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Annotated ATF Form

Annotated ATF Form

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Xerxes Wilson
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214 views6 pages

Annotated ATF Form

Annotated ATF Form

Uploaded by

Xerxes Wilson
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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US. DepuGase-diaa-cr-00061-MN Document 157-3 Filed 05/20/24 Page 2 of 7 PagelD # Firearms and Fi Firearms Transaction Record Tormation so provide Wi un Control Ast, IBUS.C. 921 WARNING: You may not reece = ddicrmine whether you are prohibit of. eq are punishable by upto 10 ations ofthe $250,000 fie. ricunciue trichintingraen | 5, O53 ie, Wear "NIN" Read the Noties, Instr ince bus . 2 ioe#l Roker HY NTER_ ma NaS OS resTations Bre aGeepiaic, Cannow Ue w pow alice DON unty Stare | ZIP Code vt ee DE ge? inna See foto ethnic, select ome or more race fn TOI Banh Wa. and TOK mst be answered) ransTerecbuyer yu th licensee cannot transfer arm) on behalf of another pi mn: Ifyou are picking up a repaired firearms), are acqui the firearms) to you. Fxce The use or possession of marijuana remains unlawful under Federal law regardes of whether i has been dccriminalized for medicinal or recreational purposes in the state where you reside i : . = x z iMegally or un Transferee Buyer Continue to Next Page 'S BECOME SEPARATED DOu-01-00000379 ‘ox cal lam. Lundersiand that» person who answers yes” to any ofthe questions IL.b. through IL andor 12.. through 12. {s prohibited from perchasing or receiving a firearm. I understand that» person who answers “yes" to question 12.4.1 is prohibited from receiving or possessing firearm, unless the person answers “Vex” to question 12.4.2 and provides the documentation required in 18. 1 ‘any fake oralor written statement, or exhibiting any false or misrepresented identification with respect o this transaction, is. crime punishable 28 felony under Federal law, and may abo violate State and/or local law. I further understand that the repetitive purchase of firearms forthe purpose of eral firearms cease isa Violation of Federal law. (See Insiructions for Question 14.) pees 7 ns) 0 Be wanforred (ohooh oF mark all dat app ptiandews Ove [Otter (rifles or See Instructions for Question 16) is ata qualifying gun show or event em frame, receiver ete. | Name of Function: Ta ican fg Vrs Dvr Tic TH DU or hr vl goverment ph Hct) (Se fact for Goeth) Ising Autor and Type of eniicaion | Noes ou deatieaton Expintion Dee of detetion (fry) U.S. Pass PERT or os |2 “TR Supplemental Goveriment sued Documentation (7 teen oneaTon catenin nmeange cue residence adress) (See Distrctions for ow) DE Venice PESTSTRA7Z TRE Fxcepiton fo the Notimmnigrant Alicn Proibison 1 the wanstoroe buyer answered "VES to [2a3 the lice man neal peat documentation showing the exception tothe prohibition and atach a copy to this ATF Form 4473. (See Instructions for Question 1S) ‘Questions Ta, Date the wansferee's buyer"s identifying tnformation ia Secion A was transmitted to NICS or the appropriate State ba Bog SB TTY? ‘oF TT Mast Be Completed Prior To The Transfer OF The Firearms) (See Taractioms for Qiestions 17,20 ant 277 TID. The NICS oF State wansaction number Tile The response niall (fist) proved by NICS or the appropriate Stats | TW. The flowing responsts) was wer later cee fern NICS othe agency war prope State agency eave Pre i (dete) Overumnd 5] cancetes (dates ‘Wie (Complete Fapplicable) After te frsarm vas wansfeed, the Following response was received from NICS o __ te 1 Proceed (] Denied (] cane TDI The name and Brady lsnilfeaion numberof the NICS examines Opvional) [0g Name of FFL Employes Complating NICS check. (Optional —_— aang qasen V TORMER 2B NONKS check war required bosauss aad the NFA rear an check was Comal daring The NE appreval proces ov hs Taal who WU TESTS instructions for Querton 20) HI [J Ne NIGS cfech was required becaue the tansforeeTuyer hax a vald perma or the State w asanexemption toNICS, (See Instruction for Question 21) hare the transfer eto take place, which qual Issuing State and Permit Type Date ofan fam) | apeton Dat om Permit Number (an) Tie nt day from the date 3). (See Instructions for Question 22 and [certify that my answers to the questions in Section A ofthis form ares the anetor of the Frear ay ater pa ion A, the wanstorstoayer st comp Section € immediately prior to the transfer of th reel and 3, Transferee Taye Si rare TE. Receniication Date Transteror Seller Continue to Vent Page STAPLE IF PAGES BECOME SEPARATED. DOv-01-00000380 Model dap besignated) Manufacturer and importer (fan) he sanifctiner andl importer re ier the FFL must elude both) = Caliber o Gauge Type (See inirctions “for Questo REMINDER By the Close of Business Complete ATF Form 33104 For Mulliple Purchases of Handguns Within § Consccuthve Dusinew Days [30-Total Number of Firearms Transfened Please hansdwrite By printing ©, 2070, ‘one, hwo, tive, ee. Do mat se numeral.) ONE 30 Cheek any par of Wis wanastion fa pawn edempion [[] Line Number(s) From Question 24 Above: 31. For Use by Licenses (See Instructions Jor Question 37) [320 Check itis wansaction isto feiiate a private pay wane [See tsrrion for Question 32) 35, Trade/corporate name and address of wansferorseller and Federal Firearm License Number (si contain atleast fe dee ad last five digs of FFL Number X PANN) (Hand stamp may be sed) ARQUEST SHOOTERS & SURVIVAL SUPPI 3701 CONCORD PIKE MINGTON. DE 19 8-51-003-01-9E-00996, “The Person Tranerring The Firearitay Must Complete Quastam 37 For Denied/Cancelled Transactions, the Person Who Completed Section B Must Complete Questions 3436. ‘Loertify that: (1) Thave read and understand the Notes, lastructions, and Definitions on this ATF Form 473: 2) dhe information recorded in Sections B and Dis ‘rue, core, and comple: and G) this entire transaction record hasbeen competed at my Bivens business premises Ycensed premises ined business {temporarily conducted froma qualifying gun show or event in the same Statin which the eens premss oat) uns this transaction fas met the requirements of 1 USC. 922). Unless this transtion has been dened canceled urther certify on the basi of (1) the transfere'vuyers respons Section (and Section C,ifapplicable (2) my verification ofthe identification recorded in question 18 (and my reseritication athe ine of transfer, Seton C ‘as completed) and (3) State oral law applicable othe firearms business itis my bei that t's not unlawful for me to sel, deliver, transport cr otherwise spose ofthe firearm) sted on this form to the person identified in Section A. HH. Transferor's Seller's Name (Please prin) N01 ESSINSTIRECTIONS. AND DEFINITIONS Purpose ofthe Form: The inoematon and certain o this form te esgned so hat a peson licensed under 18 US.C. 923 may determine hehe nay lawl sell or dliver a ream wo the person dette in Sects A, and toler the trasferecbuner of ceri retrstns on the rcpt ad poweston ft firarms. The transferor slr of firearm mst determine thea Tunes of the tanscton and maintain proper cone the Wansacton. Consent, the transferor sll mint be famior wth the provisions of IX USC. 921-931 ad the regulations in 27 CFR Parts 478 and 4. In determining the lefuloess of these o delivery of aif or shogun 0 3 eset of anther Sia, the transferor is presumed to kaos the applicable Stas aes and published ordinances in bth the wanteror sellers State and the transferees buyers Sate. (Sev ATF Publicotion $300.5, Sie Laws ond Published Ordnance.) (Gencraly, ATE Form 4473 mt be completed atthe licensed business premises when a firearm is trnsfeed vcrhe-couner. Feder iw, 18 US.C. 922.¢h allows Hens importer, manufacturer, or dealer sla Srearm to ann svho doesnot spear in persona the lgetsee'sbisnes premises only lithe wansere ber meets cera eguraments. These rsuiemens ae set forth in seton 924,27 CFR A784), and ATE Provedure 2013-2, After the transfor has completed the firearms transaction, he the must make the completed, exiginal ATF Form $173 which includes the Noes. Gen ‘ral Insircions. and Definitions). aay supporting documents, pr of hiner permanent cor. Such Forms 4473 must be rettine fra as 20 yeas and ater tha prod may be submited to ATF. Fling muy be chronological iy ate {of dsposinon alphabet iby name of rrchaser, oe rum fy ranac= ‘ion seria number) as log a al ofthe raster s completed Vorns “4973 are fled inthe sare mane Page 3 of 6 IBS. Transteror's Sellers Si lndon-T Covell 0 Sales Lele Lise Fonds 471 FOR DENIED CANCELLED TRANSFERS MUS nt xedatNP BG. Transferor'sSeler’s Title [37 Ir the taesfer of firearm is desedeancelad by NICS, oi foray ote ras0n| ‘he wansfer snot competed after a NICS chek is iniat the Lense must ait the ATE For 4873 in hin hor ecords frat least S years. Farms 4473 wth respect ‘o which sae, delivery or transfer di not ake plac bal be separately timed alphabetical by name of trae or chronologic hy date of rarer certain) ont Ifthe tansfeoesllar othe ransferse buyer discovers that an ATF For 4473 i incomplete or inpropely completed afr the frcarm has ben rasfred athe transferor ele othe transferee bayer wisest ome the omission) or str), photocopy the inaccurate or ad make an) ecewary addons revisions othe photocopy. The uasfeonsle soli nly make shang 10 Sections B and D, The tansferce buyer shuld only make changes to Section A and CC. Whoever made the changss should inital ad due te changes. The emecied photocopy sbould be tached tothe orginal Frm 4473 and veined pt the transfers elles permanent recor Exporiation of Firearms: The Sue or Comeree Deparinents may rege a firearms exporter to bin a iense prior. expan. Warning: Any peron who es Pots fearm without proper authorwaton maybe fined mot mors tan 100,000 andor impesoned fr not more than 20 years, See 22 US.C. 277M) Section 4 The ransive buyer must personaly complete Seton Af this frm and erty (stg tha the ansvers ae us ore and comple Howeser ithe transite buyer sunblew rea andlor writs, the answers th hn the sir mplted by another perso, ensuing the transferor sli. Two persons than he ransfro seer) asthe sgh a8 witness tothe ers and signature eration is question 4 DOu-01-00000381 wren ASE 223-97, O08, MN, ROGUMMENE dale 3S pnorsip other sich buses nf, am otRcer auorized wc. el ff the busines must complete Section Aof the form with hisher personal {nferaton, sgn Section A, and attach a writen statement, evcued under umalics perjury stating: (A) heme eine acqui forthe use of nd ‘Sie the proper ofthat misinss ety and (B) the rame and adres of at bins enti. ‘Question 1. IF the transfers Payers name in question 1 eget ans forcrsellr mus pint the tansferee'vhuyer's mae above the are wit by the maaseretayer Question 2. Current Residence Address! rua route (RR) maybe accepted provided he tansferee foyer ives ina State or locality wher itis considered 2 {teal residence ads, County and Parish ate one ad the same. Ifthe transferee is a member of the Armed Fores on active dy ser Sat of ressonce the Sten which hier permanent duty station hated, Tuk scsi nmr cing «firearm i tate whore hier pvmanont thy tations located, but eis in diferent Si, the wansfreebuver must {ist bth hivher permanent ty station adress and hier residence addres in response to aussion 2. Ifthe tansfretbayer has two States of resides, the Tfansrcebayer should ist hither erent residence adress m respons 10 (enn 2 ee, ifthe ranferccbayr x purchasing a. frearm while saving rhs horwecket home i tae Xe should isthe addres in Sae-X reponse mo question? ‘Question 9, Unique Personal Idemication Number (UPIN}: For transferees Fhiers approved to ave inforoton aimained about them inthe FBENICS ‘olumay Apes! Fil, NICS wil provide them witha UPIN, which te trans Teretnayer soul recordin question 9, The Hcense shoul! provide the UPIN tno condocting Background checks trough the NICS or the tate POC. ‘Question 10a, and 10, Fedral rgultions (27 CPR 478.2461) require ‘exmes to obtain the race ofthe ansfercetbuyet. This information bes the Fi anor Sis POW snk orl out peal atch Sing the backround ‘heck process and can sis with esmial vestigations. Pasian to Mee oF ‘Management and ise (OMB), festive lapuary 1.2003, al Fedral agencies requiring eoleton of race and ehneity information on adminsraive forms {al ocatds, were roqured to colette sformadon to standard frm. Soe G2FRSQ7RD) The standard OMB format consis of to categories for data on ‘ticity “Hispanic ot Latino,” and "Not Hispanic or Latino” and ive categories fordat on rae: American Undian of Alaska Native. Asian Black o Afian ‘Arercan, Native Hawaiian or Other Paci Ishnder, and Whi. ticity refers toa parson’ heritage. Persons of Cuban, Mexican, Past Rican, South or Cental Ameriin or oher Spanish eulture ec origi, egardlss “face, ar considered Hisar Latino, axe- vn or mere ofthe lowing rapes uct erecta (1) Amin Indio or Aska Nauve=Aperaom having origins in any ofthe vigil popes ‘of North and South America (eluding Cental Ameria), and who maintains a trial afiiton or community atachment (2) Asian A person having ris Iany ofthe erga pops ofthe Far Ean, Southeast Asia, or the Indian ‘Subcontinent including, fr example, Cambodia, China, li, Japan, Kore, ‘Malay Pakistan. the Philippe Island, Thala, and Viet (3) Black ot [fia (4) Native Howaian or Other Pace Islands = person having gins in any of he eriginal peoples of Hawai, Guam, Samoa of other Pcie Islands; tnd) White" A person having eens in any ofthe orginal peoples of Europe, the Middle Fast or Nort Aca, Any othr race or etic that does ta tvithin those india, lene selet the closest representation, ‘Question 1.2, Actual TeausfereeBuyers For purpoacs ofthis form. person ‘the atl tansfercebayer if he he fe purebasing the fear fr hiherslf tw othervise seguir the rear for imheret fg medeeming the ear Jrom pan reviving frm consent: firearm rai wianer). A peso tbo the aca transferee yer he she legitimately purchasing he ier 8 ‘shona fie gift fora thir pay git snot Bonafide another person offered Srgine the person completing ths or tana, Serves), or ites of vale to str th ca oe nee, or he ter person pro yaw De reves ing or possessing the fear, ACTUAL TRANGFFRFRIRI'VER EXAMPLES: Me Soh aks Mé Jones To purchase fran fx Mr Smith io may or may mat be prohibited). Mr Smith gives Me Jones the money forthe firearm. Me Jones is NOT THE Page 4 of 6 Filed P5(2AR RAR HA T:PAgElD #2574 -no” io Musson Ia Thelcsnove ay not wuneer he feat t he Tones. Homer {Ye Brown bas the fear with hs ow mney Wo give to Me. Black asa git ‘nth no servic or tangible hing of alu provided by Me Block. Me. row is he ‘actual rnsere ber ofthe firearm and shoul anner "YES" to question 1. However the wansfersller may no tasfra firearm 1 any person Bese ROWS ‘has resonable caus to belive profited under 18 U.S.C. 9224p), (0) 0 EXCEPTION: if person picking up a epurdfreara(s) for another person ete is aot equal io answer Ia and ay posta to gestion 1. Question 1b, - 12. Gencrally, 18 U.S.C 922() pros the shine. transport thon, repent or possession nor aecting interstate commerss of fear by one teh: has ben convicted ofa elony in any Federal, State o alco, o any ‘ater erie, punishable by imprisonment fora erm excesding one yea (hi des tot include State misdemeanors punishable by imprisonment of te years or fs). Tha fgitive fom justices an uuu wer of, acted to mariana oy ‘epresan tina, nasi das of any eer contol substance hs Deen djuicated es a ental defective or has ben commited oa meta isttation: has aes diaharged rm the Anned Pores isc ichonrahe tome: soc 00 ‘eran restraining orders: consid ofa misdemeanor crime of domestic violence ‘under Federal, State or Tribal lw; as renounced hisher US. ities: a alien italy inthe United States or an alien admited othe United Stats under a noni Imigrant vist Further, sion 922) prohibits the shipment, tansporaton, feceipt nor ffecng interstate commerce of fiearm by ane wh wie dist ‘ment or information for felony in any Fedral, State o lea eur or any er hes jai Uy upeoowment fo arm exceedn 2 formal ceusaton ofa erie vere by a prose Amenber ofthe Armed Forces mist answer "yes" to 1. HL ifcanged with offers that was citer refered oa General Cout Maria ra wish he mm ‘bec was caticted. Discharged “under dishonorable condiiuns” meats separation fiom the Armed Free eshing fom a dishonorable discharge or dismissal a jdzed by General Court-Martial. Tha term does not ince anyother discharge ‘oe spartion fom the Armed Forces, LEXCERHION: A person wh ser ei Flo any ees ei, fo ‘mish th judge could ave imprisoned the person for mre than one year. cf Who Tas been consisted ofa misdomennor rime of does wolenes oot poked Tom puchoving meshing oF posing ear if (I) under the aw ofthe juris

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