Form ATF F 5630.5R ATF F 5630.5R 2011 NFA Special Tax Renewal Registration and Return

OMB No. 1140-0090 (xx/xx/xxxx)

U.S. Department of Justice
Bureau of Alcohol, Tobacco, Firearms and Explosives

1. Employer Identification Number

2011 NFA Special Tax Renewal Registration
and Return (Tax Period: 7/1/2010 - 6/30/2011)

Section I - Taxpayer Identifying Information
2. Ownership Information (Check one box only)
Business Telephone
Individual Owner
Partnership
Other (Specify)

Corporation
3. Eligibility for Reduced Rates

Yes, the taxpayer is an NFA Importer or
Manufacturer (with gross receipts less than
$500,000 for most recent income tax year.)
4. Federal Firearms License Number (FFL)

5. Name (Last, First, Middle)

or

7. Mailing Address

Section II - Corrections to Preprinted Taxpayer Identifying Information
(Complete ONLY if needed and ONLY for the items requiring change)
Corporate Name (If corporation)
6. Trade Name
8. City, State, Zip Code

10. Employer Identification Number

9. Date of Change (mm/dd/yyyy)

11. Business Telephone Number
(
)
Section III - Change in Ownership Status
(Check and complete as applicable)

12.

The person identified above no longer owns the business or is no longer engaged in the operations covered by this special tax renewal return.
(Please complete Section V below.) Date Business Discontinued:
(mm/dd/yyyy).

13.

I am the new owner of the business identified at the location above. I commenced new business operations on
Please complete Sections II and V on this form and correct the enclosed location registration listing.

(mm/dd/yyyy).

Section IV - Tax Computations
(Check and complete as applicable)

14.
(a)
Tax Class

(b)
Tax
Code

(c)
Number of
Locations

(d)
Tax Rate
($)

(e)
Tax Due
($)

$

$

$

$

$

$

$

$

$

$

You Must Pay Your Special Tax For This Tax Period By July 1, 2010

15. Total Tax Due
$

Make check or money order payable for the full amount owed to the "Bureau of Alcohol, Tobacco, Firearms and Explosives." Write your Employer
Identification Number on the check and send it with the return to Bureau of ATF, NFA-SOT, P.O. Box 403269, Atlanta, GA 30384-3269.
Section V - Taxpayer Certification
Under penalties of perjury, I declare that the statements in this return/registration are true and correct to the best of my knowledge and belief; that this
return/registration applies only to the specified business operations at the location specified or, where the return/registration is for more than one location,
to the business operations at the locations specified on the attached list. Note: Violation of Title 26, United States Code 7206 with respect to a declaration
under penalty of perjury, is punishable upon conviction by a fine of not more than $100,000 ($500,000 in the case of a corporation) or imprisonment for not
more than 3 years, or both, with the costs of prosecution added thereto.
16. Signature
17. Title
18. Date
ATF Form 5630.5R
Revised March 2010

Instruction Sheet
ATF Form 5630.5R, Special Tax Renewal Registration and Return
General Instructions

Specific Instructions for Special Tax Renewal
Registration and Return

This is your renewal form for Tax Year 2011 (July 1, 2010 - June 30, 2011).
Please read and follow these instructions carefully.

Section I -

Special tax for Tax Year 2011 is due and payable by July 1, 2010. If you are
liable for special tax and do not pay on a timely basis, interest will be charged
and penalties for failure to file and failure to pay may be incurred.

Item 1 - If any taxpayer identifying information in this block is incorrect,
enter ONLY the corrected information in the appropriate blocks in
Section II.

You will be issued a Special Tax Stamp, ATF Form 5630.6A as evidence of
tax payment for each location and/or business. Your cancelled check may
also be used as evidence of tax payment. You should receive your special tax
stamp eight to ten weeks after payment check/money order clears the bank
(provided that your return is properly executed). Missing, incomplete or
incorrect data may delay processing of your return and issuance of your
special tax stamp.

Your return must contain a valid Employer Identification Number (EIN).
A missing or incorrect EIN will delay return processing and the issuance
of your special tax stamp. The EIN is a unique number for business
entities issued by the Internal Revenue Service (IRS). You must have an
EIN whether you are an individual ownership, partnership, corporation
or agency of the government. If you do not have an EIN, contact your
local IRS office immediately to obtain one. While ATF may assign a
temporary identification number (beginning with XX) to allow individual
processing of a return which lacks an EIN, a tax stamp will not be issued
until you have submitted a valid EIN. If your return has an XX number
of an incorrect EIN in Item 1, be sure to enter the correct EIN in Item 11.
Do not delay submission of your return and payment pending receipt of
your EIN. Submit your EIN by separate correspondence after receipt
from the IRS.

Please verify the preprinted information on the registration and return form
and location registration form(s). If the preprinted information is completed
and correct (or after corrections are made as indicated below):
 Complete the taxpayer certification (Section V). Each registration and
return must have an original signature.
 Make your check or money order payable to the Bureau of Alcohol,
Tobacco, Firearms and Explosives (ATF). Be sure to include your
Employer Identification Number (EIN) on your remittance.
 Mail your return, location registration form(s), and payment to ATF at
the address noted immediately above Section V on the return. For
your convenience a pre-addressed return envelope is enclosed.
If you had a change in ownership or responsibility, attach a separate sheet
showing the change. A change in ownership includes not only a complete
change in business ownership, but also includes a change in partners or any
change involving any person owning 10 percent or more of the outstanding
stock in the business. A change in responsibility refers to any person with the
power to control the management policies or buying or selling practices
pertaining to firearms.
If you are an NFA firearms importer, manufacturer, or dealer and do not
intend to pay special tax for the next year, you must dispose of any
machineguns manufactured or imported after May 19, 1986, prior to your
special tax status lapsing. Questions concerning the status of NFA firearms
manufactured or imported prior to May 19, 1986, should be directed to the
National Firearms Act Branch at 304-616-4500 or to ATF, 244 Needy Road,
Suite 1250, Martinsburg, WV 25405. If you are an NFA proprietor, your
EIN is also your ATF identification number and must be used on all of your
registration and transfer forms in the conduct of your business.
National Firearms Act Tax Class Reference Chart
Tax Class

Tax Rate

Tax Code

Class 1 - Importer of Firearms

$1,000

61

Class 1 - Importer of Firearms Reduced

$500

71*

Class 2 - Manufacturer of Firearms

$1,000

62

Class 2 - Manufacturer of Firearms Reduced

$500

72*

Class 3 - Dealer of Firearms

$500

63

* See Item 3.

Taxpayer Identifying Information.

Item 2 - Check only one box to describe the type of ownership of the
business identified in Item1.
Item 3 - Check "Yes" only if you are a National Firearms Act manufacturer or importer and your gross receipts are less than $500,000 per year
for your entire business entity. You must declare your eligibility each
year. The regular rates were used to compute the amount shown on this
form.
Item 4 - Please provide your Federal Firearms License Number for the
address in Item 1.
Section II. Corrections to Preprinted Taxpayer Identifying Information.
Correct only those items requiring change.
Section III. Change in Ownership Status.
Item 12 - If you have discontinued business operations, check item 11,
enter the date discontinued in the space provided, and complete Section V.
Item 13 - If you are the new owner of the business, check Item 12 and
complete Sections II and V. Also, correct any errors on the return and
location registration listing(s).
Section IV. Tax Computations. If the preprinted information in Section
IV is incorrect, line through the incorrect items and write in the correct
data alongside. See the Tax Class Reference Chart on this page for the
correct tax class and tax rate.
Item 14(e) - The tax due is computed by multiplying the number of
locations (Item 13(c)) by the tax rate (Item 13(d)). Add additional tax
classes (if necessary) in the vacant spaces provided or attach additional
sheets.
Item 15 - The total tax due is computed by adding the figures in Item 14.
Items 16, 17, and 18 - Complete as indicated.

Paperwork Reduction Act
This information is used to ensure compliance by taxpayers with P.L. 100-203, Revenue Act of 1987, P.L. 100-647, Technical Corrections Act of 1988,
and the Internal Revenue laws of the United States. ATF uses the information to determine and collect the right amount of tax.
The estimated average burden associated with this collection is 15 minutes per respondent or recordkeeper, depending on individual circumstances.
Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be directed to Reports Management Officer,
Document Services, 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 5630.5R
Revised March 2010