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Firearm Registration Refusal Form
Business Name
*
Business Address
*
Contact Number
*
Email Address
invalid email address
*
Federal Firearm Lic. #
*
Rejected Buyer Name
*
Date of Birth
December 2025
December 2025
S
M
T
W
T
F
S
49
30
1
2
3
4
5
6
50
7
8
9
10
11
12
13
51
14
15
16
17
18
19
20
52
21
22
23
24
25
26
27
53
28
29
30
31
1
2
3
2
4
5
6
7
8
9
10
*
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
*