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ATF Form 4473

ATF Form 4473 is a form requiring someone to fill out when she or he buys a firearm when someone from a gun shop.

ATF Form 4473
ATF Form 4473
WARNING: You may not receive a firearm if prohibited by Federal or State law. The information you provide will
be used to determine whether you are prohibited under law from receiving a firearm. Certain violations of the Gun
Control Act, 18 U.S.C.
§§ 921 et. seq., are punishable by up to 10 years imprisonment and/or up to a $250,000 fine.
Prepare in original only. All entries must be handwritten in ink. Read the Notices, Instructions, and Definitions on
this form. “PLEASE PRINT.”
Section A - Must Be Completed Personally By Transferee (Buyer)
2. Current Residence Address (U.S. Postal abbreviations are acceptable. Cannot be a post office box.)
Month Day
Year
11. Answer questions 11.a. (see exceptions) through 11.l. and 12 (if applicable) by checking or marking “yes” or “no” in the boxes to the right of the questions.
1. Transferee’s Full Name
a. Are you the actual transferee/buyer of the firearm(s) listed on this form Warning: You are not the actual buyer if you are
acquiring the firearm(s) on behalf of another person. If you are not the actual buyer, the dealer cannot transfer the firearm(s)
to you. (See Instructions for Question 11.a.) Exception: If you are picking up a repaired firearm(s) for another person, you are not
required to answer 11.a. and may proceed to question 11.b.
d. Are you a fugitive from justice
e. Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance
g. Have you been discharged from the Armed Forces under dishonorable conditions
f. Have you ever been adjudicated mentally defective (which includes a determination by a court, board, commission, or other lawful
authority that you are a danger to yourself or to others or are incompetent to manage your own affairs) OR have you ever been
committed to a mental institution (See Instructions for Question 11.f.)
b. 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 Instructions for Question 11.b.)
c. Have you ever been convicted in any court of 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 Instructions for Question 11.c.
)
h. 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 Instructions for Question 11.h.)
i. Have you ever been convicted in any court of a misdemeanor crime of domestic violence (See Instructions for Question 11.i.)
Male
Female
8. Social Security Number (Optional, but will help prevent misidentification)
3. Place of Birth
10.a. Ethnicity
14. What is your country of citizenship (List/check more than
one, if applicable. If you are a citizen of the United States,
proceed to question 16.)
13. What is your State of residence
(if any) (See Instructions for
Question 13.)
U.S. Department of Justice
Bureau of Alcohol, Tobacco, Firearms and Explosives
Firearms Transaction Record Part I -
Over-the-Counter
OMB No. 1140-0020
Last Name
First Name Middle Name (If no middle name, state “NMN”)
Number and Street Address City State
ZIP Code
County
U.S. City and State
Foreign Country
4. Height 5. Weight
(Lbs.)
7. Birth Date6. Gender
9. Unique Personal Identification Number (UPIN) if applicable (See
Instructions for Question 9.)
l. Are you an alien admitted to the United States under a nonimmigrant visa (See Instructions for Question 11.l.) If you answered
“no” to this question, do NOT respond to question 12 and proceed to question 13.
k. Are you an alien illegally in the United States
j. Have you ever renounced your United States citizenship
American Indian or Alaska Native
Black or African American White
Asian
Native Hawaiian or Other Pacific Islander
15. If you are not a citizen of the United States,
what is your U.S.-issued alien number or
admission number
United States of America
Other (Specify)
ATF Form 4473 (5300.9) Part I
Revised April 2012
Ft.
In.
Transferor's Transaction
Serial Number (If any)
Note: Previous Editions Are Obsolete
-OR-
Transferee (Buyer) Continue to Next Page
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Page 1 of 6
STAPLE IF PAGES BECOME SEPARATED
10.b. Race (Check one or more boxes.)
Hispanic or Latino
Not Hispanic or Latino
12. If you are an alien admitted to the United States under a nonimmigrant visa, do you fall within any of the exceptions set forth in the
instructions (If “yes,” the licensee must complete question 20c.) (See Instructions for Question 12.) If question 11.l. is answered
with a “no” response, then do NOT respond to question 12 and proceed to question 13.
Yes
No
ATF Form 4473
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