNameandAddress[0])/TU(3a. If Applicable: Decedent's Name, Address, and Date of Death)/Type/Annot>> endobj 1229 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 26.169 504.499 580.648 531.927]/StructParent 529/Subtype/Widget/T(TransferorNameandAddress[0])/TU(3b. Transferor's Name and Address \(Include trade name, if any\) \(Executors: see instruction 2.K\))/Type/Annot>> endobj 1230 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 26.853 460.763 174.807 478.412]/StructParent 531/Subtype/Widget/T(TransferorNumber[0])/TU(3c. Transferor's Telephone \(area code and number\))/Type/Annot>> endobj 1231 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 178.682 460.764 279.672 477.729]/StructParent 532/Subtype/Widget/T(emailadd1[0])/TU(3d. E-Mail address)/Type/Annot>> endobj 1232 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 285.032 461.676 581.663 483.089]/StructParent 530/Subtype/Widget/T(NumberStreetCityStateZipDifferent[0])/TU(3e. Number, Street, City, State and Zip Code of Residence \(Or firearms business premises\) If Different from Item 3a.)/Type/Annot>> endobj 1233 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 28.193 360.884 235.496 404.847]/StructParent 534/Subtype/Widget/T(NameandAddressofMakerManuImporter[0])/TU(4a. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Name and Address of Maker, Manufacturer and/or Importer of Firearm)/Type/Annot>> endobj 1234 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 240.211 361.466 358.597 390.11]/StructParent 537/Subtype/Widget/T(TypeofFirearm[0])/TU(4b. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Type of Firearm \(See definitions 1.C\))/Type/Annot>> endobj 1235 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 363.954 360.808 415.448 388.794]/StructParent 538/Subtype/Widget/T(CaliberorGauge[0])/TU(4c. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Caliber or Gauge)/Type/Annot>> endobj 1236 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 420.809 413.592 582.809 428.913]/StructParent 533/Subtype/Widget/T(Model[0])/TU(4d. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Model)/Type/Annot>> endobj 1237 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 458.929 386.164 521.929 404.164]/StructParent 535/Subtype/Widget/T(LengthofBarrel[0])/TU(4e. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Length \(Inches\) of Barrel:)/Type/Annot>> endobj 1238 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 525.135 385.509 579.135 403.509]/StructParent 536/Subtype/Widget/T(LengthOverall[0])/TU(4f. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Length \(Inches\) Overall:)/Type/Annot>> endobj 1239 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 420.021 360.462 582.021 375.126]/StructParent 539/Subtype/Widget/T(SerialNumber[0])/TU(4g. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Serial Number)/Type/Annot>> endobj 1240 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 103.584 326.449 304.138 349.424]/StructParent 540/Subtype/Widget/T(AdditionalDescription[0])/TU(4h. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Additional Description or Data Appearing on Firearm \(Attach additional sheet if necessary\))/Type/Annot>> endobj 1241 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 18 0 R /Parent 1038 0 R /Rect[ 523.443 338.808 532.443 347.808]/StructParent 541/Subtype/Widget/T(CheckBoxYes[0])/TU(4i. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Has the Firearm been rendered unserviceable as defined in Definition 1m? \(If "yes," describe the method by which the firearm has been rendered unserviceable. Use additional sheets.\) Yes)/Type/Annot>> endobj 1242 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 18 0 R /Parent 1038 0 R /Rect[ 556.189 338.809 565.189 347.809]/StructParent 542/Subtype/Widget/T(CheckBoxNo[0])/TU(4i. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Has the Firearm been rendered unserviceable as defined in Definition 1.M? \(If "yes," describe the method by which the firearm has been rendered unserviceable. Use additional sheets.\) Yes\r\(If "No," describe any other method by which firearm has been rendered unserviceable. Use additional sheets. - No)/Type/Annot>> endobj 1243 0 obj <>/MaxLen 6/P 18 0 R /Parent 1038 0 R /Rect[ 27.34 271.743 108.941 287.073]/StructParent 545/Subtype/Widget/T(FederalFirearmsLicense6dig[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\)- First 6 digits)/Type/Annot>> endobj 1244 0 obj <>/MaxLen 2/P 18 0 R /Parent 1038 0 R /Rect[ 114.412 271.743 170.473 287.073]/StructParent 546/Subtype/Widget/T(FederalFirearmsLicense2dig[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\)- 2 digits)/Type/Annot>> endobj 1245 0 obj <>/MaxLen 2/P 18 0 R /Parent 1038 0 R /Rect[ 175.363 271.743 235.341 287.073]/StructParent 547/Subtype/Widget/T(FederalFirearmsLicense2dig2[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\)- 2 digits)/Type/Annot>> endobj 1246 0 obj <>/MaxLen 5/P 18 0 R /Parent 1038 0 R /Rect[ 240.698 271.907 303.57 287.237]/StructParent 548/Subtype/Widget/T(FederalFirearmsLicense5dig[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\) 5 digits)/Type/Annot>> endobj 1247 0 obj <>/MaxLen 6/P 18 0 R /Parent 1038 0 R /Rect[ 26.657 214.163 109.182 230.292]/StructParent 553/Subtype/Widget/T(TFederalFirearmsLicense6dig[0])/TU(7. Transferor's Federal Firearms License \(If any\) - First 6 digits)/Type/Annot>> endobj 1248 0 obj <>/MaxLen 2/P 18 0 R /Parent 1038 0 R /Rect[ 113.737 214.163 171.337 230.292]/StructParent 554/Subtype/Widget/T(TFederalFirearmsLicense2dig[0])/TU(7. Transferor's Federal Firearms License \(If any\) - 2 digits)/Type/Annot>> endobj 1249 0 obj <>/MaxLen 2/P 18 0 R /Parent 1038 0 R /Rect[ 174.694 214.163 235.65 230.292]/StructParent 555/Subtype/Widget/T(TFederalFirearmsLicense2dig2[0])/TU(7. Transferor's Federal Firearms License \(If any\) - 2 digits)/Type/Annot>> endobj 1250 0 obj <>/MaxLen 5/P 18 0 R /Parent 1038 0 R /Rect[ 242.51 214.48 305.312 230.102]/StructParent 556/Subtype/Widget/T(TFederalFirearmsLicense5dig[0])/TU(7. Transferor's Federal Firearms License \(If any\) - 5 digits)/Type/Annot>> endobj 1251 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 307.757 271.069 442.876 300.495]/StructParent 543/Subtype/Widget/T(TransfereeSpecialTaxStatus[0])/TU(6a. Transferee's Special \(Occupational\) Tax Status \(If any\) - Employer Identification Number)/Type/Annot>> endobj 1252 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 448.237 271.069 586.009 301.15]/StructParent 544/Subtype/Widget/T(TransfereeSpecialTaxStatusClass[0])/TU(6b. Transferee's Special \(Occupational\) Tax Status \(If any\) - Class)/Type/Annot>> endobj 1253 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 308.923 214.418 443.359 243.842]/StructParent 557/Subtype/Widget/T(TransferorSpecialTaxStatus[0])/TU(8a. Transferor's Special \(Occupational\) Tax Status \(If any\) - Employer Identification Number)/Type/Annot>> endobj 1254 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 448.894 214.872 585.351 245.639]/StructParent 558/Subtype/Widget/T(TransferorSpecialTaxStatusClass[0])/TU(8b. Transferor's Special \(Occupational\) Tax Status \(If any\) - Class)/Type/Annot>> endobj 1255 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 307.757 160.092 499.731 173.415]/StructParent 559/Subtype/Widget/T(NameTitleAuthorizedOfficial[0])/TU(10. Name and Title of Authorized Official \(Print or type\))/Type/Annot>> endobj 1256 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 505.746 159.435 581.332 174.073]/StructParent 560/Subtype/Widget/T(DateField1[0])/TU(11. Date)/Type/Annot>> endobj 1257 0 obj <>/P 18 0 R /Parent 1038 0 R /Rect[ 26.853 160.089 302.426 173.415]/StructParent 561/Subtype/Widget/T(SignatureField1[0])/TU(9. Signature of Transferor \(Or authorized official\))/Type/Annot>> endobj 1258 0 obj <>/MaxLen 6/P 18 0 R /Parent 1038 0 R /Rect[ 27.998 256.651 109.599 271.02]/StructParent 549/Subtype/Widget/T(FederalFirearmsLicense6dig6[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\)- First 6 digits)/Type/Annot>> endobj 1259 0 obj <>/MaxLen 2/P 18 0 R /Parent 1038 0 R /Rect[ 115.07 256.651 171.131 271.02]/StructParent 550/Subtype/Widget/T(FederalFirearmsLicense2dig7[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\)- 2 digits)/Type/Annot>> endobj 1260 0 obj <>/MaxLen 2/P 18 0 R /Parent 1038 0 R /Rect[ 176.02 256.651 235.998 271.02]/StructParent 551/Subtype/Widget/T(FederalFirearmsLicense2dig28[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\)- 2 digits)/Type/Annot>> endobj 1261 0 obj <>/MaxLen 5/P 18 0 R /Parent 1038 0 R /Rect[ 241.356 256.998 304.228 270.431]/StructParent 552/Subtype/Widget/T(FederalFirearmsLicense5dig9[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\) 5 digits)/Type/Annot>> endobj 1262 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 18 0 R /Parent 1038 0 R /Rect[ 184.501 594.643 193.501 603.643]/StructParent 518/Subtype/Widget/T(ole[0])/TU(2a. Transferee's Full Legal Name and Address \(Include trade name, if any\) \(See instruction 2.K\) - Other Legal Entity)/Type/Annot>> endobj 1263 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/Ff 1/MK<>/P 18 0 R /Parent 1038 0 R /Rect[ 290.812 595.095 299.812 604.095]/StructParent 520/Subtype/Widget/T(corp[0])/TU(2a. Transferee's Full Legal Name and Address \(Include trade name, if any\) \(See instruction 2.K\) - Corporation)/Type/Annot>> endobj 1264 0 obj <>/P 1 0 R /Parent 1037 0 R /Rect[ 26.555 696.487 292.181 714.538]/StructParent 851/Subtype/Widget/T(TextField4[0])/TU(12. Law Enforcement Notification \(See instruction 2.F\) - The transferee is to provide notification of the proposed acquisition and possession of the firearm described on this Form 5 by providing a copy of the completed form to the chief law enforcement officer in the agency identified below: - Agency or Department Name)/Type/Annot>> endobj 1265 0 obj <>/P 1 0 R /Parent 1037 0 R /Rect[ 318.212 695.58 583.064 716.332]/StructParent 443/Subtype/Widget/T(TextField5[0])/TU(12. Law Enforcement Notification \(See instruction 2.F\) - 12. Law Enforcement Notification \(See instruction 2f\) - The transferee is to provide notification of the proposed acquisition and possession of the firearm described on this Form 5 by providing a copy of the completed form to the chief law enforcement officer in the agency identified below: - Name and Title of Official)/Type/Annot>> endobj 1266 0 obj <>/P 1 0 R /Parent 1037 0 R /Rect[ 25.217 668.463 586.372 684.516]/StructParent 445/Subtype/Widget/T(TextField6[0])/TU(12. Law Enforcement Notification \(See instruction 2.F\) - 12. Law Enforcement Notification \(See instruction 2f\) - The transferee is to provide notification of the proposed acquisition and possession of the firearm described on this Form 5 by providing a copy of the completed form to the chief law enforcement officer in the agency identified below: - Address \(Street address or P.O. Box, City, State and Zip Code\) to which sent \(mailed or delivered\)\))/Type/Annot>> endobj 1267 0 obj <>/P 1 0 R /Parent 1037 0 R /Rect[ 53.49 592.886 290.73 602.263]/StructParent 447/Subtype/Widget/T(NameTitleTransferee[0])/TU(13. Transferee Necessity Statement \(Do not complete if the transferee is a government agency\) \(See instruction 2.E\) Name and title of Transferee)/Type/Annot>> endobj 1268 0 obj <>/P 1 0 R /Parent 1037 0 R /Rect[ 378.697 572.434 582.556 590.434]/StructParent 852/Subtype/Widget/T(Reasons[0])/TU(13. Transferee Necessity Statement \(Do not complete if the transferee is a government agency\) \(See instruction 2.E\) I, have a reasonable necessity to possess the machinegun, short-barreled rifle,short-barreled shotgun, or destructive device described on this application for the following reason\(s\))/Type/Annot>> endobj 1269 0 obj <>/P 1 0 R /Parent 1037 0 R /Rect[ 44.031 555.942 582.999 570.725]/StructParent 853/Subtype/Widget/T(reasons2[0])/TU(13. Transferee Necessity Statement \(Do not complete if the transferee is a government agency\) \(See instruction 2.E\) I, have a reasonable necessity to possess the machinegun, short-barreled rifle,short-barreled shotgun, or destructive device described on this application for the following reason\(s\))/Type/Annot>> endobj 1270 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 405.04 471.133 414.04 480.133]/StructParent 856/Subtype/Widget/T(CheckboxYes1[0])/TU(14. a. Do you intend to make any firearm listed on this form for sale or other disposition to any person described in questions 14.c. through 14.l. or a person described in question 14.m. who does not fall under an exception? Yes)/Type/Annot>> endobj 1271 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 428.845 470.591 437.845 479.591]/StructParent 855/Subtype/Widget/T(CheckBoxNo1[0])/TU(14. a. Do you intend to make any firearm listed on this form for sale or other disposition to any person described in questions 14.c. through 14.l. or a person described in question 14.m. who does not fall under an exception? No)/Type/Annot>> endobj 1272 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 404.649 446.338 413.649 455.338]/StructParent 859/Subtype/Widget/T(CheckBoxYes2[0])/TU(14. b. Do you intend to sell or otherwise dispose of any firearm listed on this form in furtherance of any felony or other offense punishable by imprisonment for a term of more than one year, a Federal crime of terrorism, or a drug trafficking offense? Yes)/Type/Annot>> endobj 1273 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 428.899 445.929 437.899 454.929]/StructParent 858/Subtype/Widget/T(CheckBoxNo2[0])/TU(14. b. Do you intend to sell or otherwise dispose of any firearm listed on this form in furtherance of any felony or other offense punishable by imprisonment for a term of more than one year, a Federal crime of terrorism, or a drug trafficking offense? No)/Type/Annot>> endobj 1274 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 406.046 368.438 415.046 377.438]/StructParent 866/Subtype/Widget/T(CheckBoxYes3[0])/TU(14. e. Are you a fugitive from justice? \(See definition 1.T\) Yes)/Type/Annot>> endobj 1275 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 429.151 368.432 438.151 377.432]/StructParent 867/Subtype/Widget/T(CheckboxNo3[0])/TU(14. e. Are you a fugitive from justice? \(See definition 1.T\) No)/Type/Annot>> endobj 1276 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 404.955 340.907 413.955 349.907]/StructParent 870/Subtype/Widget/T(CheckBoxYes4[0])/TU(14. f. Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance? Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside. Yes)/Type/Annot>> endobj 1277 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 429.151 340.627 438.151 349.627]/StructParent 872/Subtype/Widget/T(CheckBoxNo4[0])/TU(14. f. Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance? Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside. No)/Type/Annot>> endobj 1278 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 405.397 308.186 414.397 317.186]/StructParent 873/Subtype/Widget/T(CheckBoxYes5[0])/TU(14. g. On or after the age of 16, have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution? \(See definition 1.O and 1.P\) Yes)/Type/Annot>> endobj 1279 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 428.697 308.186 437.697 317.186]/StructParent 875/Subtype/Widget/T(CheckBoxNo5[0])/TU(14. g. On or after the age of 16, have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution? \(See definition 1.O and 1.P\) No)/Type/Annot>> endobj 1280 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 405.349 287.579 414.349 296.579]/StructParent 876/Subtype/Widget/T(CheckBoxYes6[0])/TU(14. h. Have you been discharged from the Armed Forces under dishonorable conditions? Yes)/Type/Annot>> endobj 1281 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 428.306 287.55 437.306 296.55]/StructParent 877/Subtype/Widget/T(CheckBoxNo6[0])/TU(14. h. Have you been discharged from the Armed Forces under dishonorable conditions? No)/Type/Annot>> endobj 1282 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 404.955 266.46 413.955 275.46]/StructParent 880/Subtype/Widget/T(CheckBoxYes7[0])/TU(14. i. Are you subject to a court order restraining you from harassing, stalking, or threatening your child or an intimate partner or child of such partner? \(See definition 1.Q\) Yes)/Type/Annot>> endobj 1283 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 428.567 266.48 437.567 275.48]/StructParent 879/Subtype/Widget/T(CheckBoxNo7[0])/TU(14. i. Are you subject to a court order restraining you from harassing, stalking, or threatening your child or an intimate partner or child of such partner? \(See definition 1.Q\) No)/Type/Annot>> endobj 1284 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 405.394 246.788 414.394 255.788]/StructParent 881/Subtype/Widget/T(CheckBoxYes8[0])/TU(14. j. Have you ever been convicted in any court of a misdemeanor crime of domestic violence? \(See definition 1.R\) Yes)/Type/Annot>> endobj 1285 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 428.697 246.727 437.697 255.727]/StructParent 882/Subtype/Widget/T(CheckBoxNo8[0])/TU(14. j. Have you ever been convicted in any court of a misdemeanor crime of domestic violence? \(See definition 1.R\) No)/Type/Annot>> endobj 1286 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 47.129 51.316 56.129 60.316]/StructParent 493/Subtype/Widget/T(CheckBox5usa[0])/TU(20a. Country of Citizenship \(Check/List more than one, if applicable. Nationals of the United States may check U.S.A.\) \(See definition 1.S\) - United States of America)/Type/Annot>> endobj 1287 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 176.419 49.445 185.419 58.445]/StructParent 495/Subtype/Widget/T(CheckBox5other[0])/TU(20a. Country of Citizenship \(Check/List more than one, if applicable. Nationals of the United States may check U.S.A.\) \(See definition 1.S\) - Other country/Countries \(specify\):)/Type/Annot>> endobj 1288 0 obj <>/P 1 0 R /Parent 1037 0 R /Rect[ 317.894 51.715 538.441 67.212]/StructParent 494/Subtype/Widget/T(TextField6other[0])/TU(20a. Country of Citizenship \(Check/List more than one, if applicable. Nationals of the United States may check U.S.A.\) \(See definition 1.S\) - Other country/Countries \(specify\):)/Type/Annot>> endobj 1289 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 407.316 228.365 416.316 237.365]/StructParent 883/Subtype/Widget/T(CheckBoxYes11[0])/TU(14. k. Have you ever renounced your United States citizenship? Yes)/Type/Annot>> endobj 1290 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 431.941 228.365 440.941 237.365]/StructParent 884/Subtype/Widget/T(CheckBoxNo11[0])/TU(14. k. Have you ever renounced your United States citizenship? No)/Type/Annot>> endobj 1291 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 406.667 211.472 415.667 220.472]/StructParent 885/Subtype/Widget/T(CheckBoxYes12[0])/TU(14. l. Are you an alien illegally or unlawfully in the United States? Yes)/Type/Annot>> endobj 1292 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 431.303 210.782 440.303 219.782]/StructParent 886/Subtype/Widget/T(CheckBoxNo12[0])/TU(14. l. Are you an alien illegally or unlawfully in the United States? No)/Type/Annot>> endobj 1293 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 407.537 193.975 416.537 202.975]/StructParent 887/Subtype/Widget/T(CheckBoxYes13[0])/TU(14. m.1. Are you an alien who has been admitted to the United States under a nonimmigrant visa? Yes)/Type/Annot>> endobj 1294 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 431.314 193.747 440.314 202.747]/StructParent 888/Subtype/Widget/T(CheckBoxNo13[0])/TU(14. m.1. Are you an alien who has been admitted to the United States under a nonimmigrant visa? No)/Type/Annot>> endobj 1295 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 407.078 179.079 416.078 188.079]/StructParent 889/Subtype/Widget/T(CheckBoxYes14[0])/TU(14. m.2. If YES, do you fall within any of the exceptions stated in the instructions? Attach the documentation to the application. Yes)/Type/Annot>> endobj 1296 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 430.855 179.225 439.855 188.225]/StructParent 890/Subtype/Widget/T(CheckBoxNo14[0])/TU(14. m.2. If YES, do you fall within any of the exceptions stated in the instructions? Attach the documentation to the application. No)/Type/Annot>> endobj 1297 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 445.498 178.419 454.498 187.419]/StructParent 891/Subtype/Widget/T(checkbox18f2NA[0])/TU(14. m.2. If YES, do you fall within any of the exceptions stated in the instructions? Attach the documentation to the application. N/A)/Type/Annot>> endobj 1298 0 obj <>/P 1 0 R /Parent 1037 0 R /Rect[ 361.208 162.992 584.748 173.336]/StructParent 480/Subtype/Widget/T(TextField19[0])/TU(16. If you are an alien. record your U.S.-Issued alien or Admission number \(AR#, USCIS#, or I94#\):)/Type/Annot>> endobj 1299 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 348.891 144.134 356.891 152.134]/StructParent 482/Subtype/Widget/T(CheckBox20upinyes[0])/TU(17. Have you been issued a Unique Personal Identification Number \(UPIN\)? \(See instructions 2.H\) Yes)/Type/Annot>> endobj 1300 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 378.895 144.134 386.895 152.134]/StructParent 893/Subtype/Widget/T(CheckBox20upinno[0])/TU(17. Have you been issued a Unique Personal Identification Number \(UPIN\)? \(See instructions 2.H\) No)/Type/Annot>> endobj 1301 0 obj <>/P 1 0 R /Parent 1037 0 R /Rect[ 481.609 145.236 581.338 155.259]/StructParent 481/Subtype/Widget/T(TextField20ifyes[0])/TU(17. Have you been issued a Unique Personal Identification Number \(UPIN\)? \(See instructions 2.H\) If yes please provide)/Type/Annot>> endobj 1302 0 obj <>/P 1 0 R /Parent 1037 0 R /Rect[ 26.169 108.618 310.753 126.227]/StructParent 484/Subtype/Widget/T(ssn16[0])/TU(18. Social Security Number: \(SSN\) \(See Instructions 2.H\))/Type/Annot>> endobj 1303 0 obj <>/P 1 0 R /Parent 1037 0 R /Rect[ 314.099 108.617 584.402 126.694]/StructParent 485/Subtype/Widget/T(dob16[0])/TU(18. Date of Birth)/Type/Annot>> endobj 1304 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 95.737 96.225 104.737 105.225]/StructParent 486/Subtype/Widget/T(ehl[0])/TU(19a. Ethnicity. 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Are you under indictment or information in any court for a felony, or any other crime, for which the judge could imprison you for more than one year? \(See definition 1.N\) Yes)/Type/Annot>> endobj 1313 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 427.875 411.544 436.875 420.544]/StructParent 861/Subtype/Widget/T(CheckBox15no[0])/TU(14. c. Are you under indictment or information in any court for a felony, or any other crime, for which the judge could imprison you for more than one year? \(See definition 1.N\) No)/Type/Annot>> endobj 1314 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 405.516 387.75 414.516 396.75]/StructParent 865/Subtype/Widget/T(CheckBox16yes[0])/TU(14. d. Have you ever been convicted in any court for a felony, or any other crime, for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation? \(See definition 1.N\) Yes)/Type/Annot>> endobj 1315 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 1 0 R /Parent 1037 0 R /Rect[ 427.407 387.75 436.407 396.75]/StructParent 864/Subtype/Widget/T(CheckBox16no[0])/TU(14. d. Have you ever been convicted in any court for a felony, or any other crime, for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation? \(See definition 1.N\) No)/Type/Annot>> endobj 1316 0 obj <>/DA(/TimesNewRomanPSMT 7 Tf 0 g)/F 4/FT/Tx/Ff 8392704/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 102.438 704.999 308.44 716.332]/StructParent 741/Subtype/Widget/T(bet365 Control[0])/TU(bet365 Control Number)/Type/Annot>> endobj 1317 0 obj <>/DA(/TimesNewRomanPSMT 7 Tf 0 g)/F 4/FT/Tx/Ff 8392704/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 402.106 704.957 582.046 715.649]/StructParent 742/Subtype/Widget/T(InternalControl[0])/TU(Internal Control Number)/Type/Annot>> endobj 1318 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 2645 0 R /Parent 1036 0 R /Rect[ 27.18 609.719 35.18 617.719]/StructParent 743/Subtype/Widget/T(CheckBox5firearm[0])/TU(1. Type of Transfer: tax exempt - I believe that I am entitled to exemption from the payment of the Transfer Tax Imposed by section 5811 \(26 U.S.C. Chapter 53\) on the Firearm described herein for the following reason \(See Instruction 2.B\): - Firearm is unserviceable and is being transferred as a curio or ornament)/Type/Annot>> endobj 1319 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 2645 0 R /Parent 1036 0 R /Rect[ 27.623 589.332 35.623 597.332]/StructParent 744/Subtype/Widget/T(CheckBox6firearm[0])/TU(1. Type of Transfer: tax exempt - I believe that I am entitled to exemption from the payment of the Transfer Tax Imposed by section 5811 \(26 U.S.C. Chapter 53\) on the Firearm described herein for the following reason \(See Instruction 2.B\): - Firearm is being transferred to or from a Government Entity)/Type/Annot>> endobj 1320 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 2645 0 R /Parent 1036 0 R /Rect[ 27.623 569.173 35.623 577.173]/StructParent 745/Subtype/Widget/T(CheckBox7firearm[0])/TU(1. Type of Transfer: tax exempt - I believe that I am entitled to exemption from the payment of the Transfer Tax Imposed by section 5811 \(26 U.S.C. Chapter 53\) on the Firearm described herein for the following reason \(See Instruction 2.B\): - Firearm is being transferred to a lawful heir or by operation of law)/Type/Annot>> endobj 1321 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 2645 0 R /Parent 1036 0 R /Rect[ 27.181 548.336 35.181 556.336]/StructParent 746/Subtype/Widget/T(CheckBox8firearm[0])/TU(1. Type of Transfer: tax exempt - I believe that I am entitled to exemption from the payment of the Transfer Tax Imposed by section 5811 \(26 U.S.C. Chapter 53\) on the Firearm described herein for the following reason \(See Instruction 2.B\): - Other \(Specify\))/Type/Annot>> endobj 1322 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 97.078 551.489 175.677 561.064]/StructParent 747/Subtype/Widget/T(Other[0])/TU(1. Type of Transfer: tax exempt - I believe that I am entitled to exemption from the payment of the Transfer Tax Imposed by section 5811 \(26 U.S.C. Chapter 53\) on the Firearm described herein for the following reason \(See Instruction 2.B\): - Other \(Specify\))/Type/Annot>> endobj 1323 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8392704/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 182.701 607.827 584.013 670.827]/StructParent 749/Subtype/Widget/T(TransfereeNameandAddress[0])/TU(2a. Transferee's Full Legal Name and Address \(Include trade name, if any\) \(See instruction 2.K\))/Type/Annot>> endobj 1324 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 473.641 577.924 579.994 590.567]/StructParent 757/Subtype/Widget/T(County[0])/TU(2b. County/Parish)/Type/Annot>> endobj 1325 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 2645 0 R /Parent 1036 0 R /Rect[ 183.88 581.442 192.88 590.442]/StructParent 752/Subtype/Widget/T(CheckBox9ind[0])/TU(2a. Transferee's Full Legal Name and Address \(Include trade name, if any\) \(See instruction 2.K\) - Individual)/Type/Annot>> endobj 1326 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 2645 0 R /Parent 1036 0 R /Rect[ 290.965 579.647 299.965 588.647]/StructParent 754/Subtype/Widget/T(CheckBox9trust[0])/TU(2a. Transferee's Full Legal Name and Address \(Include trade name, if any\) \(See instruction 2.K\) - Trust)/Type/Annot>> endobj 1327 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 2645 0 R /Parent 1036 0 R /Rect[ 373.836 580.095 382.836 589.095]/StructParent 755/Subtype/Widget/T(CheckBox9gov[0])/TU(2a. Transferee's Full Legal Name and Address \(Include trade name, if any\) \(See instruction 2.K\) - Government Entity)/Type/Annot>> endobj 1328 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8392704/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 182.701 543.872 581.989 565.16]/StructParent 759/Subtype/Widget/T(DecedentNameandAddress[0])/TU(3a. If Applicable: Decedent's Name, Address, and Date of Death)/Type/Annot>> endobj 1329 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8392704/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 26.169 504.969 580.648 532.397]/StructParent 761/Subtype/Widget/T(TransferorNameandAddress[0])/TU(3b. Transferor's Name and Address \(Include trade name, if any\) \(Executors: see instruction 2.K\))/Type/Annot>> endobj 1330 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 26.853 461.233 174.807 478.882]/StructParent 763/Subtype/Widget/T(TransferorNumber[0])/TU(3c. Transferor's Telephone \(area code and number\))/Type/Annot>> endobj 1331 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 178.682 461.234 279.672 478.199]/StructParent 764/Subtype/Widget/T(emailadd1[0])/TU(3d. E-Mail address)/Type/Annot>> endobj 1332 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8392704/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 285.032 462.146 581.663 483.559]/StructParent 766/Subtype/Widget/T(NumberStreetCityStateZipDifferent[0])/TU(3e. Number, Street, City, State and Zip Code of Residence \(Or firearms business premises\) If Different from Item 3a.)/Type/Annot>> endobj 1333 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8392704/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 28.193 361.354 235.496 405.317]/StructParent 768/Subtype/Widget/T(NameandAddressofMakerManuImporter[0])/TU(4a. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Name and Address of Maker, Manufacturer and/or Importer of Firearm)/Type/Annot>> endobj 1334 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8392704/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 240.211 361.936 358.597 390.58]/StructParent 770/Subtype/Widget/T(TypeofFirearm[0])/TU(4b. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Type of Firearm \(See definitions 1.C\))/Type/Annot>> endobj 1335 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8392704/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 363.954 361.279 415.448 389.265]/StructParent 772/Subtype/Widget/T(CaliberorGauge[0])/TU(4c. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Caliber or Gauge)/Type/Annot>> endobj 1336 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 420.809 414.063 582.809 429.384]/StructParent 774/Subtype/Widget/T(Model[0])/TU(4d. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Model)/Type/Annot>> endobj 1337 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 458.929 386.634 521.929 404.634]/StructParent 776/Subtype/Widget/T(LengthofBarrel[0])/TU(4e. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Length \(Inches\) of Barrel:)/Type/Annot>> endobj 1338 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 525.135 385.98 579.135 403.98]/StructParent 778/Subtype/Widget/T(LengthOverall[0])/TU(4f. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Length \(Inches\) Overall:)/Type/Annot>> endobj 1339 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 420.021 360.932 582.021 375.596]/StructParent 780/Subtype/Widget/T(SerialNumber[0])/TU(4g. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Serial Number)/Type/Annot>> endobj 1340 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8392704/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 103.096 326.803 303.65 349.778]/StructParent 782/Subtype/Widget/T(AdditionalDescription[0])/TU(4h. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Additional Description or Data Appearing on Firearm \(Attach additional sheet if necessary\))/Type/Annot>> endobj 1341 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 2645 0 R /Parent 1036 0 R /Rect[ 523.443 339.279 532.443 348.279]/StructParent 787/Subtype/Widget/T(CheckBoxYes[0])/TU(4i. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Has the Firearm been rendered unserviceable as defined in Definition 1m? \(If "yes," describe the method by which the firearm has been rendered unserviceable. Use additional sheets.\) Yes)/Type/Annot>> endobj 1342 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 2645 0 R /Parent 1036 0 R /Rect[ 556.189 339.279 565.189 348.279]/StructParent 790/Subtype/Widget/T(CheckBoxNo[0])/TU(4i. Description of Firearm \(Complete items a through i\) \(See instruction 2.N\) Has the Firearm been rendered unserviceable as defined in Definition 1.M? \(If "yes," describe the method by which the firearm has been rendered unserviceable. Use additional sheets.\) Yes\r\(If "No," describe any other method by which firearm has been rendered unserviceable. Use additional sheets. - No)/Type/Annot>> endobj 1343 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/MaxLen 6/P 2645 0 R /Parent 1036 0 R /Rect[ 26.853 272.097 108.454 287.427]/StructParent 791/Subtype/Widget/T(FederalFirearmsLicense6dig[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\)- First 6 digits)/Type/Annot>> endobj 1344 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/MaxLen 2/P 2645 0 R /Parent 1036 0 R /Rect[ 113.924 272.097 169.985 287.427]/StructParent 805/Subtype/Widget/T(FederalFirearmsLicense2dig[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\)- 2 digits)/Type/Annot>> endobj 1345 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/MaxLen 2/P 2645 0 R /Parent 1036 0 R /Rect[ 174.875 272.097 234.853 287.427]/StructParent 811/Subtype/Widget/T(FederalFirearmsLicense2dig2[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\)- 2 digits)/Type/Annot>> endobj 1346 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/MaxLen 5/P 2645 0 R /Parent 1036 0 R /Rect[ 240.211 272.262 303.083 287.592]/StructParent 816/Subtype/Widget/T(FederalFirearmsLicense5dig[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\) 5 digits)/Type/Annot>> endobj 1347 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/MaxLen 6/P 2645 0 R /Parent 1036 0 R /Rect[ 26.169 214.518 108.694 230.647]/StructParent 831/Subtype/Widget/T(TFederalFirearmsLicense6dig[0])/TU(7. Transferor's Federal Firearms License \(If any\) - First 6 digits)/Type/Annot>> endobj 1348 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/MaxLen 2/P 2645 0 R /Parent 1036 0 R /Rect[ 113.25 214.518 170.85 230.647]/StructParent 837/Subtype/Widget/T(TFederalFirearmsLicense2dig[0])/TU(7. Transferor's Federal Firearms License \(If any\) - 2 digits)/Type/Annot>> endobj 1349 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/MaxLen 2/P 2645 0 R /Parent 1036 0 R /Rect[ 174.206 214.518 235.162 230.647]/StructParent 839/Subtype/Widget/T(TFederalFirearmsLicense2dig2[0])/TU(7. Transferor's Federal Firearms License \(If any\) - 2 digits)/Type/Annot>> endobj 1350 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/MaxLen 5/P 2645 0 R /Parent 1036 0 R /Rect[ 242.022 214.835 304.824 230.457]/StructParent 840/Subtype/Widget/T(TFederalFirearmsLicense5dig[0])/TU(7. Transferor's Federal Firearms License \(If any\) - 5 digits)/Type/Annot>> endobj 1351 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 307.757 271.54 442.876 300.966]/StructParent 828/Subtype/Widget/T(TransfereeSpecialTaxStatus[0])/TU(6a. Transferee's Special \(Occupational\) Tax Status \(If any\) - Employer Identification Number)/Type/Annot>> endobj 1352 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 448.237 271.539 586.009 301.62]/StructParent 830/Subtype/Widget/T(TransfereeSpecialTaxStatusClass[0])/TU(6b. Transferee's Special \(Occupational\) Tax Status \(If any\) - Class)/Type/Annot>> endobj 1353 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 308.923 214.888 443.359 244.312]/StructParent 842/Subtype/Widget/T(TransferorSpecialTaxStatus[0])/TU(8a. Transferor's Special \(Occupational\) Tax Status \(If any\) - Employer Identification Number)/Type/Annot>> endobj 1354 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 448.894 215.343 585.351 246.11]/StructParent 844/Subtype/Widget/T(TransferorSpecialTaxStatusClass[0])/TU(8b. Transferor's Special \(Occupational\) Tax Status \(If any\) - Class)/Type/Annot>> endobj 1355 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8392704/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 307.757 160.563 499.731 173.886]/StructParent 848/Subtype/Widget/T(NameTitleAuthorizedOfficial[0])/TU(10. Name and Title of Authorized Official \(Print or type\))/Type/Annot>> endobj 1356 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/P 2645 0 R /Parent 1036 0 R /Rect[ 505.746 159.905 581.332 174.543]/StructParent 850/Subtype/Widget/T(DateField1[0])/TU(11. Date)/Type/Annot>> endobj 1357 0 obj <>/P 2645 0 R /Parent 1036 0 R /Rect[ 26.853 160.56 302.426 173.886]/StructParent 846/Subtype/Widget/T(SignatureField1[0])/TU(9. Signature of Transferor \(Or authorized official\))/Type/Annot>> endobj 1358 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/MaxLen 6/P 2645 0 R /Parent 1036 0 R /Rect[ 27.51 257.006 109.111 271.375]/StructParent 820/Subtype/Widget/T(FederalFirearmsLicense6dig6[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\)- First 6 digits)/Type/Annot>> endobj 1359 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/MaxLen 2/P 2645 0 R /Parent 1036 0 R /Rect[ 114.582 257.006 170.643 271.375]/StructParent 823/Subtype/Widget/T(FederalFirearmsLicense2dig7[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\)- 2 digits)/Type/Annot>> endobj 1360 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/MaxLen 2/P 2645 0 R /Parent 1036 0 R /Rect[ 175.533 257.006 235.511 271.375]/StructParent 825/Subtype/Widget/T(FederalFirearmsLicense2dig28[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\)- 2 digits)/Type/Annot>> endobj 1361 0 obj <>/DA(/TimesNewRomanPSMT 8 Tf 0 g)/F 4/FT/Tx/Ff 8388608/MK<<>>/MaxLen 5/P 2645 0 R /Parent 1036 0 R /Rect[ 240.868 257.352 303.74 270.785]/StructParent 826/Subtype/Widget/T(FederalFirearmsLicense5dig9[0])/TU(5. Applicant's Federal Firearms License \(If any\) or Explosives License or Permit Number \(Give complete 15-digit number\) \(See instruction 2.C\) 5 digits)/Type/Annot>> endobj 1362 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 2645 0 R /Parent 1036 0 R /Rect[ 184.501 595.114 193.501 604.114]/StructParent 750/Subtype/Widget/T(ole[0])/TU(2a. Transferee's Full Legal Name and Address \(Include trade name, if any\) \(See instruction 2.K\) - Other Legal Entity)/Type/Annot>> endobj 1363 0 obj <>/N<>>>/AS/Off/F 4/FT/Btn/MK<>/P 2645 0 R /Parent 1036 0 R /Rect[ 290.812 595.566 299.812 604.566]/StructParent 751/Subtype/Widget/T(corp[0])/TU(2a. Transferee's Full Legal Name and Address \(Include trade name, if any\) \(See instruction 2.K\) - Corporation)/Type/Annot>> endobj 1364 0 obj <>/P 5 0 R /Parent 1034 0 R /Rect[ 313.614 743.8 583.263 755.83]/StructParent 496/Subtype/Widget/T(cob[0])/TU(20c. Country of Birth)/Type/Annot>> endobj 1365 0 obj <>/P 5 0 R /Parent 1034 0 R /Rect[ 332.011 698.08 464.542 712.049]/StructParent 499/Subtype/Widget/T(DateField5[0])/TU(Date)/Type/Annot>> endobj 1366 0 obj <>/P 5 0 R /Parent 1034 0 R /Rect[ 32.292 698.079 248.712 711.609]/StructParent 498/Subtype/Widget/T(SignatureField2[0])/TU(Signature of Transferee)/Type/Annot>> endobj 1367 0 obj <>/P 5 0 R /Parent 1034 0 R /Rect[ 30.937 602.561 289.176 613.939]/StructParent 900/Subtype/Widget/T(TextField7n[0])/TU(22. Provide the full name \(printed or typed\) below for each Responsible Person associated with the applicant trust or legal entity \(if there are more Responsible Persons than can be listed on the form, attach a separate sheet listing the additional Responsible Person\(s\)\). Please note that a completed 5320.23, National Firearms Act \(NFA\) Responsible Person Questionnaire, must be submitted with the Form 5 application for each Responsible Person. Full Name)/Type/Annot>> endobj 1368 0 obj <>/P 5 0 R /Parent 1034 0 R /Rect[ 31.397 580.461 289.636 596.463]/StructParent 903/Subtype/Widget/T(TextField8n[0])/TU(22. Provide the full name \(printed or typed\) below for each Responsible Person associated with the applicant trust or legal entity \(if there are more Responsible Persons than can be listed on the form, attach a separate sheet listing the additional Responsible Person\(s\)\). Please note that a completed 5320.23, National Firearms Act \(NFA\) Responsible Person Questionnaire, must be submitted with the Form 5 application for each Responsible Person. Full Name)/Type/Annot>> endobj 1369 0 obj <>/P 5 0 R /Parent 1034 0 R /Rect[ 31.606 560.492 288.949 576.471]/StructParent 905/Subtype/Widget/T(TextField9n[0])/TU(22. Provide the full name \(printed or typed\) below for each Responsible Person associated with the applicant trust or legal entity \(if there are more Responsible Persons than can be listed on the form, attach a separate sheet listing the additional Responsible Person\(s\)\). Please note that a completed 5320.23, National Firearms Act \(NFA\) Responsible Person Questionnaire, must be submitted with the Form 5 application for each Responsible Person. Full Name)/Type/Annot>> endobj 1370 0 obj <>/P 5 0 R /Parent 1034 0 R /Rect[ 326.186 603.028 585.706 614.378]/StructParent 901/Subtype/Widget/T(TextField10n[0])/TU(22. Provide the full name \(printed or typed\) below for each Responsible Person associated with the applicant trust or legal entity \(if there are more Responsible Persons than can be listed on the form, attach a separate sheet listing the additional Responsible Person\(s\)\). Please note that a completed 5320.23, National Firearms Act \(NFA\) Responsible Person Questionnaire, must be submitted with the Form 5 application for each Responsible Person. Full Name)/Type/Annot>> endobj 1371 0 obj <>/P 5 0 R /Parent 1034 0 R /Rect[ 326.186 581.139 587.044 597.801]/StructParent 904/Subtype/Widget/T(TextField711n[0])/TU(22. Provide the full name \(printed or typed\) below for each Responsible Person associated with the applicant trust or legal entity \(if there are more Responsible Persons than can be listed on the form, attach a separate sheet listing the additional Responsible Person\(s\)\). Please note that a completed 5320.23, National Firearms Act \(NFA\) Responsible Person Questionnaire, must be submitted with the Form 5 application for each Responsible Person. Full Name)/Type/Annot>> endobj 1372 0 obj <>/P 5 0 R /Parent 1034 0 R /Rect[ 326.642 560.991 587.058 577.65]/StructParent 505/Subtype/Widget/T(TextField12n[0])/TU(22. Provide the full name \(printed or typed\) below for each Responsible Person associated with the applicant trust or legal entity \(if there are more Responsible Persons than can be listed on the form, attach a separate sheet listing the additional Responsible Person\(s\)\). Please note that a completed 5320.23, National Firearms Act \(NFA\) Responsible Person Questionnaire, must be submitted with the Form 5 application for each Responsible Person. Full Name)/Type/Annot>> endobj 1373 0 obj <>/P 5 0 R /Parent 1034 0 R /Rect[ 363.37 666.233 435.37 677.557]/StructParent 500/Subtype/Widget/T(TextField18[0])/TU(21. 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