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ATF Form 4

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ATF Form 4
ATF Form 4
ATF Control Number
Submit in Duplicate to:
National Firearms Act Branch
Bureau of Alcohol, Tobacco, Firearms
and Explosives, P.O. Box 530298
Atlanta, GA 30353-0298
1. Type of Transfer (Check one)
$5 $200
2a. Transferee's Name and Address (Including tradename, if any) (See instruction 2)
2b. County
3a. Transferor's Name and Address (Including trade name, if any) (Executors: see instruction 2k)
3c. If Applicable: Decedent's Name, Address, and Date of Death
The above-named and undersigned transferor hereby makes application as required by Section 5812 of the National Firearms Act to transfer and register the firearm described
below to the transferee.
4. Description of Firearm (Complete items a through h)
a. Name and Address of Manufacturer and/or Importer of
b. Type of Firearm (See
instruction 1c)
c. Caliber,
Gauge or
d. Model
g. Serial Number
5. Transferee's Federal Firearms License (If any)
7. Transferor's Federal Firearms License
(If any)
6. Transferee's Special (Occupational) Tax Status (If any)
a. Employer Identification Number
8. Transferor's Special (Occupational) Tax Status (If any)
b. Class
b. Class
a. Employer Identification Number
Under Penalties of Perjury, I Declare that I have examined this application, and to the best of my knowledge and belief it is true, correct and complete, and that the transfer of the described
firearm to the transferee and receipt and possession of it by the transferee are not prohibited by the provisions of Chapter 44, Title 18, United States Code; Chapter 53, Title 26, United States Code;
or Title VII of the Omnibus Crime Control and Safe Streets Act, as amended; or any provisions of State or local law.
10. Signature of Transferor (or authorized official)
11. Name and Title of Authorized Official
(Print or type)
The Space Below is for the use of the Bureau of Alcohol, Tobacco, Firearms and Explosives
h. Additional Description or Data Appearing on Firearm (Attach additional sheet if necessary)
12. Date
e. Of Barrel: f. Overall:
9. Consent to Disclosure of Information to Transferee (See instruction 8) . I Do or Do Not (Circle one) Authorize ATF to Provide Information Relating to this
Application to the Above-Named Transferee .
Approved (with the following conditions, if any)
By authority of the Director, This Application has been Examined, and the Transfer and Registration of the Firearm Described
herein and the Interstate Movement of that Firearm, when Applicable, to the Transferee are:
Disapproved (For the following reasons)
Stamp Denomination
Signature of Authorized ATF Official
Submit with your application a check or
money order for the appropriate amount
made payable to the Bureau of Alcohol,
Tobacco, Firearms and Explosives. Upon
approval of this application, this office
will acquire, affix and cancel the required
"National Firearms Act" stamp for you.
(See instructions 2h, 2i and 3.)
3b. Transferor’s Telephone Number and
Area Code
OMB No. 1140-0014 (01/31/2014)
U.S. Department of Justice
Bureau of Alcohol, Tobacco, Firearms and Explosives
Application for Tax Paid Transfer and
Registration of Firearm
ATF Form 4 (5320.4)
Revised March 2006
3d. Number, Street, City, State and Zip Code
of Residence (or Firearms Business
Premises) if Different from Item 3a.
First 6 digits
(Give complete 15-digit number) (See instruction 2b)
2 digits 2 digits 5 digits
First 6 digits
(Give complete 15-digit number) (See instruction 2b)
2 digits 2 digits 5 digits
ATF Form 4