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Firearm Registration Refusal Form
Business Name
Business Address
Contact Number
Email Address
Federal Firearm Lic. #
Rejected Buyer Name
Date of Birth
March, 2019
March, 2019
S
M
T
W
T
F
S
9
24
25
26
27
28
1
2
10
3
4
5
6
7
8
9
11
10
11
12
13
14
15
16
12
17
18
19
20
21
22
23
13
24
25
26
27
28
29
30
14
31
1
2
3
4
5
6
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