{1}
##LOC[OK]##
{1}
##LOC[OK]##
##LOC[Cancel]##
{1}
##LOC[OK]##
##LOC[Cancel]##
Firearm Registration Refusal Form
Business Name
Business Address
Contact Number
Email Address
Federal Firearm Lic. #
Rejected Buyer Name
Date of Birth
December, 2018
December, 2018
S
M
T
W
T
F
S
48
25
26
27
28
29
30
1
49
2
3
4
5
6
7
8
50
9
10
11
12
13
14
15
51
16
17
18
19
20
21
22
52
23
24
25
26
27
28
29
53
30
31
1
2
3
4
5
Race
Please select
Asian
Black
Hispanic
Middle Easterner/Arabic
Native American
Other
Pacific Islander
Unknown
White
Sex
Please select
Male
Female
Driver's Lic. #
Address
Make of Firearm
Model of Firearm
Caliber of Firearm
Submitting Employee