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pdfOMB No. 1140-0039 (07/31/2012)
U.S. Department of Justice
Bureau of Alcohol, Tobacco, Firearms and Explosives
Federal Firearms Licensee Firearms
Inventory Theft/Loss Report
All entries must be in ink. Please read notices and instructions on reverse carefully before completing this form.
Section A - Federal Firearms Licensee Information
Federal Firearms License Number
Federal Firearms Licensee Telephone Number (Include area code)
Trade/Corporate Name
Street Address of Federal Firearms Licensee
City
State
Zip Code
Telephone Number (with area code)
City
State
Zip Code
Telephone Number (with area code)
Full Name of Person Making Report
Street Address of Person Making Report
Section B - Theft/Loss Information
Time
Date
Description of Incident
Date of Theft/Loss Discovered
Police Notification
Burglary
Robbery
Larceny
Missing Inventory
ATF Issued Incident Number
ATF Notification
Name of Local Authority to Whom Reported (For burglary, larceny or robbery, include the police report number and officer/ detective name).
Street Address of Local Authority
City
State
Theft Location if Different from FFL Premises
Zip Code
City
State
Zip Code
Name and Telephone Number of the ATF Representative Notified (If this report is the result of an ATF compliance inspection, provide the name
and telephone number of the ATF Inspector.)
Brief Description of Incident (e.g., How firearms were stolen, etc.):
Section C - Description of Firearms
Acquisition
Type
Date
Manufacturer
Model
Caliber/
Gauge
Serial Number
Certification
I hereby certify that the information contained in this report is true and correct. I also understand that failure to report the theft or loss
of a firearm from my inventory or collection within 48 hours of the discovery of the theft/loss is a violation of 18 U.S.C. § 923(g)(6) punishable as a felony.
Signature of Licensee
Date
ATF Form 3310.11
Revised September 2009
Important Notice
Section 923 (g), Title 18 U.S.C., requires each Federal Firearms Licensee (FFL) to report the theft/loss of a firearm from the licensee's inventory or
from the collection of a licensed collector, within 48 hours of discovery to the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) by
calling 1-888-930-9275 and to local law enforcement authorities.
FFLs who report a firearm as missing and later discover its whereabouts should advise ATF that the firearms have been located. Licensees reporting
theft/loss of firearms registered under the National Firearms Act must provide written notification to the National Firearms Act Branch, pursuant to
27 C.F.R. § 179.141.
This form should not be used by common carriers for reporting the theft/loss of firearms. Thefts/losses from interstate shipments must continue to be
reported on ATF Form 3310.6, Interstate Firearms Shipment Report of Theft/Loss.
Instructions To Federal Firearms Licensees
1.
FFLs must report the theft/loss of firearms to the ATF Stolen Firearms Program Manager within 48 hours of discovery (toll free 888-930-9275).
2.
This form is to be used to provide written notification of firearms thefts/losses in addition to reporting firearms thefts/losses by telephone
to the ATF Stolen Firearms Program Manager. Document in Section B the date that you reported the information by telephone. If the call
is after normal business hours, you will be directed to call the ATF Hotline where a representative will contact the ATF Field Office in your
area. During normal business hours, or on the following business day, the Stolen Firearms Program Manager will provide you with an ATF
Incident Number to record in this report. You will then be directed to forward a copy of this report to the address set forth in item 5 below.
3.
A separate form is required for each theft/loss report. This form must be prepared in ink, signed, and dated. Please use ATF Form 3310.11A,
Federal Firearms Licensee Theft/Loss Report Continuation Sheet, when the number of lost/stolen firearms exceeds the space allowed in Section C.
4.
The description of the lost or stolen firearms provided in Section B of this form should be identical to the information contained in the Record
of Acquisition and Disposition required by 27 CFR Part 178 Subpart H.
5.
Upon completion, the original must be forwarded to the following address:
Bureau of Alcohol, Tobacco, Firearms and Explosives
National Tracing Center
Attn: Firearms Interstate Theft Program Manager
244 Needy Road
Martinsburg, WV 25405
6.
Copy 1 should be removed and retained as part of the licensee's permanent records.
7.
FFLs must reflect the theft/loss as a disposition entry in the Record of Acquisition and Disposition required by 27 CFR Part 178, Subpart H.
The disposition entry should indicate whether the incident is a theft or loss, the ATF Issued Incident Number, and the Incident Number
provided by the local law enforcement agency.
8.
Should any of the firearms be located, they should be re-entered into the Record of Acquisition and Disposition as an acquisition entry.
9.
Additional forms may be obtained through the ATF Distribution Center, 1519 Cabin Branch Drive, Landover, Maryland 20785, (301) 583-4696.
Paperwork Reduction Act Notice
The information required on this form is in accordance with the Paperwork Reduction Act of 1995. The purpose of this information is to provide
notification to ATF of the theft or loss of firearms from the inventory of a Federal firearms licensee and from the collection of a licensed collector.
The information is subject to inspection by ATF offices. The information on this form is required by 18 U.S.C. 923(g)(6).
The estimate average burden associated with this collection is 24 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 3310.11
Revised September 2009
File Type | application/pdf |
File Title | F331011(Rev) |
Subject | F331011(Rev) |
Author | namiller |
File Modified | 2012-06-28 |
File Created | 2010-05-06 |