ATF Form 4473

For additional Notices, Instructions, or Definitions, please see 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 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.

Section A

1. Transferee's/Buyer's Full Name (If legal name contain an initial only, record "IO" after the initial. If no middle initial or name, record "NMN".)

2. Current State of Residence and Address (U.S. Postal abbreviations are acceptable. Cannot be a post office box.)

3. Place of Birth (complete only one of the following 2 fields; leave the other blank)

4. Height (required)

6. Sex (required)
MaleFemale

7. Date of Birth (required)

Month Day Year

10a. Ethnicity (required)
Hispanic or LatinoNot Hispanic or Latino

10b. Race (required - select as many as apply)
American Indian or Alaska NativeAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhite

11a. Are you the actual transferee/buyer of the firearm(s) listed on this form? Warning: You are not the actual transferee/buyer if you are acquiring the firearm(s) on behalf of another person. If you are not the actual transferee/buyer, the licensee cannot transfer the firearm(s) to you. 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.
YesNo

Generally, 18 U.S.C. 922(g) prohibits the shipment, transportation, receipt, or possession in or affecting interstate commerce of a firearm by one who: has been convicted of a felony in any Federal, State or local court, or any other crime, punishable by imprisonment for a term exceeding one year (this does not include State misdemeanors punishable by imprisonment of two years or less); is a fugitive from justice; is an unlawful user of, or addicted to, marijuana or any depressant, stimulant, or narcotic drug, or any other controlled substance; has been adjudicated as a mental defective or has been committed to a mental institution; has been discharged from the Armed Forces under dishonorable conditions; is subject to certain restraining orders; convicted of a misdemeanor crime of domestic violence under Federal, State or Tribal law; has renounced his/her U.S. citizenship; is an alien illegally in the United States or an alien admitted to the United States under a nonimmigrant visa. Furthermore, section 922(n) prohibits the shipment, transportation, or receipt in or affecting interstate commerce of a firearm by one who is under indictment or information for a felony in any Federal, State or local court, or any other crime, punishable by imprisonment for a term exceeding one year. An information is a formal accusation of a crime verified by a prosecutor.

11b. 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?
YesNo

11c. 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?
YesNo

11d. Are you a fugitive from justice?
YesNo

11e. 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.
YesNo

11f. Have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution?
YesNo

11g. Have you been discharged from the Armed Forces under dishonorable conditions?
YesNo

11h. 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?
YesNo

11i. Have you ever been convicted in any court of a misdemeanor crime of domestic violence?
YesNo

Country of Citizenship (Check/List more than one, if applicable. Nationals of the United States may check U.S.A.)

12a. Are you a citizen of the United States of America (U.S.A.)
YesNo

12b. Have you ever renounced your United States citizenship?
YesNo

12c. Are you an alien illegally or unlawfully in the United States?
YesNo

12.d.1. Are you an alien who has been admitted to the United States under a nonimmigrant visa?
YesNo

12.d.2. If "yes", do you fall within any of the exceptions stated in the instructions?
N/AYesNo

By selecting 'Yes' below, you certify to the following statement:

I certify that my answers in Section A are true, correct, and complete. I have read and understand the Notices, Instructions, and Definitions on ATF Form 4473. I understand that answering 'yes' to question 11.a. if I am not the actual transferee/buyer is a crime punishable as a felony under Federal law, and may also violate State and/or local law. I understand that a person who answers 'yes' to any of the questions 11.b. through 11.i and/or 12.b. through 12.c. is prohibited from purchasing or receiving a firearm. I understand that a person who answers 'yes' to question 12.d.1. is prohibited from receiving or possessing a firearm, unless the person answers 'yes' to question 12.d.2. and provides the documentation required in 18.c. I also understand that making any false oral or written statement, or exhibiting any false or misrepresented identification with respect to this transaction, is a crime punishable as a felony under Federal law, and may also violate State and/or local law. I further understand that the repetitive purchase of firearms for the purpose of resale for livelihood and profit without a Federal firearms license is a violation of Federal law.

YesNo

Section B

Driver's license (or other ID) expiration date (required)

Month Day Year

Complete the following section only if you have a valid state-issued weapons carry permit. If you do not have a permit, the information above will be used to perform a background check.