Form ATF F 1370.4 ATF F 1370.4 ATF Distribution Center Survey

OMB No. 1140-0001 (08/31/2006)

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

ATF Distribution Center Survey

Paperwork Reduction Act Notice. This request is in accordance with the Paperwork Reduction Act of 1995, your response is voluntary.
The estimated average burden associated with this collection of information is 1 minute per respondent. Comments concerning the
accuracy of this burden estimate and suggestions for reducing this burden should be addressed to Reports Management Officer,
Document Services Branch, 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.
Was the order correct and complete?
Invoice Number
Date of Shipment
For Freight Shipments Only

Yes

No

Condition of Shipment When Received
Good

Damaged But Useable

Damaged and Unuseable
Name and Address of Your Organization

How would you rate the Overall Performance of the ATF Distribution
Center compared to other agencies?
Excellent

Good

Fair

Poor

Date Shipment Received

Additional Comments (If any)

ATF Form 1370.4
Revised October 2003