3310.11A Federal Firearms Licensee (FFL) Firearms Inventory Theft

OMB No. 1140-0039 (xx/xx/xxxx)

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

Type

Manufacturer

Importer

Model

Caliber/Gauge

Serial Number

D

R

AF
T

Acquisition Date

Federal Firearms Licensee Firearms
Inventory Theft/Loss Continuation Sheet

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 3310.11A
Revised (
)