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pdfOMB No. 1140-0014 (10/31/2007)
U.S. Department of Justice
Bureau of Alcohol, Tobacco, Firearms and Explosives
Application for Tax Paid Transfer and
Registration of Firearm
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
2a. Transferee's Name and Address (Including tradename, if any) (See instruction 2)
1.
Type of Transfer (Check one)
$5
2b. County
$200
Submit with your application a check
or money order for the appropriate
3a. Transferor's Name and Address (Including trade name, if any) (Executors: see instruction 2k)
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
3b. Transferor’s Telephone Number and
"National Firearms Act" stamp for
Area Code
you. (See instructions 2h, 2i and 3.)
3d. Number, Street, City, State and Zip
Code of Residence (or Firearms
3c. If Applicable: Decedent's Name, Address, and Date of Death
Business Premises) if Different
from Item 3a.
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.
d. Model
4. Description of Firearm (Complete items a through h)
c. Caliber,
a. Name and Address of Manufacturer and/or Importer b. Type of Firearm
(See instruction 1c)
Gauge
of Firearm
Length
e. Of Barrel:
f. Overall:
or Size
(Inches)
(Specify)
g.
h.
Additional Description or Data Appearing on Firearm
5. Transferee's Federal Firearms License (If any)
(Give complete 15-digit number) (See instruction 2b)
First 6 digits
2 digits
2 digits
7. Transferor's Federal Firearms License (If any)
(Give complete 15-digit number) (See instruction 2b)
2 digits
2 digits
First 6 digits
Serial Number
(Attach additional sheet if necessary)
6. Transferee's Special (Occupational) Tax Status
a. Employer Identification Number b. Class
(If any)
8.
a.
(If any)
5 digits
Transferor's Special (Occupational) Tax Status
Employer Identification Number b. Class
5 digits
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.
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.
10. Signature of Transferor (or authorized official)
11. Name and Title of Authorized Official
12. Date
(Print or type)
The Space Below is for the use of the Bureau of Alcohol, Tobacco, Firearms and Explosives
Stamp Denomination
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:
Approved (with the following conditions, if any)
Signature of Authorized ATF Official
Disapproved (For the following reasons)
Date
ATF Form 4 (5320.4)
Revised November 2004
Transferee Information
The following questions must be answered by any transferee who is not a Federal firearms licensee or government agency. The transferee shall give full
details on a separate sheet for all “YES” answers. (See instruction 2d)
13. Are You:
Yes
No 14. Have You:
Yes No
a. Been convicted in any court of a crime for which the
a. Charged by information or under indictment in any court for
judge could have imprisoned you for more than one
a crime punishable by imprisonment for a term exceeding
year, even if the judge actually gave you a shorter
one year?
sentence?
b. A fugitive from justice?
b. Been discharged from the armed forces under dishonorable
c. An alien who is illegally or unlawfully in the United States?
conditions?
d. Under 21 years of age?
c. Been adjudicated mentally defective or been committed
e. An unlawful user of or addicted to, marijuana, or any depresto a mental institution?
sant, stimulant, or narcotic drug, or any other controlled subd.
Renounced
your United States citizenship?
stance?
e.
Been
convicted
in any court of a misdemeanor crime of
f. Subject to a court order restraining you from harassing,
domestic violence? This includes any misdemeanor conviction
stalking or threatening an intimate partner or child of such
involving the use or attempted use of physical force committed
partner?
by a current or former spouse, parent, or guardian of the victim,
or by a person with a similar relationship with the victim.
15. Transferee’s Certification
16.
(See instruction 2e)
I,
Photograph
, have a reasonable necessity to
(Name of Transferee)
possess the machinegun, short-barreled rifle, short-barreled shotgun, or destructive device described on this
application for the following reason(s)
and my possession of the device or weapon would be consistent with public safety (18 U.S.C. 922(b) (4) and 27
CFR 478.98).
Affix
Recent Photograph Here
(Approximately 2" x 2")
(See instruction 2f.)
UNDER PENALTIES OF PERJURY, I declare that I have examined this application and the documents submitted in
support thereof, and to the best of my knowledge and belief it is true, correct and complete.
(Signature of Transferee)
(Date)
17. Law Enforcement Certification (See instruction 2e)
I certify that I am the chief law enforcement officer of the organization named below having jurisdiction in the area of residence of
. I have no information indicating that the transferee will use the firearm or device
(Name of Transferee)
described on this application for other than lawful purposes. I have no information that the receipt or possession of the firearm or device described in item 4
would be place the transferee in violation of State or local law.
(Signature and Title of Chief Law Enforcement Officer)
(Date)
(Organization and Street Address)
(County)
(Telephone Number)
Important Information for Currently Registered Firearms
If this registration document evidences the current registration of the firearm described on it, please note the following information.
Estate Procedures: For procedures regarding the transfer of firearms in an estate resulting from the death of the registrant identified in item 2a, the
executor should contact the NFA Branch, Bureau of Alcohol, Tobacco, Firearms and Explosives, 244 Needy Road, Martinsburg, WV 25405.
Change of Address: Unless currently licensed under the Gun Control Act, the registrant shall notify the NFA Branch, Bureau of Alcohol, Tobacco, Firearms
and Explosives,244 Needy Road, Martinsburg, WV 25405, in writing, of any change to the address in Item 2a.
Change of Description: The registrant shall notify the NFA Branch, Bureau of Alcohol, Tobacco, Firearms and Explosives, 244 Needy Road, Martinsburg,
WV 25405, in writing, of any change to the description of the firearm in Item 4.
Interstate Movement: If the firearm identified in item 4 is a machinegun, short-barreled rifle, short-barreled shotgun, or destructive device, the registrant
may be required by 18 U.S.C. § 922(a)(4) to obtain permission from ATF prior to any transportation in interstate or foreign commerce.
Restrictions on Possession: Any restriction (see approval block on face of form) on the possession of the firearm identified in item 4 continues with the
further transfer of the firearm.
Persons Prohibited from Possessing Firearms: If the registrant becomes prohibited by 18 U.S.C. § 922 from possessing a firearm, the registrant shall
notify the NFA Branch, Bureau of Alcohol, Tobacco, Firearms and Explosives, 244 Needy Road, Martinsburg, WV 25405, in writing, immediately upon
becoming prohibited for guidance on the disposal of the firearm.
Proof of Registration: This approved application is the registrant’s proof of registration and it shall be made available to any ATF officer upon request.
ATF Form 4 (5320.4)
Revised November 2004
Instructions
1.
d. Transferee Certification. Item 15 must be completed by the transferee if:
Definitions
(1) the firearm to be transferred is a machinegun, short-barreled
rifle, short-barreled shotgun, or destructive device;
(2) the transferor is licensed under the GCA to deal in such device or
firearm; and
(3) the transferee is not licensed under the GCA to deal in such device or
firearm.
a. National Firearms Act (NFA). Title 26, United States Code, Chapter
53. The implementing regulations are found in Title 27, Code of Federal
Regulations, Part 479.
b. Gun Control Act (GCA). Title 18, United States Code, Chapter 44. The
implementing regulations are found in Title 27, Code of Federal Regulations,
Part 478.
e. Law Enforcement Certification. Item 17 must be completed for an
individual transferee, unless the transferee is licensed as a manufacturer,
importer, or dealer under the GCA and is a special (occupational) taxpayer
under the NFA at the time of the submission of the application for transfer.
The chief law enforcement officer is considered to be the Chief of Police for
the transferee's city or town of residence; the Sheriff for the transferee's
county of residence; the Head of the State Police for the transferee's State
of residence; a State or local district attorney or prosecutor having
jurisdiction inthe transferee's area of residence; or another person whose
certification is acceptable to the Director, Bureau of Alcohol, Tobacco,
Firearms and Explosives. If someone has specific delegated authority to sign
on behalf of the Chief of Police, Sheriff, etc., this fact must be noted by
printing the Chief's, Sheriff's, or other authorized official's name and title,
followed by the word "by" and the full signature and title of the delegated
person. The certificate must be dated no more than one year prior to the
date of receipt of the application.
c. Firearm. The term “firearm” means: (1) a shotgun having a barrel or
barrels of less than 18 inches in length; (2) a weapon made from a shotgun if
such weapon as modified has an overall length of less than 26 inches or a
barrel or barrels of less than 18 inches in length; (3) a rifle having a barrel or
barrels of less than 16 inches in length; (4) a weapon made from a rifle if
such weapon as modified has an overall length of less than 26 inches or a
barrel or barrels of less than 16 inches in length; (5) any other weapon as
defined in 18 U.S.C. § 5845(e); (6) a machinegun; (7) a muffler or silencer
for any firearm whether or not such firearm is included within this definition;
and (8) a destructive device.
d. Person. The term “person” means a partnership, company, association,
trust, estate, or corporation, as well as a natural person.
e. Employer Identification Number (EIN). Required of taxpayer filing
special (occupational) tax returns under 27 CFR § 479.35.
f. Photographs and Fingerprints. An individual transferee, except if
licensed as a manufacturer, importer, or dealer under the GCA, must (1) attach
to Item 16, a 2 inch x 2 inch photograph of the frontal view of the transferee
taken within 1 year prior to the date of the application and (2) attach two
properly completed FBI Forms FD-258 (Fingerprint Card with blue lines) to
the application. The fingerprints must be clear for accurate classification and
taken by someone properly equipped to take them.
f. SPECIAL (OCCUPATIONAL) TAX. Required by the NFA to be paid by a
Federal firearms licensee engaged in the business of manufacturing (Class 2),
importing (Class 1), or dealing (Class 3) in NFA firearms.
g. Federal Firearms License. A license issued under the provisions of
the GCA to manufacture, import or deal in firearms.
h. ATF Officer. An officer or employee of the Bureau of Alcohol, Tobacco,
Firearms and Explosives (ATF) authorized to perform any function relating
to the administration of the NFA.
g. Signatures. All signatures required on ATF Form 4 must be original in ink
on both copies.
h. Remittance. A check or money order, made payable to the Bureau of
Alcohol, Tobacco, Firearms and Explosives, in the amount for the
appropriate rate of tax (see instruction 2i) must be submitted with the ATF
Form 4. Do not send cash.
i. Transfer. Selling, assigning, pledging, leasing, loaning, giving away, or
otherwise disposing of a firearm.
j. Transferor. The registered owner of a firearm who is applying to transfer
it.
i. Rate of Tax. The tax on the transfer of any NFA firearm is $200.00, except
that the tax is $5.00 on the transfer of a firearm classified as “any other weapon.”
k. Transferee. The person acquiring the firearm.
j. Photocopies, Computer Generated Versions, or Downloaded Version from
ATF Website. The ATF Form 4 may be photocopied, computer-generated (as
long as it is in the same format and contains all required information), or
downloaded from the ATF website (www.atf.gov). Please note the instructions
on the website.
l. Misdemeanor Crime of Domestic Violence. A crime that is a misdemeanor
under Federal or State law and has, as an element, the use or attempted use of
physical force, or the threatened use of a deadly weapon, committed by a
current or former spouse, parent, or guardian of the victim, by a person with
whom the victim shares a child in common, by a person who is cohabiting
with or has cohabited with the victim as a spouse, parent, or guardian. The
term includes all misdemeanors that involve the use or attempted use of
physical force (e.g., simple assault, assault and battery), if the offense is
committed by one of the defined parties. The person is NOT considered to
have been convicted of such crime unless the person was represented by a
lawyer or gave up the right to a lawyer, and, if the person was entitled to a
jury trial, was tried by a jury or gave up the right to a jury trial.
2.
k. Estates. If the firearm is being transferred from an estate, item 3a shall
reflect: the executor’s name, title (executor (or executrix, administrator,
administratrix) of the estate of (name)), and the executor’s address. Item 3c
shall reflect the address of the decedent and the date of death. (see the
ATFInternet website at www.atf.gov for additional information about
transfers from estates.)
l. Submission. All requested informtion must be entered in blue or black ink
and must be legible. Send both copies of the ATF Form 4 and attachments to
the address located in the upper right hand corner on the face side of the
ATF Form 4. The return of the application or sending it to any other address
will only delay the processing.
Preparation of Application
a. Authority. As provided by 26 U.S.C. §§ 5811 and 5812, any person
seeking to transfer a firearm tax paid must complete, in duplicate, an
application on this form for each firearm. The transferor must furnish all the
information called for on this application form.
b. Federal Firearms Licensees. If the transferor or transferee is licensed
under the GCA, the name, trade name (if any), and address shall be identified
on the ATF Form 4 as they appear on the license. If item 6 is completed, the
entity identified must be the same as the entity identified in item 5. For example,
if item 5 identified a sole proprietor, item 6 cannot identify a corporation.
This also applies for the completion of items 7 and 8.
c. Transferee Qualifications. If the transferee is an individual and not licensed
under the GCA, the questions in items 13 and 14 must be answered.
m. State or Local Permit. If a State or local permit or license is required
for the transferee prior to acquisition of the firearm, a copy of the permit
must be included with the application.
3.
Approval of Application. Upon approval of an application, the NFA Branch
will affix the appropriate NFA transfer tax stamp, cancel it, and return the
approved copy with the stamp affixed to the transferor for delivery with the
firearm to the transferee. Since the approval of the application effectuates
registration of the firearm to the transferee, the physical transfer of the firearm
must be completed immediately; however, the transferor must not transfer the
ATF Form 4 (5320.4)
Revised November 2004
firearm until the application has been approved and received. If the physical
transfer of the firearm cannot be completed immediately, the transferor must
contact the NFA Branch with the specifics.
4.
Withdrawal of Application. The transferor may withdraw an application prior
to approval subsequent to a written request. The NFA Branch will arrangefor a
refund of the taxpaid.
5.
Cancellation of Approved Application. The transferor may cancel an approved
application only if the physical transfer of the firearm has not been completed.
The transferor must return the approved application with the tax stamp affixed
with a written request for cancellation, citing the need and that the physical
transfer of the firearm did not take place. The NFA Branch will arrange for a
refund of the tax paid.
6.
Disapproval of Application. If the application is disapproved, the NFA Branch
will note the reason for disapproval on the application and return one copy of
the ATF Form 4 to the transferor. The NFA Branch will arrange for a refund of
the tax paid.
7.
Reasons for Disapproval. 26 U.S.C. § 5812 provides that applications shall be
denied if the transfer, receipt, or possession of the firearm would place the
transferee in violation of law.
a. State or Local Law. If State or local law prohibits the receipt or possession
of the firearm being transferred, the application will be disapproved.
b. Persons Prohibited from Receiving a Firearm. The application will be
disapproved if the transferee is a person prohibited from receiving a firearm
by 18 U.S.C. § 922(g), which provides that it shall be unlawful for any
person—
(8) who is subject to a court order that—
(A) was issued after a hearing of which such person received actual
notice, and at which such person had an opportunity to participate;
(B) restrains such person from harassing, stalking, or threatening an
intimate partner of such person or child of such intimate partner or
person, or engaging in other conduct that would place an intimate
partner in reasonable fear of bodily injury to the partner or child; and
(C) (I) includes a finding that such person represents a credible
threat to the physical safety of such intimate partner or child; or
(II) by its terms explicitly prohibits the use, attempted use, or
threatened use of physical force against such intimate partner or
child that would reasonably be expected to cause bodily injury, or
(9) who has been convicted in any court of a crime of domestic violence; to
ship or transport in interstate or foreign commerce, or possess in or affecting commerce, any firearm or ammunition; or to receive any firearm or
ammunition which has been shipped or transported in interstate or
foreign commerce.
8.
Status Inquiries and Questions. Information relating to the NFA and other
firearms laws is available at the ATF Internet website at www.atf.gov. Any
inquiry relating to the status of an application to transfer an NFA firearm or about
procedures in general should be directed to the NFA Branch at (304) 616-4500.
Please be aware that any dissemination by ATF of information relating to the
application to register an NFA firearm must conform with the restrictions in 26
U.S.C. § 6103. The opportunity provided in item 8 to authorize ATF to disclose
information is intended to enable ATF to respond to inquiries by the transferee
regarding the application. The failure to complete item 8 will be considered a
declination of authorization to release the information.
9. Penalties. Any person who violates or fails to comply with any of the require(1) who has been convicted in any court of a crime punishable by
ments of the NFA shall, upon conviction, be fined not more than $10,000 or be
imprisonment for a term exceeding one year;
imprisoned for not more than 10 years, or both. Any firearm involved in a
(2) who is a fugitive from justice;
violation of the NFA shall be subject to seizure and forfeiture. It is unlawful for
(3) who is an unlawful user of or addicted to any controlled substance;
any person to make or cause the making of a false entry on any application or
(4) who has been adjudicated as a mental defective or who has been comrecord required by the NFA knowing such entry to be false.
mitted to a mental institution;
(5) who, being an alien, is illegally or unlawfully in the United States or
10. Compliance with the Gun Control Act. All provisions of the GCA must
except as provided in 18 U.S.C. 922(y)(2), has been admitted to the
also be complied with, including the recordkeeping requirements for licensees
United States under a non-immigrant visa (as that term is defined in
and the retention of ATF Form 4473 (5300.9) by licensees for dispositions to
8 U.S.C. 1101(a)(26)) ;
non-licensees.
(6) who has been discharged from the Armed Forces under dishonorable
conditions;
(7) who, having been a citizen of the United States, has renounced his
citizenship;
Privacy Act Information
The following information is provided pursuant to Section 3 of the Privacy Act of 1974 (5 U.S.C. § 552(e)(3)):
1. Authority. Solicitation of this information is made pursuant to the National Firearms Act (26 U.S.C. § 5812). Disclosure of this information by the applicant is mandatory
for transfer of an NFA firearm, unless the transfer is otherwise exempt from tax.
2. Purpose. To insure payment of the tax imposed by 26 U.S.C. § 5811; to insure that the transfer would not be in violation of law; and to effect registration of the firearm.
3. Routine Uses. The information will be used by ATF to make the determinations set forth in paragraph 2. In addition, to effect registration of the firearm, information as to
the identification of the firearm, date of registration, and the identification and address of person entitled to possess the firearm will be entered into the National Firearms
Registration and Transfer Record. No information obtained from an application, registration, or records required to be submitted by a natural person in order to comply
with any provision of the National Firearms Act or regulations issued thereunder, shall, except in connection with prosecution or other action for furnishing false
information, be used, directly or indirectly, as evidence against that person in any criminal proceeding with respect to a violation of law occurring prior to or concurrently
with the filing of the application. The information from this application may only be disclosed to Federal authorities for purposes of prosecution for violation of the
National Firearms Act.
4. Effects of not Supplying Information Requested. Failure to supply complete information will delay processing and may cause denial of the application.
Paperwork Reduction Act Notice
This information request is in accordance with the Paperwork Reduction Act of 1995. The information your provide is used in applying to transfer serviceable firearms
taxpaid to persons other than special taxpayers qualified to deal in NFA firearms or government entities. Data is used to identify transferor, transferee, and firearm, and to
ensure legality for transfer under Federal, State and local laws. The furnishing of this information is mandatory. (26 U.S.C. § 5812)
The estimated average burden associated with this collection of information is 4 hour(s) per respondent or recordkeeper, depending on individual circumstances. Comments
concerning the accuracy of this burden estimate and suggestions for reducing this burden should be addressed to Reports Management Officer, Document Services Branch,
Bureau of Alcohol, Tobacco, Firearms and Explosives, Washington, DC 20226.
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.
ATF Form 4 (5320.4)
Revised November 2004
File Type | application/pdf |
File Title | F4(53204)8-2001 |
Subject | F4(53204)8-2001 |
Author | rmbutler |
File Modified | 2007-10-15 |
File Created | 2007-02-08 |